This is a 49 year old female who is 5 feet 5 inches and weighed 169 pounds at the time of her surgery. She was diagnosed with right and left breast cancer and elected for bilateral skin sparing mastectomies with immediate breast reconstruction using tissue expanders with ADM. A few months later she elected for bilateral removal of tissue expanders, capsulotomies and placement of smooth, round, ultra-high profile silcone gel breast implants. Unfortunately she developed an infection of her implant and elected for removal of left implant. She elected for adjuvant radiation therapy. She then elected for a left latissimus flap with placement of tissue expander. A few months later she then elected for removal of left tissue expander, capsulotomies, placement of smooth, round silicone gel implant with autologous fat grafting. She then elected for bilateral 3D nipple/areola tattooing.