This 45 year old woman came in for a consultation with Dr. leonard a previous diagnosis of right breast cancer treated with mastectomy. She also consulted with her surgical oncologist regarding a left mastectomy. Following the discussions with her doctors, she chose to go forward with a left mastectomy and reconstruction with both breast at the same time. She wanted the most natural breast possible and did not want to use implants. She chose a TRAM flap for her reconstruction, where skin and fattty tissue are taken from the lower abdominal area and transferred up to the breast to recreate a breast mound. She then had nipple reconstruction followed by tattooing. She was extremely please with her reconstruction. Her breast were soft and natural since they were her own abdominal tissue and she also got a flatter stomach.