This 53 year old woman left breast ductal cancer (DCIS) prior to coming in for a consultation with Dr. Leonard. Her wish was to not use implants in her reconstruction. Following her mastectomy, a TRAM flap was done for her reconstruction as an implant is not needed and it provides a very natural result. Her final reconstructive surgery was sculpting of the reconstructed breast, nipple reconstruction and a breast lift on the right breast for symmetry. She decided she did not want nipple tattooing. In the end she achieved a very nice reconstruction that was symmetrical with the right side and was soft and natural without the use of an implant.She is very happy with her results.