This is a 49-year-old woman found to have right breast invasive ductal carcinoma and left breast atypical lobular hyperplasia. She underwent bilateral non-nipple sparing mastectomies and tissue expander placement. Three months later she underwent delayed DIEP flaps, removal of tissue expanders and nipple reconstruction. The patient desired more volume and projection, so she underwent a revision surgery with fat grafting and bilateral implants placed behind the living tissue. She completed her reconstruction with nipple-areola tattoos done in the office.
