This 33 year young active woman, 5’4” and 128lb. has 2 children and was diagnosed with left breast cancer and proceeded with modified radical mastectomy and immediate reconstruction using a TRAM Flap followed by chemotherapy treatment. She then had a right breast lift for symmetry followed by a left breast nipple reconstruction and fat grafting about 8 months later. She is seen 5 ½ years post op and may proceed with nipple tattooing to finalize her personal reconstructive goals.