This patient presented with a need to undergo bilateral mastectomy. She preferred a method to achieve as complete a reconstruction in one step as possible, so a bilateral latissimus flap and implant reconstruction was chosen. Preop joint planning between breast surgeon and myself allowed for the entire mastectomy to be done through only the areola, and through which I was able to do the entire reconstruction using such limited exposure. This photo shows her prior to nipple reconstruction which will hide all evidence of mastectomy. An amazing result.