Decision making for the management of either breast cancer or BRCA gene positively includes methods of reconstruction which are individualized for each patient. Flap surgeries help create a breast fully and immediately. Here we see a young woman (who chose bilateral mastectomy and bilateral latissimus flap with silicone gel implants) shortly after her nipple and areola reconstruction was healed. Pigmentation is pending. Skin sparing mastectomy has allowed for less visible scarring. An outstanding aesthetic outcome.