This patient underwent bilateral DIEP flap breast reconstruction. She had previously had a right mastectomy followed by chemotherapy and radiation. After completing her breast cancer treatment, she underwent a left prophylactic skin-sparing mastectomy and bilateral reconstruction with DIEP flaps. Nipple-areolar reconstruction, breast revision (for optimal symmetry) and abdominal contouring were performed as a second stage. Nipple-areolar tattooing was performed as the final stage in the office.