* This 69 year old woman had a left breast cancer for which she underwent a left mastectomy. The method of breast reconstruction for her was to use the latissimus dorsi muscle from her back along with a tissue expander. She had a lot of laxity in her back skin so a large portion of skin was taken along with the muscle to make up for the breast skin that was lost with her mastectomy. Her right breast was too large and ptotic so a SPAIR breast reduction was done at the same time. Fluid was added to the tissue expander two times to stretch the skin of her left breast. Seven months later the tissue expander was removed and a moderate plus profile smooth round gel breast implant was inserted. Nipple and areola reconstruction and scar revisions completed the surgical portion of her breast reconstruction. Tattooing of her reconstructed nipple and areola was done six months later. She was very pleased with her breast reconstruction and very happy to have symmetry in her breasts.