* This 56 year old woman presented to our office after learning that she had breast cancer. She was interested in having breast reconstruction at the time of her mastectomies (immediate breast reconstruction). She made an appointment with our surgeon to discuss her reconstructive options. After a detailed discussion of her options and explanation of the procedures along with their inherant risks, she and her surgeon decided to proceed with tissue expander reconstruction using her latissimus dorsi muscles as padding and softening for the final shape of her breasts. Her 1st stage reconstruction was done at the time of her mastectomies. At this stage tissue expanders were placed, filled and covered with her latissimus muscle. Skin from over the top of her latiss muscle (from her back) was left in place of her nipple and areolas. Six months later her tissue expanders were replaced with her permanent breast implants and new nipple and areolas were reconstructed using the skin from her back. Six months later her reconstructed nipples and areolas were cosmetically tattooed. Included in her photos are views of her in between the various stages of reconstruction. The over all process takes about a year and a half but is worth the time and effort for many women who have dealt with the loss of a breast.