* This 47 year old woman presented to our office to find out her options for reconstruction of her right breast. She had found out that she needed a completion mastectomy after a lumpectomy due to a breast cancer several years ago. There were a few options presented to her and the option she chose was to have the excess tissue and fat from her abdomen as soft tissue fill for the mastectomy defect. She had what is called a “pedicle TRAM” meaning that the tissue was left attached to her body by the rectus muscle, tunneled under her skin and brought up into the mastectomy defect. Then it was trimmed and shaped into a pretty breast shape. Even some of the skin from her abdomen was used to replace missing skin as a result of her previous lumpectomy. After about six months final shaping was done to the breast, a new nipple and areola were created and other revisionary details were completed. She is shown here at 8 months following her 2nd stage procedure.