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* At 46 years old this woman was looking at her increasing chances of having a breast cancer diagnosis. She had a family history of breast cancer, had dense breast tissue that made reading her mammograms difficult and had a recent breast biopsies that showed pre-cancerous tissue. After talking with medical professionals she decided to proceed with bilateral prophylactic mastectomies. She also wanted to have breast reconstruction at the time of her mastectomies. She met with one of our experienced surgeons to discuss her options for breast reconstruction. For her the best option was to use her latissimus dorsi muscle along with a tissue expander to reconstruct her breasts. At the time of her mastectomies her reconstructive process was started. The latissimus flaps were raised and used as soft tissue coverage for the tissue expanders. Her surgeon also reconstructed a new nipple and areola complex for each breast at the first stage. Eleven months later her tissue expanders were replaced with smooth round gel breast implants. Revisions of the precious incisions on her breasts and back donor sites were also done. She is now a couple of months out from her second stage of breast reconstruction with a very favorable result and the peace of mind of reducing her risks of developing a breast cancer in the future significantly.