Breast Reconstruction: Case 3 This is a 46 year old female from Bridgeport, Connecticut, who discovered she was positive for the BRCA gene. She decided to undergo prophylactic double mastectomies. Her breasts had come down with time and gravity and she desired to save her nipples. She underwent bilateral mastectomies and tissue expander reconstruction. Her reconstruction was performed with a special technique using free nipple grafts to reattach the nipple areolar complex at the time of surgery, to avoid the need for future nipple reconstruction and tattooing. Unlike a typical mastectomy that has a large scar across the middle of the breast, her only scar is hidden in the fold underneath the breast. At a second stage surgery, she had the tissue expanders exchanged for silicone gel implants. She also had some fat grafting performed around her breast implants to give a nice soft contour.