Case Details: The patient is a 48 year old female with a history of breast cancer and BRCA mutation after prior bilateral mastectomies and reconstruction with a right latissimus flap and bilateral implants. She underwent multiple surgeries by other providers since her diagnosis in 2006, and presented with breast asymmetry, deformity and symmastia. She also had never been offered nipple reconstruction. We revised her reconstruction over several surgeries including: implant exchange, correction of symmastia with galafelx mesh, fat grafting, and nipple reconstruction. 3 months post. op last surgery. She will be revising her tattoos in the future as well.