66 year old woman with left breast cancer requiring a left mastectomy. The patient requested a TRAM flap reconstruction, however prior to the mastectomy it was unsure if she would need radiation. A tissue expander was placed on the left and a reduction performed on the right while the final pathology was reviewed. She did not require radiation and thus the tissue expander was removed and a TRAM flap performed on the left. A nipple reconstruction has been performed in the TRAM skin paddle but has not been tattooed.
