This patient presented to our office to discuss breast reconstruction options following a disfiguring lumpectomy.  She chose to proceed with bilateral skin-sparing mastectomy with immediate DIEP free flaps for breast reconstruction.  She healed well from this procedure and several months later underwent the 2nd stage revision procedure.  During that procedure, we created a 3D nipple structure as well as revision of the breasts and abdominal donor site scar.  After she healed, she opted for areolar tattoos to complete the final stage of breast reconstruction.  Areolar tattoos give the complete appearance of a true nipple-areolar complex.