Bilateral latissimus flap with saline implants. 45 yo 5′ 4″ with right breast cancer who elected to have bilateral skin sparing mastectomy (left prophylactic) and same time bilateral latissimus flap with implant reconstruction. Patient had saline 300cc moderate profile implants to achieve a “C” cup breast post op. Note location of back donor site incisions – easily hidden in a low back evening gown / bathing suite. Patient did not elect to have nipple areolar reconstruction at this time. Note symmetry and similarity in shape and contour to her native breasts.