63 year old patient with bilateral invasive lobular breast cancer, Stage 1, who elected to have bilateral nipple-sparing mastectomy with bilateral breast reconstruction as a Single Stage operation. She underwent an autologous breast reconstruction with a bilateral TRAM flap where each half of her lower abdominal tissues were used as a donor site to replace and reconstruct each one of her breasts. The mastectomy skin incisions were designed as a Wise pattern like a breast reduction and her original nipple and areolar complex was preserved and replaced as a full thickness skin graft over the reconstructed breasts. Her breast size was reduced from a 36DD to a 36D cup size post reconstruction. The abdominal TRAM flap donor site was repaired using both in-lay and an on-lay polypropylene mesh to preserve her abdominal muscle integrity and support her core rotational movement strength. The post operative photo here was only two months post-surgery showing some residual swelling at her lower abdomen that will dissipate within the next three more months. Her breast reconstruction appears natural, like a mommy makeover patient that had a breast lift / reduction and a tummy tuck.