48 year underwent left breast lumpectomy and radiation for breast cancer. This resulted in a severe scaring and tightness of the lower portion of the breast. Reconstruction was performed using a thoracodorsal artery perforator flap (TDAP) to provide addition soft tissue volume to the lower pole. Breast augmentation was performed on the right side with a 175 cc smooth moderate profile implant to improve symmetry and upper breast contour. The left breast scar was also revised and fat grafting was performed at a second stage. The patient is shown 3 months after the second surgery.