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Nipple Reconstruction with Areolar Tattooing Patient 4

62 year old who underwent right breast lumpectomy which then required right total mastectomy to completely treat the cancer. The patient also decided to undergo left prophylactic mastectomy. Bilateral total skin sparing mastectomies were performed. Immediate reconstruction was performed with bilateral pedicled TRAM flaps. Nipple reconstruction was performed at a second stage with modified star flaps. Both the right and left areolae were tattooed to provide a natural pigmentation match. She is shown 1 year after final reconstruction.