This 40 year-old female developed right sided breast cancer. Because of her young age and increased lifetime risk, she opted for bilateral mastectomies. Skin-sparing mastectomies were performed through a circular incision around the areola. An immediate breast reconstruction was performed with bilateral Latissimus muscle flaps and tissue expanders. After several months, the expanders were replaced with moderate-profile silicone gel implants. A nipple reconstruction was also performed with local skin flaps and skin grafts from the groin area. The resulting “scarless” breast reconstruction is pictured at 2 years postoperatively. The aesthetic breast shape continues to be ideal years after the reconstruction.