This 57 year- old female had a history of bilateral lumpectomies and extensive radiation damage following breast cancer on both breasts many years earlier. Unfortunately, her breast cancer recurred on the right side. She decided to undergo bilateral mastectomies. An immediate reconstruction with a latissimus flaps and tissue expanders was performed on both sides through an incision around the areola. Several months later, the expanders were removed and permanent moderate-profile silicone implants were placed. In addition, a nipple reconstruction and fat transfer were also performed. Postoperative result at 1 year shows excellent symmetry with minimal scarring, and a significant improvement in radiation damage.