This patient was known to have a genetic mutation giving her high risk for future breast cancer. She originally underwent mastectomy and implant-based reconstruction requiring numerous revisions. Ultimately, she had textured implants placed which rotated on the right side. Rather than pursuing further implant revisions, she desired implant removal and conversion to autologous tissue reconstruction. For volume requirement, a DIEP (abdominal tissue) and PAP (thigh tissue) flap reconstruction was used to build the breast. The PAP flap is used for the lower pole and DIEP for the upper pole. She is seen here roughly 6 months out from final revision surgery.