This patient with previous breast augmentation was diagnosed with left breast cancer. She desired unilateral mastectomy with implant removal and reconstruction using her own tissue. Because the majority of her body fat was located on the thigh, she chose to use this tissue for the reconstruction. To do this, tissue was taken from each inner thigh as for a vertical aesthetic thigh lift; this is known a profunda artery perforator flap, or “PAP” flap. Two flaps were used to reconstruct the left breast and sewn in a “stacked configuration.” The right breast was reduced and implant downsized according to the patient preferences. The inner thigh scar is well hidden.