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Many techniques have been described for breast reconstruction after mastectomy, and in many cases a significant reduction of the contralateral breast is needed for symmetry. This is a case report of a single-stage secondary breast reconstruction after mastectomy using the excided tissue from the contralateral reduced breast based on the perforant vessels of the internal thoracic artery. We used this technique in a 62-year-old woman with a hypertrophic contralateral breast, who had undergone mastectomy due to breast cancer. It is the first