Although breast reconstruction has been performed for centuries, there is a constant search for new approaches to achieve an aesthetically pleasing appearance while causing minimal patient morbidity. In our previous article, we have described our experience with the bipedicled musculo-derma-glandular, axio-perforator flap. The main advantage of this well-vascularized flap is the ability to restore the shape after mastectomy while removing the excess tissue from the hypertrophic and ptotic healthy breast. Based on our promising results with this technique in the previous two patients, we combined the breast reconstruction using bipedicled musculo-derma-glandular, axio-perforator flap with simultaneous nipple-areolar complex reconstruction. The surgery was successful, and the patient did not experience any complications. We believe this technique can be applied for patients with breast hypertrophy and ptosis to achieve reliable and aesthetically acceptable results in a one-stage operation.