Augmentation of female breast is now a frequent procedure, usually performed by plastic surgeons. The last few decades ago, the injection of liquefied paraffin wax for breast augmentation was practised in the Asian countries, and surgeons now occasionally face some of the problems such as tissue necrosis, granuloma formation, hypersensitivity and embolism.   In bilateral grossly infected or ulcerating lesions, total mastectomy with wide excision of  paraffin contaminated tissue is usually needed, and subsequent reconstructive procedures are invariably needed to cover the defects. This paper reviews our experience of two cases of breast paraffinoma who had been reconstructed using TRAM flap after nipple sparing subcutaneous mastectomy