Objectives: Epidermolysis bullosa is a rare skin disorder characterized by blister formation in response to minor trauma as well as extracutaneous manifestations. Details of the surgical history and technical considerations for performing breast reconstruction in a patient with epidermolysis bullosa are discussed. Method: The history and details of breast reconstruction in a patient with epidermolysis bullosa are reported. Result: A 56-year-old patient with junctional epidermolysis bullosa developed left breast cancer, which was initially treated with lumpectomy. Two years later, a completion total mastectomy was performed for recurrent disease with immediate 2-stage implant-based reconstruction. Nipple reconstruction was completed using a skate flap technique with full-thickness skin graft harvested from the groin region. No blistering, infection, or wound dehiscence was observed. Conclusions: Successful immediate implant breast reconstruction is feasible in patients with epidermolysis bullosa. Reconstructive decision-making should be individualized based on the extent and severity of the skin disease.