Breast reconstruction has improved with the use of implants made of Acellular Dermal Matrix (ADM). ADM is a biotechnologically created human tissue of pig or cow origin in whose cellular antigens are eliminated during tissue processing. We present the one stage prepectoral breast reconstruction using ADM in this case report. Using a prepectoral implant, skin reduction breast reconstruction was completed. The inferior dermal flap was used to generate a combined dermal pocket, which was then used to cover the implant. It was extended till the higher pole and then sutured with a patch of acellular dermal matrix. This method allows single stage rapid repair with a greater reliance on vascularized tissue and implant support and less need on ADM. Additionally, there is less anatomical disturbance and postoperative discomfort in the pre-pectoral region.