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Introduction: Pyoderma gangrenosum is arare cause of skin necrosis after surgery. It often appears with extensive ulcerations and scaring with significant aesthetic aftermaths. The pathogenesis is poorly understood but often associated with inflammatory diseases, however post-surgical idiopathic pyoderma gangrenosum can occur. Case Report: We report a case of pyoderma gangrenosum following a bilateral breast reconstruction in a 33-year-old woman, successfully treated with steroids. A week after the surgery wounds started to break down and extensive necrotic ulceration appeared quickly covering both breasts. After dermatopathology evaluation she received antibiotics and prednisone and three months later wounds were completely healed and surgery was not necessary.