Several reconstruction options are utilized after mastectomy, and can be categorized into two major groups; 1) prosthetic implants, which can either be placed in a one-step procedure or with an expander placed at the time of mastectomy and permanent implant placed during a separate delayed surgical procedure; and 2) autologous implants using the patient's own tissue, which can also occur at the time of mastectomy, or as a delayed procedure after radiotherapy. The approach to reconstruction often depends on several factors including need for radiation, surgical practice patterns, patient anatomy and comorbidities, and patient preference. Radiation has been shown to increase the risk for reconstruction complications, especially after prosthetic implant placement. The optimal type of reconstruction and sequencing of radiation and reconstruction remains controversial. The timing of various implant and reconstruction procedures may have a significant impact on treatment planning, risk for reconstruction complications and overall cosmesis. At the conclusion of this activity, the learner will be able to do the following: 1. Describe the major reconstructive options used after mastectomy, and their complications. 2.Explain differences in mastectomies, and risks associated with reconstructive options and radiation.