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Breast reconstruction is an integral part of treatment of breast cancer. Immediate reconstruction is breast reconstruction that is done at the same surgery as the mastectomy, whereas delayed reconstruction is done months or years after the mastectomy. Immediate and delayed reconstruction can be accomplished with autologous tissue flaps or prosthetic breast implants. The esthetic result, psychosocial effect, and cost of breast reconstruction are better with immediate reconstruction, but the risk of surgical complications is less with delayed reconstruction. Although immediate reconstruction is oncologically safe and esthetically advantageous, nationwide less than 20% of patients having a mastectomy have immediate breast reconstruction. Radiation treatment before or after mastectomy has a negative impact on the outcome of breast reconstruction and is one important factor to be considered in determining the optimal timing for breast reconstruction.