Breast reconstruction can help to address the disfigurement and sense of loss that often follow mastectomy. The decision whether to pursue reconstruction and the choice of reconstructive strategy are individualized decisions that must take into account the patient's body characteristics, overall health, breast cancer treatment plan, and personal preferences. Options for reconstruction broadly include placement of breast implants or use of the patient's own tissue (autologous reconstruction). Both saline-filled and silicone gel-filled implants are safe and effective options for implant-based reconstruction. Autologous reconstruction usually involves transfer of tissue from the abdomen, with recent advances allowing preservation of the abdominal muscles. Both implant-based and autologous procedures have advantages and drawbacks, and both types of reconstruction may be compromised by subsequent radiation therapy. For this and other reasons, consultation with a plastic surgeon early in treatment planning is important for women considering postmastectomy reconstruction.