The authors present 44 cases of mammary reconstruction after sub-cutaneous mastectomies (16 cases), modified radical mastectomies (20 cases) and total radical mastectomies (8 cases). The implantation of a prosthesis is always performed a few months after sub-cutaneous mastectomy to avoid the numerous complications. Implantation of a prosthesis after a modified radical mastectomy (conservation of the pectoral muscles) yields excellent results. The authors graft the areola-nipple complex of the mastectomised breast on the abdominal skin, each time that they are sure of its integrity. At the later implantation of the mammary prosthesis, they perform a reduction or remodeling of the controlateral breast, if indicated. The total radical mastectomy without radiation generally allows implantation of a prosthesis without additional use of skin flaps or musculo-cutaneous skin flaps. Sequellea of radiodystrophy may impose preliminary cutaneous or musculo-cutaneous skinflaps with inferior esthetic results.