Reducing postoperative psychological morbidity is an important goal in breast cancer patient care; a multidisciplinary approach is crucial in order to select candidates for immediate breast reconstruction. There is no oncologic reason for a delay after a modified radical mastectomy. Our procedure allows immediate breast reconstruction without significantly prolonging operative time and hospitalization. Complete muscular coverage of the implant and shifting of the redundant skin to the mastectomy site minimize the risk of postoperative complications and provide a natural looking reconstructed breast. Delayed reconstruction of the nipple-areolar complex performed at the time of contralateral mammaplasty ensures satisfactory breast symmetry. Satisfactory reconstruction of the nipple-areolar complex is achieved without additional scars by means of grafts taken from the opposite breast or utilizing the cryopreserved nipple and areola.