The experience of 428 mammary reconstructions (MR) performed by the same surgeon, evaluated more than two years after surgery, enable the authors to try to determine possible correlations between results of MR and methods employed. Antibiotic prevention and tissue expansion only appear to have a significant influence on MR issue, whereas capsular contracture and aesthetic result did not seem correlated with prior radiotherapy or texture of the wall implant. This study confirms the low morbidity of MR. As regards quality of life, MR provides a noticeable benefit to a wide majority of patients. No method has been proved to be higher, or not advisable, against others. So, indications must be modulated in every case, patronizing better compromise between safety, quality and stability of morphologic result, and need expressed by each patient.