Reconstructive surgery for congenital breast loss should be performed after puberty has ended and the body is fully developed. Congenital absence of breast is a rare congenital anomaly, which is characterized by the absence of one or both breasts and nipples. Its clinical manifestations are varied and often accompanied by one or more malformations, such as congenital ectodermal dysplasia, craniomaxillofacial and limb malformations. Congenital breast loss can mainly be treated surgically, and according to the patient’s requirements, breast reconstruction on the missing side, or implantation of prosthesis, transfer myocutaneous flap reconstruction and so on, should be considered. The timing should be chosen after the end of puberty, because the body is not fully developed before puberty, and breast reconstruction can not be adapted to the state of physical development.