The function of female breast is not only to secrete milk to nurse the baby, but more importantly, it is also a symbol of femininity and a necessary condition for female beauty, so after mastectomy, it will seriously affect women’s self-confidence and self-esteem. In recent years, with the advancement of comprehensive treatment of breast cancer and the development of plastic surgery technology, more and more cases of breast reconstruction are being performed at the same time after mastectomy. Immediate breast reconstruction is favored by more and more breast cancer patients due to the advantages of not having to experience the pain of breast loss, superior postoperative breast reconstruction shape compared to delayed surgery, short operation time and low cost. Safety of breast reconstruction after skin-preserving total mastectomy Studies have shown that skin-preserving mastectomy has the same local recurrence rate as conventional radical surgery, and that local recurrence is related to tumor stage, size, lymph node status, and tumor differentiation, but not to the preservation of breast skin. Therefore, scholars believe that it is oncologically safe to preserve the skin of the breast for early-stage breast cancer. The trend in breast surgery emphasizes a conservative treatment model that focuses on quality of life, the maintenance of cosmetic appearance with guaranteed disease treatment, and the improvement of surgical approaches. Breast reconstruction after total mastectomy is a remedial procedure for aesthetic deficiencies and psychological trauma, and for patients who do not have the opportunity to preserve their breasts, breast reconstruction offers the possibility to reshape their breast shape. Numerous studies have shown that breast reconstruction does not negatively affect local recurrence or overall survival. Principles and indications for breast reconstruction Breast reconstruction is the use of autologous tissue grafts or breast implants to reconstruct breast wall deformities and breast defects following mastectomy for breast disease. Breast reconstruction for breast cancer patients should be considered from the aspects of safety of tumor treatment and cosmetic surgery, and should follow the following two principles: (1) the technology used for reconstruction should not interfere with the implementation, efficacy and prognosis of breast cancer treatment, and should not affect the immediate detection and retreatment of tumor recurrence; (2) the reconstructed breast should achieve the ideal cosmetic and functional effects and improve the quality of life of patients. The indications for breast prosthesis reconstruction should still be strictly grasped: (1) clinical TNM stage 0 to II; (2) the patient has the requirement of breast reconstruction; (3) the healthy side of the breast does not sag or the breast sags within Ⅰ degree, and there is no contraindication to surgery. The advantages and disadvantages of immediate breast implant reconstruction Breast reconstruction mainly consists of two methods: autologous tissue breast reconstruction and breast implant reconstruction. With the continuous improvement of breast implant technology and surgical skills, the clinical application of breast implant reconstruction is becoming more and more widespread in China because of its safety and good cosmetic effect. For immediate breast implants, the advantages are as follows: (1) the surgical method is simple and easy, and there is no additional opening during surgery, which basically does not add additional trauma to the patient; (2) the immediate effect is satisfactory and can basically meet the needs of daily life. The disadvantage is that a few patients may experience rupture of the prosthesis, leakage, infection, contracture of the envelope, and displacement of the prosthesis. The most common complication is contracture of the implant envelope, the incidence of which is reported to be 26%. Key points of breast prosthesis reconstruction surgery Before surgery, the affected and healthy breast are marked well, focusing on the lower edge of the inferior crease and the peeled cavity. According to the volume of the resected breast and with reference to the healthy breast, choose an implant of comparable volume, and wash the silicone implant with gentamicin saline before implantation. The cavity between the large and small muscles should be sufficiently free during surgery, especially the lower edge, medial and lateral anterior serratus muscles should be free properly, the cavity must be large enough, and satisfactory implantation of the implant is an important part of the postoperative aesthetic appearance. During the operation, attention should be paid to strict hemostasis and smooth postoperative drainage to prevent the formation of postoperative hematoma. For breast implant reconstruction, hematoma is not rare, mainly due to incomplete hemostasis or poor drainage when stripping the implant space, and hematoma can increase the incidence of prosthetic contracture to a certain extent. Therefore, it is very important to place intraoperative drainage and keep it open after surgery. Breast cancer is the most common malignant tumor in women in China, and its incidence is increasing year by year. Skin-preserving breast reconstruction immediately after modified radical breast cancer surgery means preserving the skin as much as possible without affecting the radical treatment of breast cancer, and immediate breast reconstruction and repair. This method has the advantage of treating the disease without the psychological pain of losing the breast. Also, since the breast is reconstructed immediately, its shape is better and the excision and reconstruction are done in one time, which does not affect the hospitalization time and reduces the hospitalization cost, and reduces the complications after radical breast cancer surgery. In conclusion, immediate breast reconstruction with silicone breast implants after skin-preserving radical mastectomy is less invasive, safer, simpler to operate, and has faster recovery after surgery.