At present, with the gradual improvement of surgical techniques, the reconstructed breast can be made more satisfactory in both shape and texture, regardless of the method used. However, the determining factors for which method is best for a particular individual include: the patient’s overall health, the site of the mastectomy, the condition of the opposite breast and the patient’s wishes. (1) Condition of the mastectomy site: The type of mastectomy performed has a greater influence on the choice of reconstruction method. Radical mastectomy may result in subclavian depression, loss of the anterior axillary fold, and insufficient soft tissue coverage, whereas modified radical mastectomy may leave sufficient soft tissue. The amount and quality of pectoralis major muscle and skin, and the condition of the scars must all be taken into account when deciding to perform breast reconstruction, in order to decide whether implantation alone is satisfactory, whether the skin and muscle can be adequately expanded, and whether flap grafting is necessary. Only in this way can the best surgical method be selected for a particular body to obtain the best cosmetic result. (2) Patient’s physical health: Healthy patients may opt for any type of reconstructive surgery, whereas the elderly or those in poor health may be best suited for a simple procedure – subpectoral implantation of a prosthesis or tissue expansion. Healthy patients with a lax (but not excessively obese and sagging) abdominal wall may be best served by reconstruction with a transverse rectus abdominis myocutaneous flap. Preoperative consideration should also be given to whether previous abdominal surgery has been performed. This is because a subcostal incision may have damaged the rectus abdominis muscle, a paracentral incision may have damaged the vascularized perforators, and midline and lower abdominal incisions may have altered the viability of the transverse rectus abdominis myocutaneous flap. Most surgeons consider heavy smoking and diabetes to be contraindications to the transverse rectus abdominis myocutaneous flap. (3) Contralateral breast condition: Because symmetry is the goal of breast reconstruction, the size and shape of the contralateral breast must be considered to determine which approach is best. Alteration of the contralateral breast to better match the reconstructed breast may also be considered. Breast reduction or augmentation or breast suspension may be possible. However, it is important to remember that the contralateral breast is also at high risk for breast cancer. If prophylactic treatment of the contralateral breast (total mastectomy or subcutaneous mastectomy) is planned, the original treatment plan may be altered to achieve symmetry between the two sides. (4) Patient’s wish: For example, some patients are afraid of foreign materials and do not want to use prosthesis, so they should choose to use autologous tissue for reconstruction. Other patients do not want to leave new scars in other parts of the body, and have to choose tissue expanders or prostheses. However, these choices must be considered in conjunction with the local conditions described above, and it is essential to find an experienced surgeon to choose an appropriate surgical method for them.