Breast reconstructive options have evolved over the past six decades. Despite advancements in technology, improved therapeutic options, and genetic testing, women are still, unfortunately, faced with a myriad of deformities after treatments for breast cancer. In order to restore an esthetically pleasing breast mound, a careful evaluation of the patient must be taken into account. There are, generally, three components or factors that need to be considered while devising an excellent reconstructive option for a particular patient. These are: patient factors, surgeons’ factors, and oncologic factors. It is only with a detailed understanding of each one of these factors that a sound solution is arrived at. In this chapter, we will explore the various modalities of breast reconstruction available to patients. We will also demonstrate specific considerations in order to optimize an excellent outcome for our breast cancer patients.