Breast reconstruction with autologous tissue achieves more natural results and a better simulation of a real breast than reconstruction based on prosthetic implants. Unlike implant-based reconstructions, which tend to develop capsular contractures, the results of autologous tissue reconstruction tend to improve with time. In the long run, the costs of autologous breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) flaps are equal to or lower than those of reconstruction with tissue expansion and implants. Consequently, autologous tissue is preferable for most patients, provided they are suitable candidates for the surgery required by autologous reconstruction.