Breast reconstruction is performed to improve the quality of life and body image for women facing mastectomy. Whilst significant anecdotal evidence and surgical dogma exists regarding the optimal reconstructive practice, a comprehensive MEDLINE literature review has revealed a paucity of well designed, statistically powered studies to address the impact of either the type or the timing of breast reconstruction on these key patient-reported outcomes. There is little high-quality evidence to support the benefit of immediate versus delayed breast reconstruction, for example, or to suggest the superiority of autologous over implant-assisted reconstructions in terms of improvements in quality of life or body image, particularly in the context of postoperative radiotherapy (RT). There is also very limited evaluation of the impact of latissimus dorsi (LD) breast reconstruction, although this is the procedure most commonly offered by oncoplastic breast surgeons in the UK. There is currently, therefore, very little to guide patients or their surgeons in making important decisions regarding their reconstructive options.