Over the past decade, perforator flap surgical techniques and breast cancer surgery have improved the results of post mastectomy breast reconstruction.The perforator flaps commonly used in DIEP, SIA, SGAP, IGAP, Lumbar and PFA flaps.Improved breast cancer surgical techniques include skin sparing mastectomy, nipple sparing mastectomy, immediate breast reconstruction and an improved awareness of importance of incision placement.The efforts have been ongoing but are not available everywhere.The results of breast reconstructive surgery are constantly improving and patients are increasingly aware of the availability of improved results.The presentation will focus on an introduction and explanation of evolving strategies in post-mastectomy breast reconstruction by showing examples of the techniques.