Post-mastectomy breast reconstruction is a complex and evolving eld in breast cancer care. This comprehensive review explores clinical insights into various reconstruction techniques, including implants and autologous tissue-based reconstructions. Advantages and disadvantages of each approach are discussed, highlighting the importance of personalized treatment plans. Areas of uncertainty, particularly regarding the impact of radiotherapy on reconstruction outcomes, are addressed. Despite the lack of formal guidelines, recommendations emphasize the need for multidisciplinary evaluation and patient-centered decision-making. The review concludes with practical recommendations for optimizing patient care, emphasizing the importance of informed consent, managing patient expectations, and considering individual patient characteristics in treatment planning. Further research is needed to clarify optimal timing and techniques for reconstruction in patients undergoing radiotherapy. This review provides valuable insights for clinicians involved in the care of breast cancer patients considering reconstruction, helping to guide treatment decisions and improve outcomes.