Introduction and aim of the work: Breast reconstruction after mastectomy became well accepted during the past 20 years and it is now an essential part of the interdisciplinary treatment for breast cancer. We aimed in this study to offer the Egyptian women the option to obtain a nearly normal looking breast after mastectomy and to assess the complications, esthetic results and patient satisfaction. 
Patients and methods: From January 2003 to June 2004, 12 patients were offered and accepted post mastectomy autologous breast reconstruction using either Transversus rectus abdominis myocutaneous (TRAM) or Latissimus dorsi myocutaneous (LDM) flaps. Esthetic results, complications and outcome were recorded. 
Results: Four patients were reconstructed by pedicled TRAM flap and 8 patients were reconstructed by LDM flaps. The mean age was 46.6 year and the mean BMI was 29.8. Mean operative time for mastectomy was 77. 8 min. and the mean operative time for TRAM flap was 130 min. versus 95. 6 min. for LDM flap. Seroma in the back occurred in 3 cases in LDM flap. Partial flap necrosis and delayed wound healing each occurred in one case in TRAM flap. Esthetic results and patient's satisfaction were good in both groups except in two patients. 
Conclusion: Breast reconstruction after mastectomy in our locality is still not gaining popularity and had low acceptability 
rate. Autologous breast reconstruction with TRAM or LDM flap gave good esthetic results and satisfaction in most of our 
patients with few complications. Proper patient selection is the key for success of this reconstructive surgery.