Reconstruction can be performed in immediate (at time of mastectomy) or delayed (at latera date than mastectomy) setting. In the immediate setting tissue expanders can be placed, direct to implant (permanent implant placed), or free flap reconstruction can be performed. In the delayed setting, implant-based reconstruction usually includes a stage to insert expanders prior to permanent implants. Delayed free flap reconstruction can be performed without first placing tissue expanders. Implant placement generally has up to one day of inpatient observation for pain control and observation. Free flap reconstruction generally has two to three days of inpatient stay for monitoring and pain control. A second stage reconstruction is performed to improve aesthetic appearance of the reconstructed breasts as well as donor sites, which is combined with nipple reconstruction as needed. Second stage surgery is usually an outpatient procedure. Below we will describe common pathways of reconstruction.