As breast reconstruction is an important adjunct after mastectomy to regain physical integrity and also to improve affect, the present aim was to evaluate patients' subjective perceptions of body image during the whole breast reconstruction period and to assess the importance of their psychological reaction in terms of negative affectivity. Participants were 62 women, 43 women (M age = 46.4, SD = 9.8) who had had mastectomies and 19 healthy women (M age = 39.9, SD = 13.99). Patients were admitted for surgery at the Hospital S. Orsola in Bologna. Healthy subjects were relatives of the women and students, all with no history of breast pathology. The Body Satisfaction Scale and the State Anxiety Inventory-Y were administered to the two groups before, post, and 6 mo. after surgery. Analysis of scores indicated that during the period of the study, the women with mastectomies reported higher anxiety and also greater dissatisfaction with their body image than the healthy group, even when the breast had been reconstructed. This unexpected finding suggests patients' unrealistic expectations of the breast reconstruction and the surgical outcome.