The majority of women who are undergoing mastectomy can also have breast reconstruction. In most breast units, implants and latissimus dorsi flaps can be performed. The more sophisticated transverse rectus abdominis myocutaneous (TRAM) flap-based reconstructions are generally performed by plastic surgeons so that there may be logistic problems in using these techniques for immediate reconstruction. Decisions on technique will also depend on the patient's build and co-existing medical conditions together with the likelihood of need for postoperative radiotherapy as part of the primary local treatment.