After conservative treatment for small breast cancer the use of breast implants is controversial due to the negative effects of external conventional radiotherapy on soft tissues and the risk of capsular contracture. The literature reports several cases of unsuccessful breast augmentation due to implant displacement, a high percentage of capsular contracture and postoperative complications. We report the case of a 47-year-old woman with a small tumour between the inner quadrants of the left breast. She underwent quadrantectomy and sentinel node biopsy and intraoperative radiotherapy (IORT) of the target zone. Simultaneously, she received a bilateral augmentation mammaplasty. One year later we observed no evidence of local recurrence, no local fibrosis and radiodistrophy. Cosmetic results are excellent and the patient is very satisfied. The surgical technique and the possible advantage of such a procedure are also discussed.