Young women with breast cancer differ from older women in a number of ways that may affect their experience with breast reconstruction after mastectomy. Parenting, work, or recreational activities may influence a young woman's decisions about whether or not to have reconstruction, timing of reconstruction, and type of reconstruction. Young women with breast cancer are known to experience greater psychological morbidity and poorer quality of life than older women. A young woman's breast anatomy and physiology and overall medical condition generally allow more reconstructive options. Young women can often tolerate autologous reconstruction well, and more young women are expressing interest in perforator-based free tissue transfer to reduce donor site morbidity. Although the reconstructive issues are different for younger women, outcomes of breast reconstruction appear to be the same for women of all ages.