We present a new reconstructive system encompassing prostheses and fat grafting as integrated tools to improve the final reconstructive outcome. Fat grafting in our view is a preoperatively planned part of the reconstruction. The final volume we achieve will be made up of fat and implants in a variable percentage according to patient's body contour and breast morphology. We used the hybrid breast reconstruction technique in more than 350 reconstructions, both immediate and delayed, two-stage and DTI, without experiencing higher loco-regional recurrence and complication rates when compared with conventional two-stage reconstructions, obtaining excellent aesthetic results and high patients' satisfaction levels.