In a 2-year prospective study, the results of two methods of breast reconstruction were compared. The tissue expansion and implant method was found to offer an acceptable reconstruction, but it was associated with a high rate of complications and revisions. The transverse rectus abdominis musculocutaneous flap reconstruction provided a more satisfactory reconstruction, with fewer major complications as well as a higher degree of patient satisfaction and less patient dissatisfaction. The present study does not address the long-term results of either procedure.