Dissatisfied with the upper pole fullness produced by the Becker expander/mammary prosthesis, we started using 'anatomically' shaped expanders and implants, as described by Maxwell, for breast reconstruction. We reviewed the results of our first 24 breast reconstructions in 19 patients, who were deemed suitable for reconstruction with this technique between August 1994 and April 1995 (9 months). The most commonly used expander was 500 cc (range 400-700 cc) and an average of 2.73 inflations was required before replacing the expander with a definitive implant. The minimum follow-up was 6 months. Few complications were recorded and all patients were very happy with the final result. We found that the anatomically shaped expanders and implants produced better aesthetic reconstructions compared to dome shaped prostheses. Importantly, the procedure was technically simple and the results readily reproducible.