Breast cancer is now the most diagnosed cancer in the world the most common cancer diagnosis in women. In Australia and New Zealand, a new diagnosis of breast cancer this year is estimated in 20,640 and 3,500 people respectively. Breast reconstruction surgery has undergone a transformative journey over the past century, marked by significant advancements in technique, technology, and patient-centered care. This presentation provides an overview of the historical progression of breast reconstruction, shedding light on the evolution of surgical approaches and its socio-cultural context. Initially admonished by surgeons, the earliest attempts at breast reconstruction can be traced back to the late 19th century with Czerny transplanting a lipoma to recreate a breast mound. However, it wasn't until the mid-20th century that breast reconstruction gained momentum, driven by the increasing awareness of the psychological impact of the mastectomy. Pioneering surgeons like Tanzini, Ombredanne and Gillies introduced various autologous methodologies. Cronin and Gerow ushered in a new age of reconstruction with the introduction of the silicone gel breast implant in 1963. The revolutionary emergence of microsurgery in the 1970s once again changed the course of breast reconstruction. In recent decades, advancements and integration of biomaterials, imaging technology, and patient-specific treatment plans have further enhanced the field. Understanding this historical trajectory is crucial for appreciating the current state of breast reconstruction and anticipating future innovations in the pursuit of optimal patient outcomes.