Introduction: We aim to quantify and compare patient satisfaction among the three most commonly performed breast reconstruction techniques: TRAM, latissimus dorsi and TE/Implant reconstruction. Methods: 268 questionnaires were mailed to a group of consecutive breast reconstruction patients. 172(64%) patients completed and returned the questionnaire. Results: “Overall satisfaction” was greater in TRAM patients as compared to TE/Implant patients (p<0.05). However, the number of patients willing to “repeat their procedure” and “recommend their procedure to a friend” was similar among the three techniques. A greater number of TE/Implant patients as compared to TRAM patients felt they had not received “sufficient information to make an educated decision” (p<0.05). A second questionnaire sent to the TE/Implant patients revealed the majority felt uninformed about the final aesthetic outcome and the frequency and pain with expansion. Conclusions: TE/Implant patients should be told they will most likely not be as satisfied with their overall reconstruction as TRAM patients. However, our data suggests that all three groups were ultimately equally satisfied with their own personal choices. Many patients will continue to choose TE/Implants in an effort to avoid scars and more extensive surgery. Being “less satisfied” is not wrong or bad, as long as it is known.