Purpose: This study evaluates the trend in breast reconstruction surgeries in academic institutions and how such trend may influence the choices of graduating plastic surgery residents.

Methods: Questionnaires were sent out to all the ACGME approved plastic surgery residency training programs. The surveys addressed attending staff preference of breast reconstruction surgeries as well as influencing factors. The survey for the residents gauged the comfort level for various types of breast reconstruction surgeries and their level of exposure.

Results/Conclusions: Staff physicians considered the patient's anatomy, medical problems, and preference as well as time of recovery to be the most influencing factors in deciding on the type of breast reconstruction surgeries. Their 1st choice in current use and preference corresponded to the exposure of their training with the autogenous tissue breast reconstruction as their first choice with implants and free flap use as 2nd and 3rd choices. Although over 90% of residents felt confident performing implant breast reconstructions in comparison to 65% of residents being comfortable with autogenous breast reconstruction, residents preferred autogenous breast reconstruction technique over the implant use 50% to 43%. Over 35% of residents declared they were not at all comfortable using free flaps for breast reconstructions.