As the incidence of breast cancer increases and surgical procedures advance, breast reconstruction following mastectomy is becoming more common. Radiologic imaging is essential for assessing both normal postoperative changes and complications. The two main reconstruction techniques are implant-based reconstruction, which uses silicone or saline prostheses, frequently with acellular dermal matrix support, and autologous tissue reconstruction, which uses the patient’s own tissue (e.g., DIEP, TRAM, latissimus dorsi flaps). Although autologous reconstructions typically result in a neobreast with a more natural contour and softness, there is a wide range of anticipated imaging appearances and possible surgical complications, including fat necrosis, seroma, or vascular impairment. The potential issues include capsular contracture, implant intra and extra capsular rupture, and rare disorders such as breast implant-associated large cell lymphoma (BIA-ALCL). Accurately interpreting and distinguishing benign postsurgical alterations from pathologies, specifically recurrence, requires an understanding of these entities.