Breast surgery is fully justified only in aesthetic perspectives. Although there are largely two areas in breast surgery, reconstruction and aesthetic, they frequently overlap each other. A reconstructed breast, therefore, should be aesthetically as natural as possible and similar to the contralateral one, even if this means reproducing some little defects. The authors present our experience of recent 6 years in breast reconstruction with an aesthetic eye and an artistic touch, and illustrate personal tips and technical adjustments: use of anatomical prostheses, autologous tissue transfer, axillary fold and nipple-areola complex reconstruction, including augmentation mammaplasty(implant, fat injection) and reduction mammaplasty. In 6 years, 178 cases of breast surgery were performed. Breast reconstruction(post-mastectomy, post burn deformity, congenital deformity etc) was 106 cases. There were 83 TRAM free flap cases, 10 Latissimus dorsi free flap cases. 7 cases using tissue expander and breast implant and 6 were fat graft cases. Number of breast augmentation was 35(25 submuscular, 10 subglandular). Breast reduction procedure was performed in 37 cases(13 periareolar, 8 vertical, 14 inferior pyramidal and 2 free nipple graft technique). The factors characterizing aesthetic results are profiles of breast(projection, inframammary fold location, superficial evenness, and ptosis), symmetry, axillary fold, areola, and nipple. In every procedure, we take account above factors, and results were satisfactory both surgically and aesthetically.