BACKGROUND: The breast reconstruction using implant has been conducted widely. Many studies were presented to analyze the complications, but most of these studies were conducted with patients relatively short term period follow up. The authors studied with patients who were followed up at least five years. METHODS: Among the patients who were underwent breast reconstruction with implant from 1998 to 2007, 37 patients who met were followed up more than 5 years were selected in the study. Relationships between factors such as the operation methods, volume, type of surfaces of the implants, etc. and the complication rate or reoperation rate were analyzed. The level of satisfactory scoring was measured by patients' and 5 plastic surgeons. RESULTS: Complications were developed in 21 patients (65.6%) and 9 of them underwent reoperations. Infection was most common cause of complication. Implant removal was conducted to 7 patients, and 5 of them due to infection. The percentages of patients who received postoperative chemotherapy or radiotherapy in complication group and implant removal group were higher than the whole group whereas such correlation was not statistically significant. Direct Implant insertion has 50% of complication and 80% in permanent expander insertion and 73.7% of expanderimplant exchange. The average value of subjective score at last follow up was 4.2 points and the average value of objective score was 5.74. CONCLUSIONS: The incidence rate of complications was relatively high, and the final followup satisfaction score was low. This study should be helpful not only to select reconstruction methods, but also further studies to compare with other reconstruction methods.