BACKGROUND: Today partial reconstruction in breast cancer (BC) surgery involves displacement or replacement procedures to improve cosmesis without compromising safety. However, patient satisfaction should be compared among several options, in order to get additional criteria for a personalized approach. The aim is evaluate oncological, aesthetic and functional results after monolateral (reshaping or replacement) or bilateral (mammoplasty with contralateral pexy or reduction) conserving strategies. MATERIALS AND METHODS: The protocol provides for the enrollment of a prospective sample of 250 patients in a time frame of 3 years. The first 108 cases (range 18-85 years) with BC diagnosis, and suitable for type 1-2 oncoplastic surgery who gave informed consent, were selected Data analysis was focused on radicality, complications, cosmetic and functional results related to quality of life, comparing monolateral (ML) and bilateral (BL) groups. RESULTS: Tumor size (p = 0.01), multifocality (p = 0.05), multicentricity (p = 0.01) and estimated resection volume (p = 0.000) were higher in the BL group. There was a comparable re-excision rate for positive margins (p = 0.72), and after 2.3 years, no difference in local recurrences were recorded. No early (p >
0.05), but late complications were more common in the BL (p = 0.07). The overall satisfaction with cosmesis and well-being were characterized by similar proportions of good results (p>
0.05), with some details more related to each procedure. CONCLUSION: The proposed techniques represent effective solutions for reshaping that follows BC excision, achieving comparable early complications, low re-interventions with good aesthetic results and social functioning. However, is crucial a careful patient selection and surgical plan while predicting any sequel or delayed complication during follow-up.