Background and Objective. There are several surgical techniques based on the use of flaps and/or implants for breast reconstruction, which are used according to the particularity of each case. In our practice, we prefer those that use only autologous tissues because they offer, in our opinion, greater advantages We present an alternative for total breast reconstruction with autologous tissue that fuses the latissimus dorsi myocutaneous flap technique with microfat grafting as autologous filler, thus avoiding the use of prostheses. Methods.We included all patients with total mastectomy that accepted and culminated her breast delayed reconstruction with latissimus dorsi myocutaneous flap and microfat grafting in the period from January 2011 to November 2015 at the Plastic Surgery and Burn Department of Guillermo Almenara Hospital (Lima, Peru) . Results. The reconstruction was performed in 24 patients; the total volume was 380 to 780 cc (mean 525 cc) in 1 to 4 sessions. We started with the flap and the first session of microfat grafting intraoperative applying between 260-400 cc (mean 332 cc) of fatty tissue in all exposed tissues; 80% of the initial volume was injected into the myocutaneous flap,with a high degree of graftment. In 45.8% of cases was necessary the des-epithelialization of the skin island and in37.5% was performed transposition flaps in the lateral area of the breast. All results were satisfactory and the complications were minor. Conclusions.We considerer this technique as a good, secure and versatile alternative for total breast reconstruction using autologous tissues, with short and long term benefits.