Aim/Background: Immediate implant reconstruction using the wise pattern reduction technique can be used for patients needing mastectomy with large, ptotic breasts. It has an advantage of using autologous dermal sling for implant coverage. It is important to evaluate complication rates and long term oncological safety of this relatively new technique. Methods: We retrospectively collected data from Northern Ireland Electronic Care Record on all patients who underwent this technique at Belfast City and Craigavon Hospital from 2008–2016. Patient demographics, tumour characteristics, complications, local recurrence and survival rates were recorded. Results: 76 patients were analysed, 65 had bilateral procedures, 46 had mastectomy for malignancy (25 IDC,14 DCIS, 1 ILC) 32 were prophylactic. Mean age was 48, 10 had a history of smoking. 29 were grade 2–3, 27 were ER/PR+ and 4 HER 2+, 14 had Nodal metastasis. 21 received adjuvant XRT, 1 underwent neo-adjuvant chemotherapy. 15 had skin necrosis, 11 were prescribed antibiotics following discharge, 5 (6.6%) required implant removal <3 months post-op. 8 patients had unscheduled re-admission following discharge. 1 experienced delayed adjuvant treatments > 6 weeks. After a mean follow up of 71.9 months, 1 patient had local regional recurrence, 2 had metastatic disease and 1 patient died. Conclusion: Complication rates of immediate implant reconstruction using the reduction technique are comparable to NMBRA. This technique had demonstrated oncological safety after long term follow up.