Objective: To investigate the feasibility of first-stage silicone prosthesis breast reconstruction with nipple-areolar complex (NAC) preservation for repairing the defect following mastectomy for benign and malignant breast tumor. Methods: From January 2008 to November 2012, 15 patients each with benign or malignant breast tumor were selected, and underwent the first-stage breast reconstruction with silicone prosthesis implantation beneath the pectoralis major muscle after mastectomy, and the NAC was preserved during surgery. Postoperative follow-up was conducted for 13-48 months, and the cosmetic results, complications and clinical outcomes of the patients were observed. Results: Of the 30 patients, 28 cases were satisfied with the postoperative breast shape, and capsular contracture of the prosthesis and prosthesis leakage occurred in one case each at 1.5 and 2 years after surgery, respectively. No residual, recurrent or metastatic tumor associated with NAC preservation was observed. Conclusion: First-stage silicone prosthesis breast reconstruction after breast tumor resection with NAC preservation can not only successfully treat the breast tumor but also meet the aesthetic requirements for breast appearance of patients, with no risk of increasing the incidence of complications, or of residual, recurrent or metastatic tumor.