Objective To evaluate the clinical outcome of one-stage breast reconstruction with prosthesis and dermal matrices after skin-sparing mastectomy (SSM). Methods From 2012 to 2014, 28 cases suffered breast cancer were received one stage breast reconstruction after SSM, and were divided into group A and group B. The silicone prosthesis and dermal matrices was performed in group A (n=19) to reshape the breast and strengthen the inframammary fold, and silicone prosthesis without dermal matrices was used in group B (n=9). The incidence of complication was compared between two groups 1 year after operation. Results In group A, only 1 case (5.26%) with hematoma was observed. In group B, 1 case (11.11%) with prosthesis exposure, 3 cases (33.33%) with prosthesis shelloft, 1 case (11.11%) with hematoma and 4 cases (44.44%) with capsular contracture were observed. There were significant differences between two groups in the evidence of prosthesis shelloft and capsular contracture (P<0.05). All the patients were followed up for 1 year, no local recurrence and distant metastasis were observed. Conclusion Combination with prosthesis and dermal matrices had a better breast shape, higher satisfaction and less complication. It was a safer and more effective method of breast reconstruction.