[Morbidity of the abdominal wall after breast reconstruction and elective abdominoplasty]

The free TRAM flap is commonly used in breast reconstruction after mastectomy. Donor-site morbidity of the abdominal wall is usually determined by scars, loss of sensation and functional restrictions. Similar aesthetic and functional problems are described for patients after elective abdominoplasty. Is morbidity of the abdominal wall after breast reconstruction based on muscle lesions or on the trauma from operation?

21 patients after breast reconstruction and 20 patients after elective abdominoplasty were evaluated concerning the aesthetic results, scars and herniasation. Satisfaction with the result was assessed. In addition, the function of the abdominal wall was noted according to Janda.

The postoperative course was uneventful. Three cases after elective abdominoplasty developed a recurrence of rectus muscle diastasis. After breast reconstruction there was one hernia and one patient showed a rectus diastasis. Loss of sensation, functional and aesthetic problems were seen in both groups.

There are no statistic significant differences between elective abdominoplasty and abdominoplasty after breast reconstruction. In both groups loss of sensation, functional and aesthetic problems were noted. Even in elective abdominoplasty there is a loss of function in the abdominal wall. Donor-site morbidity after breast reconstruction is not only caused by the muscle lesion, but the functional and aesthetic problems are due to the general trauma of the abdominal wall.