Aesthetic approach to the rectus abdominis free tissue transfer

Refinements in microsurgery should include not only the selection of an appropriate flap based on the requirements of the recipient defect, but consideration to minimize any donor site morbidity. This concept is analyzed for preoperative assessments, when using any of the variants of the rectus abdominis muscle or musculocutaneous flaps that may be approached via vertical, horizontal, or suprapubic incisions that are chosen to avoid conspicuous scars. Of perhaps greater importance, preservation of abdominal wall integrity is possible, preventing late complications of hernia or eventration by using fascial-sparing techniques.