Options for donor sites for autogenous tissue breast reconstruction

There are now a number of viable choices for autogenous tissue breast reconstruction. These include the TRAM flap, the LTTF flap, the gluteal flap, the latissimus flap, and the Ruben's flap. The criteria for choosing one site over another should include donor site deformity, ease or difficulty of technique, availability of tissue, ability to shape the tissue into a new breast, and patient acceptance. Using the author's experience and these criteria, each procedure is compared with the others to give the reader a schema for choosing the most appropriate donor site in future patients.