Rectus abdominis myocutaneous flap of the lower type in breast reconstruction.

A lower rectus abdominis myocutaneous flap has been used in thirteen cases; in twelve patients for breast reconstruction with delay after mammectomy, and in one patient to close a defect due to an extensive mammectomy for cancer recurrence. In our opinion, the main advantages of the lower rectus abdominis myocutaneous flap are the very natural shape and the firmness of the reconstructed breast. The color and thickness of the abdominal skin is also quite similar to that of the chest. The low design of the cutaneous island, as in an abdominoplasty, gives an excellent cosmetic result. There is also enough skin and fat to make a breast implant unnecessary. In corpulent women the ends of the flap have to be resected to avoid partial necrosis. In slim women, the entire cutaneous island can be used. In all cases, repair of the musculo-aponeurotic wall has been performed without any prosthetic material. No foreign material has been used in this reconstruction. No eventration was observed in our patients.