Aesthetic Refinement of the Abdominal Donor Site after Autologous Breast Reconstruction

Background: The abdominal donor site has consistently demonstrated excellent aesthetic outcomes when used for autologous breast reconstruction. However, a consistent point of dissatisfaction is the location and appearance of the abdominal donor-site scar, which can be a frequent cause of distress for the patient. The authors consider the appearance of the donor-site to be as important to the overall reconstructive effort as that of the breast, and believe it worthwhile to achieve an aesthetically pleasing result. Thus, the authors present here their technique for aesthetic revision of the abdominal donor site after autologous breast reconstruction. Methods: This is a series of 51 patients who underwent autologous tissue breast reconstruction with deep inferior epigastric perforator flaps. All patients subsequently underwent abdominal donor-site revision during the second stage of their reconstruction, including excision and lowering of the abdominal scar, and liposuction of the abdomen and mons pubis to achieve optimum contouring. Results: The donor-site scars were lowered an average of 5.93 cm (range, 5 to 7 cm). The average procedural time was 27 minutes. No wound dehiscence, seromas, hematomas, or infections were reported postoperatively. Conclusions: With this report, the authors put forth a new obtainable standard for autologous tissue breast reconstruction donor-site aesthetics, and propose a conceptual shift that includes the trunk aesthetic unit as an integral part of the overall reconstructive outcome. The authors' results here demonstrate that this is a safe, successful, and reproducible procedural adjunct to the second stage of breast reconstruction.