TRANSVERSE RECTUS-ABDOMINIS MUSCULOCUTANEOUS FLAPS FOR LIGHTWEIGHTS -IS A PINCH ENOUGH

Recent publicity concerning silicone breast implants has fostered pati ent interest in autogenous breast reconstruction after mastectomy. The transverse rectus abdominus musculocutaneous flap has become the stan dard for autogenous breast reconstruction. However, very thin patients have not been considered ideal candidates for this procedure due to t he paucity of abdominal fat. The use of this procedure in these very t hin patients has not been addressed. In patients whose abdominal skin fold thickness was 1 cm or less, we found the procedure to be reliable . However, maximizing the amount of transferred tissue to achieve symm etry necessitates a bipedicled flap. Abdominal fascial closure in thes e very thin patients is more difficult. Although these patients may no t appear to be ideal candidates for the transverse rectus abdominis mu sculocutaneous flap at first glance, the results have been gratifying and this method of reconstruction is a reliable option.