Background
Reverse abdominoplasty along the inframammary incision was originally described by Rebello and Franco, has established utility in post-bariatric contouring, complementing the standard or inverted-T abdominoplasty, and in breast auto-augmentation. However, its versatility for post-mastectomy breast reconstruction remains underreported in the literature, and its complication profile poorly characterised.
Methods
A retrospective case series of eight patients who underwent reverse abdominoplasty in conjunction with breast surgery in a private practice in Launceston (2016-2026) was identified. Indications, operative technique, complications, and outcomes are described.
Results
All patients were female (mean age 56.5 years), with follow up ranging from six months to three years. The reverse abdominoplasty favoured the massive weight loss patient and a breast reduction with an inframammary scar. In two patients, the upper abdominal tissue was excised, one of whom also underwent augmentation-mastopexy. In a further two patients, the tissue was preserved to auto-augment breast ptosis. Two patients underwent unilateral post-mastectomy reconstruction using the flap alone, while a third reconstruction combined the flap as a fat graft with a silicone implant. The complication profile was notable with additional procedures and hospital stay. Complications included seroma, haematoma, scar revision, pneumothorax, and a wound sinus necessitating salvage with a latissimus dorsi perforator flap.
Conclusion
Reverse abdominoplasty can simultaneously address the upper abdomen and breast, offering a local tissue augmentation without microsurgery and potentially reducing implant necessity. However, the thin upper abdominal tissue is sometimes compromised by previous surgery or radiation, limiting available skin and volume for reconstruction. This demands careful surgical judgement and patient selection. The seemingly high complication rate reflects these inherent challenges and must be balanced accordingly.