Modified Component Separation with One Rectus Abdominis Muscle: Reply to Letter

We are grateful to Dr. Dadhwal for his interest in our recently published article [1]. Special thanks for his important comments regarding Figure 1b. Of course, his doubt about the accuracy of the original illustration is justified; it is correct that the human body has two rectus abdominis muscles. We have corrected Figure 1b to show this. Nevertheless, a modified component separation for smaller defects is still possible when the patient has only one rectus abdominis muscle. This might be the situation in a patient with an unstable scar or hernia of the abdominal wall (e.g., after laparotomy, infection, etc.) and as a result of the previous use of a vertical rectus abdominis myocutaneous (VRAM) flap or transverse rectus abdominis myocutaneous (TRAM) flap (e.g., after breast reconstruction, closure of groin defects, etc.).

Fig. 1

b Components of anatomic separation technique by Ramirez modified after ‘‘Reoperative Aesthetic and Reconstructive Plastic Surgery’’ by James C. Grotting, Vol. II, 1995. Transversal view. E external oblique muscle, I internal oblique muscle, T transversus abdominis muscle. The left rectus abdominis muscle is now included