Donor site grading after six autologous breast reconstructions for one single patient

Few studies exist comparing patient-reported donor site morbidity after autologous microsurgical breast reconstruction. We report a case of a 53-year-old patient who underwent three consecutive bilateral autologous breast reconstructions due to serial flap failure. Donor site morbidity after bilateral transverse myocutaneous gracilis (TMG), superior gluteal artery perforator (SGAP) and deep inferior epigastric perforator (DIEP) flap harvest was evaluated by the patient according to different variables. While the three donor sites were graded differently regarding postoperative pain, wound healing and aesthetics, no functional deficit was reported. Taking into account all variables, the DIEP donor site was rated most favourably and the TMG donor site was graded least favourably. To our knowledge, this is the first case report providing donor site evaluation after three consecutive bilateral breast reconstructions with autologous tissue in a single patient. If all three above-mentioned donor sites are available and suitable for breast reconstruction, and the patient has no preference, the DIEP donor site might be preferred by the plastic surgeon. Level of evidence: Level V, therapeutic study.