The most significant concern in using the lower rectus abdominis musculocutaneous flap is creation of an eventration or even a frank hernia of the abdominal wall. Frequently, reinforcement using an alloplastic implant following closure of the double-pedicled donor defect is required. In an effort to avoid the use of any foreign materials, particularly if the goal in breast reconstruction is to use only autogenous tissues, strong consideration for incorporating an absorbable mesh is advocated to provide abdominal wall support.