Reconstruction of the anterior abdominal wall is based on six basic principles. First, the anatomy of the abdominal wall and adjacent donor sites must be understood clearly. This includes a complete knowledge of the neurovascular anatomy and the arc of rotation of each subunit. The defect then has to be exposed completely before the definitive closure is attempted. Once the defect is established, abdominal domain is restored with some sort of support. The next phase of the repair involves reassigning local tissue to close the defect. Distant tissue then is imported from donor sites such as the thigh, if needed. Finally, the skin envelope is readjusted and closed. These principles help optimize function and restore form, hence achieving the best possible result.