The transverse rectus abdominis muscle flap has a large amount of tissue, reliable blood flow, and can achieve abdominoplasty results at the same time, making it particularly suitable for middle-aged patients with an existing abdominal pectus excavatum. According to the grafting method, the flap can be divided into the traditional transverse rectus abdominis muscle flap with rectus abdominis tip and the free transverse rectus abdominis muscle flap. (1) The former relies on the superior abdominal wall artery that travels within the rectus abdominis muscle for blood flow. Blood from the superior abdominal wall artery reaches the inferior abdominal wall artery via a spiral arterial anastomosis, which in turn supplies the flap with a penetrating branch of the inferior abdominal wall artery. Because the blood flow of the flap is often affected by twisting of the tip and compression of the tunnel, the distal inferior abdominal wall artery or the superficial abdominal wall artery can be anastomosed to the vessels in the axillary area while the rectus abdominis muscle is transferred with the tip. (2) Free transverse rectus abdominis muscle flap: This flap is tipped with the inferior abdominal wall artery, and the arterial blood supply comes from the penetrating branch of the inferior abdominal wall artery, and the vein returns to the inferior abdominal wall vein. The recipient vessels can be either the internal thoracic artery or the dorsal thoracic artery.