A widely held tenet in the reconstructive surgery literature is that muscle transplants undergo significant postoperative atrophy, contributing to progressive improvement in appearance of the reconstruction. In contrast, it has been our experience that muscle transplants retain the majority of their bulk following inset, and undergo minimal postoperative atrophy. Prospective evaluation of 20 patients undergoing muscle transplant reconstruction of Gustillo type IIIB lower limb wounds found minimal decrease in limb circumference at 6-month follow-up, as measured at the point of maximum transplant projection.Isenberg JS. What you see is what you get: lack of significant postoperative contour change in muscle transplants to the lower leg. Ann Plast Surg 1997;38:46-49