Back to 2026 Abstracts
Autologous Breast Reconstruction Outcomes With Omental Fat-augmented Free Flaps Compared With Deep Inferior Epigastric Perforator And Muscle-sparing Transverse Rectus Abdominus Myocutaneous Flaps
Kasssandra Carrion, BA1, Sophie C. Queler, BS
2, Elizabeth Tadevosyan, BS
1, Yulia Zak, MD
1, Monica Dua, MD
1, Irene Wapnir, MD
1, Mimi Y. Wu Young, MD
3, Dung H. Nguyen, MD, PharmD, MBA
1.
1Stanford University, Palo Alto, CA, USA,
2SUNY Downstate College of Medicine, New York, NY, USA,
3Georgetown University/MedStar Health, Washington D.C., DC, USA.
PURPOSE:Autologous breast reconstruction after mastectomy is commonly performed with deep inferior epigastric perforator (DIEP) and muscle-sparing transverse rectus abdominis myocutaneous (msTRAM) flaps. While effective, these techniques carry abdominal donor-site morbidity and abdominal tissue is not always viable for transfer. The omental fat-augmented free flap (O-FAFF) is a promising alternative that can be harvested laparoscopically, set within an acellular dermal matrix construct and augmented with fat grafting
METHODS:This study involved a retrospective review of consecutive autologous breast reconstructions performed by a single surgeon between 2019 and 2025. Included reconstructions were O-FAFF, DIEP, and msTRAM flaps. Demographics, operative details, postoperative complications, and revision procedures were collected. Outcomes were analyzed at the breast level using Fisher’s exact tests and multivariable logistic regression adjusting for BMI and preoperative radiation.
RESULTS: Ninety-seven patients (133 breasts) were included (O-FAFF 65, DIEP 33, msTRAM 35). Overall complication rates were significantly higher for msTRAM (62.9%) compared with O-FAFF (15.4%) and DIEP (18.2%,
p < 0.00001). O-FAFF and DIEP demonstrated comparable safety profiles, with serious complications less than 3.1% across groups. Revision procedures were common across groups (O-FAFF 61.5%, DIEP 54.5%, msTRAM 77.1%,
p = 0.16). O-FAFF was associated with fewer occurrences of secondary breast liposuction, tissue rearrangement, and scar revisions (all
p < 0.05).
CONCLUSION:O-FAFF provided surgical outcomes comparable to DIEP while avoiding abdominal morbidity and reducing certain secondary revisions. These findings support O-FAFF as a safe, effective reconstructive option, broadening choices for women undergoing autologous breast reconstruction.
Back to 2026 Abstracts
