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A study of 100 breast reconstructions using omental fat-augmented free flaps shows high satisfaction rates and low complications, with fat retention confirmed by MRI.
The omental fat-augmented free flap (O-FAFF) is a versatile option for breast reconstruction, with additional applications as a biologic implant and for concurrent management of upper extremity lymphedema. This study reviews the clinical applications, outcomes, complications, and patient-reported outcomes of the first 100 O-FAFF reconstructions performed between 2019 and 2024.
A total of 100 O-FAFF reconstructions were performed in 71 patients. The average age was 49.44 years and average BMI was 22.86. The average hospital stay was 3.25 days. Five patients received a stacked O-FAFF with a myocutaneous flap; 5 had hybrid reconstruction with saline implants; and 4 underwent concurrent omental vascularized lymph node transfer. 7.14% required return to the operating room or procedural intervention. Patients required an average of 1.35 revision procedures, mostly for volume augmentation with fat grafting (46.48%).
Postoperative MRI confirmed fat retention, with retained fat volume equivalent to at least 100% of the initial omental weight. Patients reported high rates of self-confidence, emotional health, and self-worth after O-FAFF reconstruction. Patients who had laparoscopic omental harvest reported more satisfaction with abdominal scarring than those with open harvest. 77.14% of respondents selected ratings of 8 or greater out of 10 for overall quality of life.
If you are considering autologous breast reconstruction, ask your surgeon about omental flap options, complication rates, recovery time, and whether laparoscopic harvest is available to minimize scarring.
This content summarizes scientific publications and professional-society guidelines; it does not replace your surgeon's or anesthesiologist's evaluation. Every item links its original source.