Summary
Background
Despite several efforts have been made to increase the volume of the latissimus dorsi
(LD) flap, few studies have reported the outcomes of LD flap and immediate fat transfer
(LIFT) to restore a natural native breast appearance during the initial reconstructive
procedure. The aim of this study was to report the different surgical techniques used
when implementing LIFT for breast reconstruction and evaluate the postoperative outcomes.
Methods
A systematic search was conducted across PubMed, Embase, Web of Science, Ovid MEDLINE®,
and Scopus. We included articles reporting postoperative outcomes of patients who
underwent breast reconstruction with LIFT.
Results
We included nineteen studies reporting outcomes of 704 breast reconstructions with
LIFT (57.09%). The average age and BMI of patients were 51 years and 26.01 kg/m2. The pooled rate of patients requiring additional fat grafting following LIFT was
64.9% (95% CI 43.3%-86.5%). The overall pooled incidence of total flap loss was 3%
(95% CI <0%-7.2%), wound-related complications was 14.5% (95% CI 7.3%-21.7%), seroma
was 18.2% (95% CI 5.1%-31.2%), and fat necrosis was 14.5% (95% CI 4.5%-24.4%). When
compared with abdominal free flaps, we found a significantly lower risk difference
of developing wound-related complications favoring LIFT (RD, 0.066; 95%CI 0.004–0.129;
p = 0.038).
Conclusions
LIFT offers a totally autologous, less morbid type of reconstruction in breast cancer
patients who are not ideal candidates for reconstruction with free tissue transfer.
However, immediate fat transfer during reconstruction with the LD flap does not eliminate
the need for further fat grafting.
Keywords
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Article info
Publication history
Published online: August 22, 2022
Accepted:
August 16,
2022
Received:
May 12,
2022
Footnotes
✰The contributions of all authors: (i) Conceptualization: Escandón JM, Manrique OJ; (ii) Data curation: Escandón JM, Escandón L; (iii) Formal Analysis: Escandón JM, Escandón L; (iv) Funding acquisition: Escandón JM, Manrique OJ; (v) Investigation: all authors; (vi) Methodology: Escandón JM, Escandón L, Manrique OJ, (vii) Project administration: all authors; (viii) Resources: Escandón JM, Manrique OJ; (ix) Software: Escandón JM, Escandón L;, (x) Supervision: OJ Manrique, (xi) Validation: all authors; (xii): Visualization: all authors; (xiii) Writing – original draft: all authors; (xiv) Writing – review & editing: all authors.
Identification
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© 2022 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.
