Use of free flaps in aesthetic breast surgery: a single centre experience and literature review

  • Author Footnotes
    # Equally contributing first authors
    Giovanni Zoccali
    Corresponding Author: Giovanni Zoccali, Department of Plastic & Reconstructive Surgery, IRCCS – Regina Elena National Cancer Institute, Queen Victoria Hospital NHS Foundation Trust, Via Elio Chianesi, 54-00144, Rome, IT, +3393506292
    # Equally contributing first authors
    Plastic and Reconstructive Surgery Department, IRCCS – Regina Elena National Cancer Institute, Rome, IT

    Plastic and Reconstructive Surgery Department, Queen Victoria Hospital, East Grinstead, UK
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  • Author Footnotes
    # Equally contributing first authors
    Ahmed Hagiga
    # Equally contributing first authors
    Plastic and Reconstructive Surgery Department, Queen Victoria Hospital, East Grinstead, UK
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  • Jian Farhadi
    Plastic Surgery Group, University of Basel, Zurich, Basel, CH
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  • Author Footnotes
    # Equally contributing first authors
Published:November 22, 2022DOI:



      Implant based breast augmentation is one of the most performed procedures in aesthetic surgery whereas autologous tissue application is confined to fat grafting as adjuvant procedure. The use of free flaps in cosmetic mammoplasties is not popular but the number of reports in the literature are increasing. We believe autologous tissue transfer for cosmetic purposes could be valuable alternative for volume enhancement in selected conditions especially following weight loss. In this paper, we provide a systematic literature review of the current literature of using autologous free flaps for breast augmentation in non-cancer patients and also report our experience on this topic to identify possible indications and criteria for the patients’ selection.


      PRISMA's guideline have been followed for the literature review.
      In order to demonstrate the feasibility and safety of, and patient satisfaction with, breast volume enhancement with autologous tissue, a retrospective single-centre study was conducted on women who underwent breast volume enhancement with autologous tissue.
      Patient's satisfaction was assessed with VAS creating an ad-hoc outcome scale and data summarised with descriptive statistic.


      Twelve patients were enrolled in the study. Weight loss was the main indication for surgery. The average length of procedure was 5.1h and the hospitalization was 2.3days. After 12-month patient outcome was excellent in 2 cases, good in 9 and one case moderate.


      Although further researches are needed, the literature review and our case series show that the use of free flaps for breast volume enhancement is safe and gives a satisfactory outcome.

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