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Long-Term Breast Morphological Analysis After Ergonomic FALD Flap Reconstruction: A Case-Control Study
Gennaro D'Orsi1, Benedetto Longo1, Alessio Farcomeni2
1Division of Plastic Surgery, Department of Surgical Sciences, School of Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy.
Journal of Reconstructive Microsurgery
|March 6, 2026
Summary
The ergonomic Fat-Augmented Latissimus Dorsi (FALD) flap offers superior long-term breast reconstruction outcomes. This technique provides greater breast projection and improved aesthetic results compared to the traditional FALD flap.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Breast Reconstruction
Background:
- The Fat-Augmented Latissimus Dorsi (FALD) flap combines Latissimus Dorsi (LD) muscle flap with autologous fat transfer (AFT) to enhance breast reconstruction (BR) volume.
- The ergonomic FALD flap is an advancement designed for complete BR in a single surgical step.
- This study compares long-term morphological breast changes after ergonomic FALD flap versus traditional FALD flap reconstruction.
Purpose of the Study:
- To compare the long-term morphological variations of the breast after ergonomic FALD flap reconstruction versus the traditional FALD flap technique.
- To evaluate differences in breast projection, width, and height between the two FALD flap methods.
- To assess and compare aesthetic outcomes, including breast shape and overall patient satisfaction.
Main Methods:
- A prospective case-control study involving patients undergoing BR with FALD flaps between December 2020 and April 2023.
- Patients were divided into two groups: Group A (ergonomic FALD flap) and Group B (traditional FALD flap).
- Primary endpoints included breast projection, width, and height; secondary endpoints focused on aesthetic outcomes. Propensity score weighting analysis was used.
Main Results:
- 42 ergonomic FALD flaps (Group A) and 37 traditional FALD flaps (Group B) were performed.
- After 12 months, Group A demonstrated significantly higher breast projection (6.78 vs. 5.75; p<0.0001) compared to Group B.
- Aesthetic analyses revealed superior breast shape (p=0.003) and global score (p=0.023) in the ergonomic FALD flap group.
Conclusions:
- The ergonomic FALD flap technique leads to superior long-term aesthetic outcomes in autologous breast reconstruction.
- This advanced technique results in significantly greater breast projection compared to the traditional transverse FALD flap.
- The ergonomic FALD flap represents an improved approach for achieving optimal results in breast reconstruction.
