Comparison of the Pedicled Latissimus Dorsi flap with Immediate Fat (LIFT) Transfer versus Abdominally-Based Free Tissue Transfer for Breast Reconstruction.

CONCLUSIONS: Both the LIFT and abdominally-based FTT have similar outcomes and complication rates. However, the LIFT may be preferred in patients that require shorter operation times. The LIFT may be the fully autologous breast reconstruction of choice for non-microsurgeons.

METHODS: A retrospective review of a prospectively maintained database between March 2017 and July 2018 was performed to compare the LIFTs and FTTs by the senior surgeon. Outcomes of interest included post-operative complications, flap success, and follow up revision and fat grafting procedures.

PURPOSE: Abdominally-based free tissue transfer (FTT) and latissimus dorsi and immediate fat transfer (LIFT) procedures are both fully autologous options for breast reconstruction. The former is specialized and requires comfort with microsurgical technique while the LIFT combines a common set of techniques familiar to all plastic surgeons. Comparison of the two methods for clinical effectiveness and complications for equivalency in outcomes may help elucidate and enhance patient decision making.

RESULTS: 65 breasts were reconstructed by FTT; 31 breasts were reconstructed with the LIFT. Demographics were similar (p>0.05). The LIFT had a shorter length of operation time (343+/-128 vs. 49+/-137 min) (p<0.0001) and a shorter length of stay (1.65+/-0.85 vs 3.83+/-1.65 days) (p<0.001). FTTs had a shorter time until drain removal (13.3+/-4.3 vs 24.0+/-11.2 days) (p<0.0001). The number of major (requiring operation), and minor complications were not statistically different (FTTs: major 20.0%, minor 27.7%; LIFT: major 12.9%, minor 19.35%) (p>0.05). The need for revisions (FTTs 0.80+/-0.71 vs. LIFT 0.87+/-0.71) and fat grafting (FTTs 41.54% vs. LIFT 58.8%) were not statistically different (p>0.05).

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