Abstract P2-15-02: Omentum-Lipoaspirate Free-Flap Breast Reconstruction in Women with BMI <25

Abstract The Omental Fat-Augmented Free-flap (O-FAFF) is being offered at our institution as an alternative method of breast reconstruction. This novel free-flap construct is ideal for underweight and normal weight women who lack abdominal or other donor tissue, desire to avoid donor site morbidity and/or are averse to implant-based reconstruction. We analyze omentum, mastectomy and final construct weights in women with BMI < 25 kg/m2 who underwent nipple-sparing mastectomies and O-FAFF reconstruction. Methods Operative technical features of women undergoing nipple-sparing mastectomies with immediate O-FAFF breast reconstruction over a 34 month period are included. Steps of the operative procedure are as follows: laparascopic omentectomy, liposuction and unilateral or bilateral mastectomy is performed. An acellular dermal matrix (ADM) shell is fashioned around a tissue expander. This mold is filled with the omentum and then engrafted with lipoaspirate followed by microsurgical anastomoses of gastroepiploic artery and vein to internal mammary artery and vein. Weight of biological construct is compared to native breast weight. Results 26 women with average BMI 21.2 kg/m2 underwent unilateral (15) or bilateral (11) nipple-sparing mastectomies and O-FAFF reconstruction. Average omentum weight for 37 breasts was 149 gm (82- 262) and average mastectomy weighed 212.4 gm (85 – 396). The ratio of engrafted fat to omentum weight was 0.73 for unilateral versus 0.91 for bilateral cases. The ratio of omentum-fat graft construct to mastectomy weight was 1.24 for unilateral and 0.96 for bilateral cases. Conclusion O-FAFF is a novel procedure for autologous tissue breast reconstruction after nipple-sparing mastectomy in underweight and normal weight women. Comparable weight replacement for extirpated native breast is achieved. Citation Format: Irene L. Wapnir, Monica M. Dua, Yulia Zak, Dung Nguyen. Omentum-Lipoaspirate Free-Flap Breast Reconstruction in Women with BMI <25 [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-15-02.