Implant-Free Breast Volume Restoration Using Abdominal Free Flaps in Nononcologic Patients: A Retrospective Cohort Study.
Abstract
Abdominal free flaps are established in oncologic breast reconstruction but are less frequently used for implant-free breast volume restoration in nononcologic patients. The aim of this study was to describe the indications, operative characteristics, complications, follow-up, and secondary procedures associated with abdominal free-flap breast reconstruction or augmentation in a nononcologic cohort. The authors performed a retrospective single-center cohort study of consecutive patients who underwent deep inferior epigastric perforator (DIEP) or muscle-sparing transverse rectus abdominis myocutaneous (msTRAM) flap transfer for nononcologic indications between 2004 and 2025. Patients undergoing reconstruction for oncologic breast disease were excluded. Clinical, operative, and outcome data were extracted from medical records. Surgical complications were categorized according to timing and requirement for reoperation. Elective secondary procedures were recorded separately. Fourteen patients underwent 22 abdominal free-flap reconstructions, including 19 DIEP and 3 msTRAM flaps. Primary indications were congenital breast deformity in 8 patients, primary autologous augmentation in 3, revision after aesthetic augmentation in 2, and sequelae of breast abscess in 1. Implant-associated problems were present in 8 patients. Median follow-up was 35.6 months (range, 8.2-248.5 months). No total flap loss occurred. Unplanned reoperations were required in 4 of 22 reconstructions, including 1 during the index admission and 3 after discharge. Elective secondary procedures were performed in 4 of 14 patients. In this small, heterogeneous retrospective cohort, abdominal free flaps restored breast volume without total flap loss. Unplanned reoperations and elective secondary procedures occurred during the observed follow-up period. Level of Evidence: 4 (Therapeutic) For image description, please refer to the figure legend and surrounding text.
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BibTeX
@article{musmann2026implantfree,
title = {{Implant-Free Breast Volume Restoration Using Abdominal Free Flaps in Nononcologic Patients: A Retrospective Cohort Study.}},
author = {Robert Jonathan Musmann and Mazen Hagouan and Marc Daniels and Beatrix Munder and Katrin Seidenstücker and Sonia Fertsch and Dirk Janku and Birgit Aufmesser and Nour Abu Aballah and Sogol Rajabpour and Nora Stockhausen and Annabelle Bromba and Laura Wohltat and Benedetta Vasselli and Philipp Kuhlwein and Sarina Jamchi and Andreas Wolter and Christoph Andree},
journal = {Aesthetic surgery journal. Open forum},
year = {2026},
month = oct,
doi = {10.1093/asjof/ojag187},
url = {https://europepmc.org/article/MED/42898823},
note = {CC BY},
}
RIS
TY - JOUR
TI - Implant-Free Breast Volume Restoration Using Abdominal Free Flaps in Nononcologic Patients: A Retrospective Cohort Study.
AU - Robert Jonathan Musmann
AU - Mazen Hagouan
AU - Marc Daniels
AU - Beatrix Munder
AU - Katrin Seidenstücker
AU - Sonia Fertsch
AU - Dirk Janku
AU - Birgit Aufmesser
AU - Nour Abu Aballah
AU - Sogol Rajabpour
AU - Nora Stockhausen
AU - Annabelle Bromba
AU - Laura Wohltat
AU - Benedetta Vasselli
AU - Philipp Kuhlwein
AU - Sarina Jamchi
AU - Andreas Wolter
AU - Christoph Andree
PY - 2026
DA - 2026/10/06
JO - Aesthetic surgery journal. Open forum
DO - 10.1093/asjof/ojag187
UR - https://europepmc.org/article/MED/42898823
AB - Abdominal free flaps are established in oncologic breast reconstruction but are less frequently used for implant-free breast volume restoration in nononcologic patients. The aim of this study was to describe the indications, operative characteristics, complications, follow-up, and secondary procedures associated with abdominal free-flap breast reconstruction or augmentation in a nononcologic cohort. The authors performed a retrospective single-center cohort study of consecutive patients who underwent deep inferior epigastric perforator (DIEP) or muscle-sparing transverse rectus abdominis myocutaneous (msTRAM) flap transfer for nononcologic indications between 2004 and 2025. Patients undergoing reconstruction for oncologic breast disease were excluded. Clinical, operative, and outcome data were extracted from medical records. Surgical complications were categorized according to timing and requirement for reoperation. Elective secondary procedures were recorded separately. Fourteen patients underwent 22 abdominal free-flap reconstructions, including 19 DIEP and 3 msTRAM flaps. Primary indications were congenital breast deformity in 8 patients, primary autologous augmentation in 3, revision after aesthetic augmentation in 2, and sequelae of breast abscess in 1. Implant-associated problems were present in 8 patients. Median follow-up was 35.6 months (range, 8.2-248.5 months). No total flap loss occurred. Unplanned reoperations were required in 4 of 22 reconstructions, including 1 during the index admission and 3 after discharge. Elective secondary procedures were performed in 4 of 14 patients. In this small, heterogeneous retrospective cohort, abdominal free flaps restored breast volume without total flap loss. Unplanned reoperations and elective secondary procedures occurred during the observed follow-up period. Level of Evidence: 4 (Therapeutic) For image description, please refer to the figure legend and surrounding text.
SN - 2631-4797
ER -