Li Ying Teoh, Mee‐Hoong See, Yin Cheng Lim, Shaqirah Azraq Alya, Lee Lee Lai, Suniza Jamaris, Visnu Lohsiriwat, Wei Qi Soh, Chen Hoi Lee, Yee Chi Wong, Qing Yi Tan, Jing Hui Ng
Background: Traditional mastectomy often results in aesthetic and psychological concerns for patients. The latissimus dorsi (LD) flap remains a widely used autologous option, especially in Asian women with smaller breast volumes. However, volume deficiency remains a limitation. This study assesses the feasibility and outcomes of fat-augmented LD (FALD) flap reconstruction. Methods: system and injected into the LD flap and surrounding tissues. Cosmetic outcomes were assessed using Aesthetic Item Scale (AIS) and Body Image Scale (BIS) at 1, 6, and 12 months postoperatively. Results: Median age was 41 years. Average fat volume injected was 232 mL. Most patients were satisfied with their cosmetic outcomes; however, satisfaction declined slightly over time. The nipple-sparing mastectomy (NSM) group consistently scored higher in AIS compared to skin-sparing mastectomy (SSM). Interrater agreement between patients and assessors was low [intraclass correlation coefficient (ICC) <0.5]. Complications were minimal and manageable. Conclusions: FALD flap reconstruction is a feasible, single-stage procedure with promising cosmetic and patient-reported outcomes, especially in patients unsuitable for larger volume flaps.