Applications of the Fold Flap in Breast Reconstruction

We read with great interest the article “Reverse Submammary Adipofascial Perforator Flap: Preliminary Results of a Dual-plane Acellular Dermal Matrix-free, Direct-to-implant Hybrid Reconstruction” by Ribuffo et al.1 After the COVID-19 pandemic,2 in 2023, we published in your journal an article entitled: “Fascio adipose intramammary fold flap for full expander coverage in breast reconstruction” by Baccarani et al.3 The described technique relies on the same pedicle (intercostal perforator) and, with some technical differences, resembles the one described by our group, albeit with different indications. Recently, we have also used the fold flap in direct-to-implant subpectoral reconstructions, for managing fistulas or to support skin healing after implant exposure, especially in irradiated patients. We have found this technique to be very promising and, therefore, would like to support Prof. Ribuffo’s conclusions. We are happy to note that this new technique may be a valuable tool in the field of breast reconstructive surgery and hope that further studies from different groups will come along with the 2-fold purpose of scientifically validating the idea and creating a consensus. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.