Latissimus Flap Breast Reconstruction

Many post-mastectomy patients choose to receive tissue-based reconstruction instead of breast reconstruction with implants. While this is considered a more complicated procedure, it has distinct benefits including producing a natural-feeling breast. One of the options for tissue-based breast reconstruction is latissimus dorsi flap reconstruction. This procedure uses skin, muscle and fat from the upper back to create a new breast mound.

What is Latissimus Dorsi Flap Reconstruction?

The latissimus dorsi is the long muscle that runs beneath the armpit and diagonally across the back; when you raise your arm, the muscle can be felt along the side of the rib cage. During latissimus dorsi flap reconstruction, the surgeon uses this area of muscle and skin to build a new breast. Because of this muscle’s proximity to the chest area, utilizing tissue from this region for breast reconstruction after mastectomy is a popular technique among cosmetic surgeons. Additionally, the muscle and skin flap can remain attached to its natural blood supply, making the procedure less complicated than “free flap” procedures such as DIEP flap and gluteal flap reconstruction.

Latissimus Dorsi Flap Procedure

Latissimus dorsi flap breast reconstruction is a unique procedure because the flap is not completely disconnected from its source at any point during surgery. This flap is sometimes referred to as a “pedicle flap.” During latissiumus dorsi flap breast reconstruction, a tunnel is created beneath the skin from the back muscle to the breast area. Through this tunnel, the surgeon transfers the flap to the breast area. In addition, any blood vessels that were cut during the procedure are reconnected with microsurgery.

Once the flap is in place, the surgeon forms the tissue into the desired shape, and sutures it into position. Finally, the back and chest incisions are closed and recovery begins. In some instances, a surgeon may also place a breast implant in order to produce more aesthetic results. Because the musculature of the back is slightly diminished after surgery, some patients are left with minor asymmetry, though back strength and function and minimally affected.

Benefits and Risks of Latissimus Dorsi Flap Reconstruction

Each form of breast reconstruction surgery has its own unique set of advantages, and one type of surgery may be better suited for you than others. It is important to discuss your options for treatment with your doctor in order to decide if latissimus dorsi flap reconstruction is right for you. Some of the benefits of latissimus dorsi flap reconstruction include:

• Use of own tissue creates a more natural feel than breast implant reconstruction
• Muscle and skin remained attached to natural blood supply, improving chances of breast sensation
• No foreign materials are placed in the body
• Results are long-lasting
• Increased self-confidence

Latissimus dorsi flap reconstruction has some risks and disadvantages as well, including:

• Weakened back and shoulder muscle
• Scarring at donor site and breast area
• Two surgical sites results in increased risk of infection, and more recovery time
• Not ideal for patients who are overweight or have other health problems such as diabetes

Many Patients Want to Know ...

What is "free flap" reconstruction

Free flap reconstruction refers to a type of tissue-based reconstructive surgery in which the skin and muscle from the donor site is completely removed from its natural blood supply and reconnected to a different blood supply at the breast site. This includes surgeries such as the DIEP flap and gluteal flap procedures.TRAM flap surgery can be performed as a pedicle or free flap procedure.

Contact a Plastic Surgeon

Contact a plastic surgeon to find out if breast reconstruction is right for you.