Latissimus dorsi flap breast reconstruction

What is latissimus dorsi flap breast reconstruction?

Latissimus dorsi flap breast reconstruction is one of several procedures that use a patient's own tissue (fat, muscle, blood vessels and skin) to reconstruct a woman’s breasts. Using a patient’s own tissue rather than implants can provide a more natural look and feel. This procedure is performed under general anaesthesia.

The latissimus dorsi muscles (colloquially called ‘lats’) are the largest muscles of your upper body. Latissimus dorsi muscles span the mid to lower back and span from the sides to the near the centre line of the back. It’s located behind the armpit.

Why is it done?

Using donor tissue is beneficial for patients who don’t want to have an implant.

There are several breast reconstruction procedures involving a patient’s own tissue and the latissimus dorsi flap is one of them. Taking tissue from the abdomen, upper buttocks, thighs and stomach area are other options but if there is not enough donor tissue in these locations, the latissimus dorsi flap is often recommended.

What does it involve?

The breast surgeon will make an incision in the back to lift a section of tissue. This will create the ‘flap’ that is still connected to the original site. The surgeon will rotate the tissue onto the chest and shape the tissue into the new breast.

How do you prepare for the latissimus dorsi flap procedure?

Before the procedure, ensure you discuss with your breast surgeon if it’s necessary to stop any medications you’re currently taking. You should also make sure you discuss if this procedure is the right breast reconstruction for you and all potential complications.

Aftercare

After the procedure, patients will usually remain in hospital for 1-5 days and it can take about four weeks to recover. As latissimus dorsi flap breast reconstruction uses muscle and not only fat, the back may have a loss of function and strength. Physiotherapy and exercise will most likely be required to strengthen the back and increase mobility.

Alternatives to this treatment

There are several methods of breast reconstruction. They can be categorised into two groups: with implants and without implants. Patients who do not want implants may also consider:

  • TRAM (transverse rectus abdominis muscle) flap - using tissue and muscle from the stomach
  • DIEP (deep inferior epigastric perforator) flap - using tissue from the stomach, but not muscle
  • SIEP (superficial inferior epigastric perforator) flap - similar to the DIEP flat but different blood vessels are used
  • TUG (transverse upper gracilis) flap – using muscle and tissue from the inner thigh
  • Gluteal flap (GAP flap) – using tissue from the upper buttocks
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