
Breast Reconstruction With Latissimus Dorsi Flap

Author: Dr. Gary Arishita
What is Latissimus flap breast reconstruction?
A latissimus (LAT) flap is a procedure where part of the muscle on the back is used to do a reconstruction. A small segment of skin is also included with that muscle to do a reconstruction of the breast on the same side. The majority of the time a tissue expander and implant is used on these cases because the muscle does not provide a huge amount of volume to the reconstruction. So if a woman undergoing breast reconstruction has a breast that is large (c or d cup), it probably won’t be sufficient to do the reconstruction solely with the LAT flap and tissue expander and implant would be required.
There is an alternative procedure where a slightly larger volume of fatty tissue is used with the LAT and that is called an extended LAT flap and in those cases we do not need a tissue expander and implant. The only drawback with this procedure is that it is associated with a slightly higher incidence of complication in the site where the LAT came from.
As far as the aesthetic appearance of the back after this procedure, we are usually able to place the scar along where a normal bra would be located; therefore if a woman wears a low cut dress, the scar would be hidden. So it wouldn’t have a negative impact on the aesthetics if a LAT flap is required.
A study published in Plastic and Reconstructive Surgery examined the abdominal recovery rates and patient satisfaction after breast reconstruction with different abdominal flaps: the DIEP, SIEA and muscle-sparing free TRAM.
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Linda
I had an extended lat flap 12 years ago and am still getting therapy every 2 weeks because of the complications. It may look good, but it totally ruined my body functioning. I hope plastic surgeons explain the possible complications so patients can make truly informed decisions. Women care more about how they feel than how they look. I wasn’t told of any possible complications. I was just given a pamphlet from an implant manufacturer with all the possible risks of implants and decided I didn’t want them. I wish every day I could have my reconstruction reversed. I’m sure procedures have changed quite a bit in the past 12 years, but it’s just something to consider. Removing a muscle from your back affects your whole body
Debra
Linda, could you tell me some of your issues, I had that procedure March 2011, @ the same time I had my mastectomy. I am having issues also, just assumed I tried to do too much in one day?! Thanks & sorry you are still dealing with all that!
Joyce
I had a latissimus dorsi procedure in April last year and had/have a reoccurrence of bc on the same site. I truly regret the surgery as I was 10yrs free of the disease – I have asked my surgeon to remove the implant early Dec…..has anyone had the implant removed with some relief???? Pse message me on ljoyce748@aol.com I wld love to hear from you!
PRMA Plastic Surgery
So sorry to hear Joyce! Please know we are thinking of you! Wishing you the best as you and your plastic surgeon work together and make the best decisions for you!