Latissimus flap breast reconstruction uses skin, fat and muscle (latissimus dorsi) from the back, beneath the shoulder blade area. The tissue ("flap") is brought around to the chest to create a new breast.
When latissimus flap reconstruction is being performed under the same anesthesia as the mastectomy ("immediate reconstruction"), the flap portion of the surgery typically won't begin until after the mastectomy has finished. Following the mastectomy, the patient is turned onto her side or stomach and the flap harvest begins. In some instances the mastectomy can be performed with the patient on her side. In these cases, the latissimus flap surgery can begin at the same time as the mastectomy.
A section of skin, fat and muscle is lifted off the back from below the shoulder blade region. This tissue is then tunneled to the front of the chest to create the new breast. The patient is then turned onto her back to complete the shaping of the new breast.
Many patients undergoing a latissimus flap procedure require also require a tissue expander or fat grafting (or both) for additional volume. If a tissue expander is going to be used, this is placed at the time of the initial flap surgery and replaced by a permanent implant at a second procedure down the line (known as the "revision stage" or "stage 2"). Fat grafting can be added at stage 2 to address contour defects resulting from the mastectomy. Fat grafting alone can also be used to add volume and allows some patients to avoid implants altogether.
The procedure leaves a scar on the mid-back region below the shoulder blade that can sometimes be seen through a tank-top, swimsuit or sundress. The upper back can be numb or for a few months until the nerves grow back. Some patients will experience areas of permanent numbness. Women who are very active in sports should know that this procedure can impact ability to participate in activities like golf, climbing, swimming, or tennis.
- The latissimus flap uses skin, fat and muscle from the back to create a new breast
- The flap is tunneled under the skin and into the chest to create a new breast
- Many patients also require a tissue expander or fat grafting for additional volume
- The procedure leaves a scar on the mid-back region below the shoulder blade
- To learn if you are a latissimus flap candidate or to schedule a consultation, please contact us here or call us at (800) 692-5565.