Studies have shown that the number of patients who opt to undergo breast reconstruction after a full or partial mastectomy is on the rise. There are several techniques that can be used to perform breast reconstruction, including using skin, tissue, and muscle grafts from the abdominal area or using a breast implant covered with the remaining breast skin and tissue. In some cases, however, a graft or a breast implant will not be suitable for reconstructing the breast. This is when a latissimus dorsi flap breast reconstruction technique might prove useful to obtain good results.

What Is the Latissimus Dorsi?

The latissimus dorsi is a muscle group along the upper side of the body, next to the shoulder and below the armpit. It is responsible for twisting motions involving the upper part of the body. Examples of such movements would be those necessary for swinging a tennis racquet or a golf club.

Latissimus Dorsi Flap Procedure

In this procedure, Dr. Paul Pin will take an oval-shaped flap of skin, tissue, and muscle from the latissimus dorsi and pull it toward the front of the body to serve as the material for reconstructing the breast. The flap remains attached to its original blood supply in the back, so there is little to no need for any microsurgery to reattach arteries and veins. This procedure is often done along with the use of an implant to replace the missing breast.

Advantages and Disadvantages of the Procedure

Advantages: A latissimus dorsi flap procedure is an excellent choice for women who may not have enough excess abdominal tissue, skin, or muscle for either a TRAM or a DIEP graft procedure. This makes it a good option for thin women who have slight frames. In other cases, a woman may need to later have a mastectomy to the remaining breast, or the first reconstructive procedure using TRAM or DIEP may have failed. In such cases, she cannot undergo another TRAM or DIEP procedure, so the graft must come from elsewhere on the body. Finally, the procedure has the advantage of needing minimal to no microsurgery to ensure a steady blood flow to the flap graft, as the latissimus dorsi has a very strong blood supply. Both the TRAM and DIEP procedures will require at least some microsurgery techniques, which not only can mean longer recovery times, but a higher risk of complications, including possible tissue death due to inadequate blood supply.

Disadvantages: One disadvantage to the latissimus dorsi procedure is that patients may have reduced mobility in the area from which the flap was harvested. This may make it difficult to twist or turn the upper body, so having the same procedure done on both breasts is not recommended. Patients may also find that because fat from the back is firmer than that from the abdomen, the reconstructed breast may feel tighter than the remaining one.

Overall, a latissimus dorsi flap procedure is an excellent fallback technique to use in cases where other reconstructive techniques have failed. Many of Dr. Pin's patients have had excellent results with this technique, either as a primary or secondary option.