Latissimus Dorsi Flap for Breast Reconstruction

ABSTRACT

Breast reconstruction following mastectomy has, become increasingly popular in recent years. Reconstruction surgeons have responded to patients' needs for effective and versatile procedures that will restore the normal shape and symmetry of breasts. Among the various techniques for these purpose, transverse rectus abdominis myocutaneous(TRAM) flap is now cosidered as the most acceptable technique. However, there are some limitations to use the TRAM flap, such as heavy smoker, obesity, and previous abdominal surgery. Also TRAM flaps are not good candidates for the patients with absent anterior axillary fold. In these respects, latissimus dorsi flap can be used as an alternative method for successful breast reconstuction. Latissiomus dorsi flaps have several advantages as compared to TRAM flaps, such as reliable blood supply, versatility of skin paddle orientation, and low donor site morbidity. It is also available for patients without anterior axillary fold, such as radical mastectomy defect or Poland syndrome. Latissimus dorsi flaps, however, and implants to obtain projection and symmetry of the reconstructed breast. Main disadvantages of latissimus dorsi flap method are difference in color and texture between skins of flap and chest, and capsular contracture resulted in high riding implant or distortion of breast contour. In this study, we performed latissimus dorsi flap for reconstruction fo breast and anterior axillary fold in 10 cases. To minimize the above problems more fullness and natural shape, implants were completely covered with muscle and overexpanded for more than 3-months and then deflated to the desired volume. These maneuvers produced aesthetically acceptable results during the latissimus dorsi breast reconstruction.