Breast reconstruction with a latissimus dorsi flap • hello healthy

Definition

What is breast reconstruction with a latissimus dorsi flap?

Breast reconstruction is a medical procedure to form new breasts after mastectomy. The reconstruction is performed using donor muscle, fat, and skin from the back (latissimus dorsi flap), usually with an implant.

What are the benefits of a reconstruction procedure with a latissimus dorsi flap?

Breast reconstruction with a latissimus dorsi flap is performed to get your breasts back in shape. The donor tissue from your body will give your breasts a natural appearance.

When should I do breast reconstruction with a latissimus dorsi flap?

The tissue donor for the latissimus dorsi flap is taken from an area closer to your chest, rather than the abdominal tissue donor, and the blood vessels in this area are generally more solid.

The latissimus dorsi procedure is a reconstruction option that is generally recommended if your team of surgeons assesses your condition as unsuitable for other reconstructive procedures, such as:

there are not enough tissue donors in your abdomen
You've had a flap from a previous procedure that didn't work and need another method
You don't have access to a plastic surgeon who can perform microsurgery without using a flap

A latissimus dorsi flap is also a great choice for women with small or medium breast sizes, as the back tissue usually does not contain much fat which can be used to support your new breasts. In general, breast implants must be inserted under the flap to produce the desired shape, size and projection of the breast. The latissimus dorsi flap will leave a scar on your back, but the surgeon will generally make an incision where your bra can cover.

Precautions & warnings

What should I know before performing breast reconstruction with a latissimus dorsi flap?

Although the latissimus dorsi flap is generally recommended as a low-risk breast reconstruction option, this cosmetic surgery has several drawbacks:

You may lose some strength and function in your body, making it difficult for you to lift objects and stretch. This can affect your ability to perform certain activities, such as swimming, playing golf or tennis, or turning an object around. The latissimus dorsi procedure is generally not an option for use in reconstruction of both breasts because you can have muscle problems on both sides of your body.

Most women require implants at the same time as a latissimus dorsi flap, and some women report their implants feeling softer than the front tissue.

The texture of the fat around the latissimus muscle is stiffer, when compared to the fat in the abdominal area, therefore, most women report that the reconstructed chest of the latissimus dorsi feels firmer than the other breasts.

Furthermore, if you have an implant implanted under the latissimus dorsi flap, there are some risks similar to implant reconstruction.

What are the alternatives to dorsi flap reconstruction?

You can use bras with pads or bra inserts that shape the breasts.

Reconstruction with implants only is possible.

Which breast implant should I choose?

The implant is made of a silicone bag which can be filled with silicone (gel / liquid) or saline water . Liquid silicon and saline water will give the implant a more supple and natural appearance. Silicone in gel form will give your breast implants a firmer, more shapely appearance. General silicone gel is recommended for women who are undergoing breast reconstruction.

If you don't have enough skin tissue or you've had a mastectomy, your surgeon may need expandable implants.

Process

What should I do before breast reconstruction with a latissimus dorsi flap?

Before having a mastectomy, your doctor will schedule you to consult a plastic surgeon. Generally, your doctor and plastic surgeon will work together to design a breast reconstruction strategy that suits your condition.

The reconstructive procedure is performed after you have been given general anesthesia. Follow all of your doctor's instructions for preparation for surgery, including eating and drinking guidelines, adjusting medications, and quitting smoking.

How is the breast reconstruction process with a latissimus dorsi flap?

The procedure takes about 4 - 6 hours.

The surgeon will make an oval-shaped incision in your back, usually along a fold of skin, and an incision in your breast. Then, he will move the latissimus dorsi muscle that is located in the back to the front of your chest to create your new breast shape. If you need implants, the surgeon will make an incision under the flap and separate the surrounding tissue to make room for the breast sac implant.

What should I do after breast reconstruction with a latissimus dorsi flap?

You will be able to go home 2 - 6 days after the procedure.

You can return to your normal routine in 4 - 6 weeks.

Using a soft and well-fitting bra will help relieve postoperative discomfort. If you have a latissimus dorsi flap in both your breasts, it may be difficult to lift or pull your body.

If you have expandable implants, you will have regular consultations scheduled with your doctor.

The shape of the reconstructed breast will look natural over time, generally a few weeks to a year after the procedure.

Complications

Complications

General Complications

pain
bleeding
infection in the surgical area (wound)
mild scarring
blood clotting

Specific Complications

Breast reconstruction complications:

a lump arises under the scar from the operation
loss of the flap
skin necrosis
unnatural movements or twitching of the reconstructed breast
differences in shape and appearance
numbness or prolonged pain around the armpit or inner arm
permanent numbness in wounds on the back and on the surface of the reconstructed breast
stiff shoulders
the arm feels weak

Breast implant complications