Latissimus Dorsi Flap Reconstruction (Back)
Use of tissue from your back is a less common type of breast reconstruction and is typically reserved for a specific subset of patients:
- The patient has failed previous reconstructive attempts and does not have adequate skin that is soft and supple enough for implant-based reconstruction only.
- The patient has undergone a mastectomy and radiation and does not have enough donor tissue from the abdomen.
Oftentimes, the latissimus flap does not provide enough tissue to reconstruct an entire breast. In this case, an implant is often required underneath the flap to achieve the desired shape, size and projection of the breast.
The Latissimus Dorsi Flap Procedure
The surgery is typically 4 hours long for reconstruction of one breast and 8 hours long for reconstruction of both breasts. The Latissimus Dorsi muscle is located on your upper back just below your shoulder blade. The muscle and an overlying ellipse of skin are used to reconstruct the breast. Unlike the abdominal flap, where the blood vessels are usually disconnected and transferred to the chest, the blood vessels of the latissimus flap stay attached to the flap. The flap is then moved from the back to the breast pocket by tunneling it underneath the intervening skin, leaving its blood supply completely intact.
Recovery after the Latissimus Dorsi Flap
Following surgery, the patient is admitted to hospital for 2 days. Drainage tubes will be inserted in the back and breast and will be removed by Dr. Yau when the drainage has decreased sufficiently, usually by post-operative day 10-14. Patients typically resume regular activities in 2 weeks and full strenuous exercise in 4 weeks. Nipple reconstruction typically occurs 3 months after surgery.