Breast reconstruction with latissimus dorsi flap

Latissimus dorsi flap breast reconstruction is one of the most common techniques used following mastectomy. This method is often criticized for causing back pain, but advances in surgical techniques now minimize back-related complications, allowing for a quicker return to normal activities post-surgery.

Latissimus dorsi flap breast reconstruction: is it a good practice?

Latissimus dorsi flap breast reconstruction involves taking the latissimus dorsi muscle from the back along with skin and transferring it to the mastectomy site to reconstruct the breast. This procedure can be combined with the placement of a breast implant during the same operation.

This technique often has a negative reputation and is known for leaving back pain as a side effect. However, recent advancements have significantly reduced these complications, allowing patients to return to normal activities quickly. For information on other types of breast reconstruction using flaps, click here.

1. Autologous Latissimus Dorsi breast reconstruction

This breast reconstruction technique eliminates the need for implants. Initially, the reconstructed breast may be smaller, but volume can be added later through fat grafting. This method replaces the implant with fat alone, providing a more natural and stable result over time, and avoids the need for future implant replacements.

2. Latissimus Dorsi breast reconstruction with partial muscle removal

This breast reconstruction technique involves removing only a portion of the latissimus dorsi muscle, as opposed to the traditional method which removes the entire muscle. Known as “muscle-sparing” latissimus dorsi flap reconstruction, this approach retains 80-90% of the muscle, significantly reducing back-related complications such as pain.

3. Latissimus Dorsi flap breast reconstruction without muscle removal

This more complex reconstruction method avoids removing any muscle. Instead, only skin is harvested while the entire latissimus dorsi muscle remains intact, referred to as the “TDAP” (Total Dorsal Adipofascial Pedicle) flap. This approach minimizes muscle removal and its associated complications.

The patient arrives at the clinic in the morning. Latissimus dorsi flap breast reconstruction is performed under general anesthesia and typically lasts between 1.5 and 2 hours.

Generally, the patient can go home the next day with drains in place. If desired, a longer stay at the clinic to have the drains removed can be arranged. Physiotherapy sessions may be beneficial around one month post-surgery. Expect approximately 3 weeks off work.

The cost of latissimus dorsi flap breast reconstruction varies depending on the technique used. This breast reconstruction procedure is covered by health insurance.