Latissimus Dorsi Flap

Breast reconstruction after mastectomy (removal of breast tissue to treat breast cancer) can involve the use of an artificial implant or a flap of your own tissue removed from another part of your body and inserted into your chest. Latissimus dorsi flap is a flap of tissue containing the latissimus dorsi muscle that is located in the back, below the shoulder blade and behind the armpit, which helps in twisting and lifting your arm. The latissimus dorsi flap procedure involves using muscle, fat and skin from the latissimus dorsi area for breast reconstruction.

You may be recommended for a latissimus dorsi flap if you have small sized breasts, sufficient tissues in the latissimus dorsi area and have previously undergone radiation. This flap is usually preferred because of its close proximity to the breast, making it less complicated to transfer the tissue while it remains attached to its original blood supply. However, you will be advised against this procedure if you participate in sports activities such as swimming and skiing, activities which depend largely on these muscles.

Latissimus dorsi flap procedure is performed under general anesthesia on an inpatient basis. Your surgeon makes an incision near the shoulder blade and elevates a portion of skin, muscle, fat and blood vessels and moves it to the breast defect area through a tunnel formed under the skin. This tissue is then shaped into the breast mound. The blood supply is left intact. Your surgeon may also insert an implant under the flap. The incision is closed. The entire procedure takes about 4 to 6 hours to complete. You may be required to stay in the hospital for 4 to 5 days.

As with any surgery, latissimus dorsi flap insertion may involve certain risks and complications such as tissue breakdown, muscle weakness, lump formation and deposition of fluid under the wound.