Latissimus Dorsi Myocutaneous Flap +/- Saline/Silicone-Filled Breast Implant
The latissimus dorsi flap is a rotational autologous flap made up of skin, fat, muscle and the associated blood vessels that keep it alive. This flap does not require microsurgery and often times is used in combination with breast implants. In general, this is a more painful method of breast reconstruction and it is associated with a significant donor site incision. Some surgeons have explored novel endoscopic techniques to avoid the donor site incision and eventual scar. It also has been associated with recurrent fluid collections in the back donor site where the muscle is removed.
A latissimus dorsi flap can be completed in the setting of a 4-hour general anesthetic and a 3-day hospital stay as a Stage 1 procedure. Some patients elect for the placement of an immediate implant versus a tissue expander with an exchange to a permanent implant as a Stage 2 procedure. There are benefits to each approach depending on your prior history of irradiation or need for irradiation in the future. Blood thinners are administered in the peri-operative period to prevent deep venous thromboses or pulmonary emboli.
Nipple and areolar reconstructions are preformed as staged procedures (see below).
Dr. Marga would be pleased to discuss this reconstructive option with you noting its specific risks and benefits.