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. 2011:11:e39.
Epub 2011 Oct 17.

Latissimus dorsi myocutaneous flap for breast reconstruction: bad rap or good flap?

Galen Perdikis  1 , Stephanie Koonce, George Collis, Dustin Eck
Affiliations

Latissimus dorsi myocutaneous flap for breast reconstruction: bad rap or good flap?

Galen Perdikis et al. Eplasty. 2011.

Abstract

Objective: This article serves to review latissimus dorsi myocutaneous flap as an option for breast reconstruction postmastectomy. Since the introduction of the latissimus dorsi myocutaneous flap in the late 1970s, its use has always been as a secondary technique, particularly after the development of the transverse rectus abdominus myocutaneous flap in the 1980s.

Methods: A literature review of the history of latissimus dorsi myocutaneous flap utilized for breast reconstruction as well as a review of our institution's experience with latissimus dorsi myocutaneous flap and tissue expander placement was performed.

Results: There remains a paucity of published studies investigating latissimus dorsi myocutaneous flap for breast reconstruction. Most studies have small numbers and do not utilize tissue expanders. More recently several small studies have been published that show acceptably low complication rates with aesthetically pleasing outcomes when latissimus dorsi myocutaneous flap is employed with a tissue expander. At our institution, we have employed latissimus dorsi myocutaneous flap with tissue expander placement for both delayed and immediate reconstruction with subsequent replacement with a permanent implant with a capsular contraction rate of 10.5%. Our data and others more recently published demonstrate very acceptable capsular contracture rates and aesthetic outcomes, particularly when an expander is utilized.

Conclusion: The latissimus dorsi myocutaneous flap remains an excellent choice for breast reconstruction with a low risk of complications.

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Figures

Figure 1
Figure 1
A patient a few days after skin sparing mastectomy and immediate breast reconstruction. The bolsters are utilized for inset of the latissimus dorsi muscle in the inframammary fold.
Figure 2
Figure 2
A patient after delayed reconstruction of right breast with latissimus dorsi myocutaneous flap.
Figure 3
Figure 3
A patient following reconstruction of the left breast with latissimus dorsi myocutaneous flap and expander following a failed deep inferior epigastric perforator flap (DIEP) flap. The right side was reconstructed with a DIEP flap.
See this image and copyright information in PMC

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