Latissimus dorsi breast reconstruction. Long term results and return of sensibility

Abstract

The long-term results of 44 patients who underwent breast reconstruction after mastectomy with latissimus dorsi musculocutaneous flaps with endoprostheses were studied. Good symmetry without a brassiere was achieved in 15 patients, slight asymmetry in 24 and poor symmetry in five (11%). Symmetry when a brassiere was worn was acceptable in all but one of the patients (43/44). A third of the patients (n = 13) had developed unacceptable (grade III or IV) capsular contraction, but 39 (89%) of the patients studied were satisfied with the long-term reconstruction. Cutaneous sensibility, measured by von Frey's test, had returned to 28 (64%) of the cutaneous skin islands, to their medial parts in particular. The flaps in patients who had received concentrated radiation or who had large prostheses remained numb. Sensation was normal in the scars of the donor areas in all but three patients. Latissimus dorsi breast reconstruction with an endoprosthesis is safe and simple. It gives a subjectively satisfactory result in nine out of 10 patients and is therefore a valuable method of reconstruction after mastectomy.