
Latissimus Dorsi Flap
Breast reconstruction using a latissimus dorsi flap is typically performed in combination with a tissue expander or an implant, but can be used alone in small-breasted women. This option is best suited for breasts where the skin is very thin or has been damaged by radiation; both situations where implants alone often fail to deliver pleasing results. The procedure is performed by harvesting an elliptical patch of skin, along with the latissimus muscle from the patient’s back. This “flap” is then tunneled under the skin below her underarm and used to cover the expander or implant, creating the breast shape. In effect, the back skin and muscle are used to replace the thin or radiotherapy-damaged skin, effectively covering the implant or expander with healthy soft tissue. This approach leads to a more attractive, natural breast shape. While very nice cosmetic results can be achieved, the downside of the latissimus flap includes a donor site scar on the patient’s back, a longer surgery, and a longer recovery. Patients will typically stay one or two nights in the hospital and full recovery takes 4-6 weeks.