What is Latissimus Dorsi Tissue Flap Breast Reconstruction?The latissimus dorsi is a tissue flap procedure that uses muscle and skin from your upper back to create a new breast mound after a mastectomy. An ellipse of skin and your latissimus dorsi muscle will be tunneled from your upper back to your mastectomy area to create your reconstructed breast. Your reconstructed breast will not look and feel exactly the same as your natural breast, and you will need additional surgery to create a nipple and areola, if your own cannot be saved.
Advantages of the Latissimus DorsiA tissue flap breast reconstruction such as latissimus dorsi should last you for life. It may require a small breast implant, in addition to your own tissue. The transplanted skin will be a close color match for your breast skin. Your reconstructed breast will feel warm and somewhat flexible.
Disadvantages of the Latissimus DorsiThe Latissimus Dorsi method is considered a major procedure, and you will be in surgery longer than a patient who is getting breast implants only. Healing will also take longer with a tissue flap procedure, since you will have two surgical sites and two scars. Afterward, many women may experience weakness in the arm and back muscles and need physical therapy. There is a risk of developing infection at the surgical sites and experiencing trouble healing. The risk of failure for the latissimus dorsi is less than 1%. A very experienced plastic surgeon can try to prevent complications and flap failure.
You're Not a Candidate If...Blood vessels will be moved and reconnected during a tissue flap procedure, so if you have any conditions that affect your circulation, you would not have successful tissue transplantation. Women who have any of these problems are not candidates for tissue flap reconstruction:
- vascular disease
- connective tissue
Breast Reconstruction Now or Later?Breast reconstruction can be done at the same time as mastectomy or after treatment. If you need radiation therapy to the underarm area or chest, however, it is worth waiting; having the procedure done before treatment is complete severely limits a radiation therapist's ability to treat you properly.
If you are thinking about reconstruction, it's a good idea to talk with your plastic surgeon before having a mastectomy. This gives you the chance to have measurements and pictures taken of your natural breasts, so your reconstructed breast can be recreated as accurately as possible. Your plastic surgeon will have a range of options to offer you, and can help save skin and prevent unnecessary scars, if you consult with him beforehand.
What to Expect During a Latissimus Dorsi Breast ReconstructionYou will not be awake during your mastectomy or reconstruction, so you will have intravenous sedation or general anesthesia. Talk to your surgeon and the anesthesiologist about which will work best for you, and be sure he or she is informed of all medications and supplements you are taking. If you are having a mastectomy and reconstruction at the same time (immediate reconstruction), your general surgeon will first remove your breast, sparing as much skin as will be safe to keep.
Getting Ready for Latissimus Dorsi Breast Reconstruction
Moving Muscle and Skin
Closing Incisions and Starting Recovery
Recovering from Latissimus Dorsi Breast ReconstructionYou may need to stay in the hospital for three or four days as you begin healing from breast reconstructive surgery. If you have surgical drains, you will learn how to empty those and keep records of the fluid volume. Report pain if you have any, so that it can be treated. Don't go right back to work – plan on taking it easy for three to six weeks for recovery. Be sure to have someone around to help drive you and do any lifting. Be sure to go for your follow-up appointments so your surgeon can keep an eye on your incisions and dressings and remove your drains.
American Cancer Society. Breast Reconstruction After Mastectomy. Types of Breast Reconstruction. Revised: 09/06/2007.
National Cancer Institute. Surgery Choices for Women with Early-Stage Breast Cancer. Step 3. Find out about your breast cancer surgery choices. Breast Reconstruction Surgery. Posted: 10/22/2004.