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Latissimus Dorsi Flap Reconstruction
The latissimus dorsi flap is a reconstruction technique that uses skin, fat, and sometimes muscle (the latissimus dorsi) from the patient's upper back to recreate the breast. This tissue around the upper back is rotated on its blood supply into the front of the body to recreate the breast shape. It is suited as a reconstructive technique after a mastectomy. Like the DIEP flap reconstruction, the latissimus dorsi flap is a good alternative for reconstruction when the skin over the cancer-affected breast needs to be removed together with the breast in cases such as simple mastectomy and/or delayed reconstruction. This may occur when cancer has affected the skin. The latissimus dorsi flap and DIEP flap both utilise the skin and tissue from other parts of the body to reconstruct the breast. In situations where the tissue taken from the patient's back is insufficient to create a breast form which matches the other breast, a breast implant may be used in conjunction with the latissimus dorsi flap.
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Illustration of the latissimus dorsi flap being lifted and rotated into the breast cavity. A nipple can be reconstructed using the skin in the area, or tattooed on
Reconstruction alternatives that use the patient's tissue for reconstruction (also known as autologous reconstruction) have advantages and disadvantages when compared to reconstruction using implants.
  1. Less affected by the effects of radiotherapy compared to implants
  2. Will evolve in shape and size (along with the rest of the body) as a person changes in body weight and ages
  3. Feels more natural than implants
  4. Does not require ongoing attention/maintenance
  5. Avoids risks specific to implants (e.g. rupture, capsular contracture)
  1. Potentially longer recovery time
  2. Typically involves a longer surgery
  3. May require an additional scar, depending on where the tissue is obtained (scar fades over time)
  4. Not all patients have sufficient tissue for autologous reconstruction
  5. When the latissimus dorsi muscle is used for reconstruction, the use of the muscle may lead to limited strength and mobility to perform daily tasks, or even discomfort. However, this is not common.
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