Back Muscle: Latissimus Dorsi (LD) flap
This is a surgical technique that involves transferring the back muscle (latissimus dorsi) with the surrounding fat and overlying skin into the mastectomy site. Removal of the muscle doesn’t usually affect an individual in most day-to-day activities, though some patients may notice slight shoulder weakness and stiffness.
The two variations of this technique are:
Extended LD : This involves additional recruitment of surrounding fat around the muscle +/- lipofilling to increase the size later.
LD + implant : The muscle is augmented with an implant at the same time to build up volume.
Overall, results with ELD reconstruction are very good but there are some limitations and risks.
Fluid collection on the back (seroma) occurs in 30-40% of patients and may necessitate serial needle aspirations.
Scars heal well but can become stretched and lumpy (hypertrophic).
Infection can occur which may require antibiotics.
Bleeding straight after surgery may necessitate a return to theatre.
Wound breakdown and delayed healing can occasionally occur.
Some patients get a dish like deformity in the back due to muscular transfer.
Excess tissue on the back or chest scar may require revision.
Lumpiness in the armpit as the flap passes from behind to before.
Muscle often twitches on the reconstructed breast during shoulder movement.
Stiffness of shoulder - we’ll advise on exercises to help.
Flap failure is uncommon (<1%) but may necessitate removal if it occurs.
Blood clots in the calf and lungs can occur after any major operation.
Anaesthetic risk - Although this is rare, it will be discussed with your Anaesthetist.