Latissimus Flap
The breast can also be reconstructed by surgically moving a section of skin, fat and muscle to the chest from another area of your body. The section of tissue may be taken from such areas as your abdomen, upper back, upper hip or buttocks. The reconstructed breast may be made from the tissue flap alone or from the tissue flap and a breast implant.
The tissue flap may be left attached to the blood supply and moved to the breast area through a tunnel under the skin called a pedicle flap, or it may be removed completely and reattached to the breast area by a microsurgical technique called a free flap.

Who is a candidate for tissue flap surgery?

Flap surgery has the advantage of being able to replace tissue in the chest area. This may be useful when the chest tissues have been damaged and are not suitable for tissue expansion, when extra tissue is desired to recreate a large breast without a breast implant or when extra tissue coverage is needed over a breast implant.
It is important for you to be aware that tissue flap surgery, particularly the TRAM flap, requires a hospitol stay of several days, and a longer recovery time than tissue expander/implant reconstruction. It requires good general health and strong emotional motivation. Flap surgery also creates scars at the site where the flap was taken, and possibly additional scars on the reconstructed breast. But if the remaining tissues on your chest are insufficient or inadequate to allow breast reconstruction with a tissue expander and implant, you may be a good candidate for flap surgery.
If you are very overweight, smoke, have had previous surgery at the flap site or have any circulatory problems, you may not be a good candidate for a tissue flap procedure. Also, if you are very thin, you may not have enough tissue on your abdomen or back to create a breast with this method.

During a latissimus dorsi flap procedure, the surgeon moves a section of tissue from your back to your chest to reconstruct the breast.
Because the latissimus dorsi flap is usually thinner and smaller than the TRAM flap, an implant may be used under the flap to provide more volume and shape to the reconstructed breast.
The latissimus dorsi flap procedure typically takes two to four hours of surgery under anesthesia. Typically, the hospital stay is two to three days. You can resume daily activity after two to three weeks. You may have some temporary or permanent muscle weakness and difficulty with movement in your back and shoulder. You will have a scar on your back which can usually be hidden in the braline. You may have additional scars on your reconstructed breast.

Breast Reconstruction (Latissimus Flap)
Procedures by Stephen Madry, M.D.
© 2013 Stephen A. Madry, MD. All Rights Reserved.
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