Latissimus Flap

Latissimus Flap Breast Reconstruction San Diego

With the Latissimus flap breast reconstruction procedure, Dr. Gupta uses the latissimus muscle from the upper back, and the overlying skin and fat, to reconstruct the breast. The tissue from the back is left attached to its blood and nerve supply in the armpit, and is tunneled through the armpit from the back to the chest. Once in the chest, the back tissue is re-shaped to reconstruct the breast. The back skin is used to replace the skin removed from the mastectomy and the fat and muscle tissue are used to reconstruct a natural looking and feeling breast mound. The resulting wound on the back is then repaired, leaving a horizontal scar. Dr. Gupta will plan the breast reconstruction surgery so that the resulting horizontal back scar hides underneath the line of the patient’s bra or a two-piece bathing suit.

flap diagram

Step 1: Following the mastectomy the patient is turned onto her side in order to raise the latissimus dorsi flap from the back. Dr. Gupta will design the flap in order to hide the eventual scar under the patient’s bra line. The back skin and muscle are carefully dissected, leaving them attached to their blood supply. The tissue is passed through a tunnel in the armpit into the chest mastectomy incision. The back incision is then closed in layers to leave a horizontal hidden scar.

flap diagram

Step 2: After the latissimus flap is raised from the back, the patient is turned onto her back, and Dr. Gupta reshapes the tissues to form a natural-appearing breast mound. The overall procedure takes approximately three hours and usually requires an overnight stay in a hospital.

diagram

Since the amount of tissue is limited, this type of breast reconstruction is more appropriate for patients who wish to have a small- or medium-sized breast reconstruction (A or B cup). For patients who desire a larger breast reconstruction, an implant can be placed beneath the latissimus flap in the chest, or the patient can consider the option of a TRAM or DIEP flap breast reconstruction. This procedure can result in some temporary weakness of the shoulder for up to three weeks. Although this strength does come back, women who are active in sports may have to temporarily adjust their physical activity.

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Since the amount of tissue is limited, this type of breast reconstruction is more appropriate for patients who wish to have a small- or medium-sized breast reconstruction (A or B cup). For patients who desire a larger breast reconstruction, an implant can be placed beneath the latissimus flap in the chest, or the patient can consider the option of a TRAM or DIEP flap breast reconstruction. This procedure can result in some temporary weakness of the shoulder for up to three weeks. Although this strength does come back, women who are active in sports may have to temporarily adjust their physical activity.

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