Restorative Techniques

LD Flap Breast Reconstruction

Latissimus Dorsi Flap Surgery

The latissimus dorsi muscle flap (sometimes called a Lat. flap or LD flap) can be used for breast reconstruction. Harvest of this flap sacrifices the largest muscle of the back. Since there is usually not enough fatty tissue on the back to provide the volume necessary to completely restore a breast removed by mastectomy, the LD flap is almost always used in conjunction with a breast implant.

(A) Skin, fat and all or part of the latissimus dorsi muscle are incorporated into a flap that is rotated and “tunneled” under the skin from the back to the chest. (B) In most cases, the LD flap is used in conjunction with a breast implant, as the flap itself does not have enough fatty tissue to restore volume adequately to a breast after mastectomy. Removing the latissimus muscle from the back can affect the strength and movement of both the shoulder and the arm.

The latissimus dorsi is a large, flat triangular muscle; it functions to help lift the arm and move the arm toward the chest. Flaps that damage the integrity of the latissimus dorsi muscle can affect these movements and produce upper body weakness that may be especially limiting for athletic women.

Breast Reconstruction Without Muscle Destruction

If you want to have breast reconstruction using your own body’s natural tissue, perforator flaps are now considered the gold-standard. This is because these advanced reconstructive procedures allow a skilled microsurgeon to restore a breast with warm living tissue that closely resembles, in appearance and feel, the breast removed by mastectomy without destroying muscle in the process. Our practice specializes in the most advanced methods of natural-tissue breast restoration, specifically, reconstructive surgery using microsurgical perforator flaps. Perforator flaps such as the TDAP flap represent the state-of-the-art in natural-tissue breast reconstruction. Perforator flap breast reconstruction techniques allow a woman to replace the breast tissue removed at mastectomy with soft, warm, living tissue without sacrificing important functional muscles.

» Learn about natural-tissue breast reconstruction options that preserve muscle