Latissimus dorsi myocutaneous flap
Citation, DOI and article data
A latissimus dorsi myocutaneous flap is a form of breast reconstruction that transplants the patient’s own latissimus dorsi muscle, fat, and skin from the middle back to the chest to form a breast mound.
This flap is more easily created and contains a robust vascular supply compared to other flaps such as transverse rectus abdominis musculocutaneous (TRAM) flap or deep inferior epigastric perforator (DIEP) flap reconstruction. Therefore, it is commonly used if a previous flap has failed 1.
A latissimus dorsi flap also causes less patient morbidity as it does not weaken the abdominal wall.
A latissimus dorsi myocutaneous flap produces a less pleasing aesthetic result when compared to transverse rectus abdominis musculocutaneous and deep inferior epigastric perforator flap reconstructions. It commonly requires an implant to achieve symmetry or a pleasing aesthetic result.
It leaves a large scar in the middle of the back and commonly is complicated by a postoperative seroma.
It causes a temporary 15-20% reduction in shoulder strength 2.
Rotated and tunnelled latissimus dorsi muscle gives a tailed appearance to the reconstruction 2.
The denuded dermal layer is seen parallel to the skin of the breast.
- postoperative seroma at donor site. Some report upwards of >95% of patients developing a postoperative seroma 3.
- postoperative wound infection
- postoperative hematoma
- wound dehiscence
- flap necrosis
- chronic back pain
- 1. Pinel-Giroux FM, El Khoury MM, Trop I, Bernier C, David J, Lalonde L. Breast Reconstruction: Review of Surgical Methods and Spectrum of Imaging Findings. (2013). Radiographics. 33(2). doi:10.1148/rg.332125108 Pubmed
- 2. Dialani V, Lai KC, and Slanetz PJ. MR imaging of the reconstructed breast: What the radiologist needs to know. (2012). Insights Imaging. 3(3): 201-213. Free full-text at PubMed Central
- 3. Burgić M, Bruant-Rodier C, Wilk A, Bodin F, Rifatbegović A, Halilbašić E, Burgić M, Brkić E, and Avdagić H. Complications Following autologous latissimus flap breast reconstruction. (2010). Bosn J Basic Medical Sciences. 10(1): 65-67. Free full-text at PubMed Central
- 4. Chandana Lall, Temel A. Tirkes, Aashish A. Patel, Ramit Lamba, Sadhna Verma, S. Gregory Jennings, Kumaresan Sandrasegaran. Flaps, Slings, and Other Things: CT After Reconstructive Surgery— Expected Changes and Detection of Complications. (2012) American Journal of Roentgenology. doi:10.2214/AJR.11.7552