Latissimus dorsi flap
To overcome some of the problems associated with implant only techniques, new tissue needs to be brought into the area from elsewhere in the body. This is particularly necessary after radio therapy. A good source of new tissue is tissue from the back where an ellipse of tissue can be transferred to the front of the chest to reconstruct the breast. The skin is transferred with a large muscle known as the Latissimus dorsi muscle which provides the blood supply to sustain the skin with the main blood vessels supplying this muscle arising underneath the arm. A scar is left on the back in a position that is well disguised by the bra strap.
In the majority of patients where a Latissimus dorsi flap is being used, an implant is required to restore the volume which is usually a shaped implant of fixed volume.
The Latissimus dorsi flap is a very reliable and robust technique with few complications. It is however implant dependant and may therefore develop problems in the future if the body reacts adversely to the implant. As a reconstruction it is also firmer than the normal breast and does not age in the same way as a natural breast.