Latissimus dorsi muscle flap and tissue expansion for breast reconstruction

Ann Plast Surg. 2006 Dec;57(6):597-601. doi: 10.1097/


Background: After mastectomy for breast cancer, especially when combined with radiation, inadequate wall thickness and insufficient elasticity of the skin are problems frequently encountered in breast reconstruction. We describe a reconstruction method using a latissimus dorsi muscle flap, followed by expansion, that creates no additional scar.

Methods: This retrospective study included 30 patients who underwent this 4-surgery reconstruction: the muscle flap was raised and drawn through the mastectomy scar; the expander was inserted; expander replacement with the definitive prosthesis and concomitant symmetrization of the contralateral breast; finally, reconstruction of the nipple-areola complex.

Results: Only 1 failure, prosthesis extrusion, was observed. A surgeon scored the outcomes as above average for 26 women, who were satisfied.

Discussion: We noted an overall lower complication rate and a lower reconstruction-failure rate compared with reported results. This approach obtained better tissue quality; the flap provided better covering thickness and expansion, yielding a larger muscle-skin pocket.

Conclusions: This reconstruction procedure seems reliable and extends the indications of skin expansion, with satisfactory results.

MeSH terms

  • Adult
  • Breast Implantation
  • Female
  • Humans
  • Mammaplasty / methods*
  • Middle Aged
  • Nipples / surgery
  • Retrospective Studies
  • Surgical Flaps*
  • Tissue Expansion*