Latissimus dorsi breast reconstruction with or without implants: A comparison between outcome and patient satisfaction

J Plast Reconstr Aesthet Surg. 2019 Mar;72(3):381-393. doi: 10.1016/j.bjps.2018.10.003. Epub 2018 Nov 28.


Background: The latissimus dorsi (LD) flap is largely used in breast reconstruction. The aim of this study is to evaluate and compare the advantage of the LD flap in association with an implant to that of LD flap in association with lipofilling to add additional volume following breast reconstruction by assessing the number of revision procedures, length of hospitalization, complication rate, and patient satisfaction.

Methods: A retrospective cohort study was performed to evaluate complication rate, number and type of revision procedures required, hospitalization time, and overall duration of the reconstructive process in patients undergoing LD breast reconstruction in our department between January 2012 and March 2015. Patient satisfaction was assessed using BREAST-Q®.

Results: Ninety-five breast reconstructions performed on 90 patients were included. In 38 patients, 42 breasts were reconstructed using LD flap in association with lipofilling (Group 1). In the remaining 52 patients, 53 breast reconstructions were performed using LD flap in association with an implant (Group 2). Findings concerning total hospitalization time, overall duration of the reconstructive process, and the distribution of supplementary surgical procedures demonstrated no statistically significant differences between the two groups. However, the surgical complication rate was higher in Group 2 than in Group 1 (14.2% vs. 18.8%, respectively). Regarding BREAST-Q, a detailed analysis of the "satisfaction with breasts" domain showed a higher score for Group 1 than for Group 2.

Conclusions: The association of a breast implant with LD reconstruction does not decrease breast reconstruction time in terms of the number of revision procedures and hospitalization time, exposes patients to a higher complication rate, and does not improve patient satisfaction.

Keywords: BREAST-Q; Breast reconstruction; Latissimus dorsi flap; Patient satisfaction.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Breast Implantation / adverse effects
  • Breast Implantation / methods*
  • Breast Implantation / psychology
  • Breast Implants
  • Female
  • Humans
  • Length of Stay
  • Mammaplasty / adverse effects
  • Mammaplasty / methods*
  • Mammaplasty / psychology
  • Middle Aged
  • Patient Satisfaction* / statistics & numerical data
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Superficial Back Muscles / transplantation*
  • Surgical Flaps / transplantation
  • Treatment Outcome