Lower rates of lipofilling sessions in latissimus dorsi flap breast reconstruction with initial higher volume transfer by preservation of subfascial fat: A 3D camera-assisted volumetric case series

J Plast Reconstr Aesthet Surg. 2020 Apr;73(4):681-689. doi: 10.1016/j.bjps.2019.11.002. Epub 2019 Dec 4.


Breast reconstruction with latissimus dorsi flap (LDF) is a well-known technique, but the crucial goal is to achieve a satisfying final volume restoration. Our hypothesis is that LDF reconstruction with the preservation of subfascial fat can achieve a higher volume in a one-time procedure than that achieved in a classic LDF harvest. The aim of the study was to quantify the volume resorption in LDF reconstructions with the preservation of subfascial fat. Fifteen breasts were reconstructed with a simple LDF and the remaining 15 with an LDF with the preservation of the subfascial fat between January 2016 and May 2017. Secondly, every patient underwent a lipofilling procedure. A supplemental lipofilling procedure was performed in unsatisfying cases. A Structure-Sensor camera manufactured by Occipital was used. Each patient received a 3D measurement during immediate postoperative care and then after 3 and 6 months of follow-up. This study shows no difference in volume retention at follow-up between the 2 techniques. The gain of an immediate and stable fatty layer in LDF + subfascial fat technique leads to breast volume improvement in one surgical step. Breast reconstruction with LDF and subfascial fat can be defined as a reliable solution, which provides an optimal result with a reduced number of surgical interventions when compared with a simple LDF.

Keywords: 3D camera; Breast cancer; Breast reconstruction; Dorsi flap; Latissimus; Lipofilling; Volumetric study.

MeSH terms

  • Adipose Tissue / transplantation*
  • Adult
  • Aged
  • Breast / anatomy & histology*
  • Breast / diagnostic imaging
  • Fascia
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Mammaplasty / methods*
  • Middle Aged
  • Organ Size
  • Organ Sparing Treatments
  • Prospective Studies
  • Superficial Back Muscles / transplantation
  • Surgical Flaps*
  • Treatment Outcome