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Latissimus Dorsi (LD) Flap

Latissimus Dorsi Muscle Flap

Diagram of how the latissimus dorsi muscle is moved from the back to the breast to provide additional tissue for breast reconstruction. An implant is usually placed under the muscle.

Latissimus dorsi (LD) reconstruction uses the skin, fat and muscle from your back to replace the skin that is removed during a mastectomy or that has shrunk following radiation. The intended result is to create a "breast" that looks essentially normal in clothes and near normal without clothes.

This procedure can be used for immediate or delayed breast reconstruction. In addition, the LD may be used for reconstruction of both breasts either at the same time or at different times. The LD Flap does not require microsurgery. This surgery is usually done in conjunction with placement of a prosthesis (expander or implant), to reconstruct the breast and achieve adequate breast volume

A drawback of this procedure is that there will be a scar on the back. Similar to the TRAM Flap, there is a risk of the loss of some of the transferred skin and fat, and a very rare possibility of a total loss of the transferred tissue (less than 1%).

Reasons for Considering

If you are missing skin and breast tissue following a mastectomy.

Procedure Description

  • A portion of skin and muscle is elevated from your upper outer back and moved to the breast defect. The blood supply is left intact in the armpit (axilla).
  • Usually, but not always, an implant is placed under the flap to provide the correct volume to the reconstructed breast.
  • The back defect is closed.
  • Nipple/areolar reconstruction is delayed until later.
  • Length of stay: Breast reconstruction is a major procedure requiring several days of hospitalization.

Recovery Process and Final Result

  • Discomfort: In the back and reconstruction site will be present for several weeks

Full use of the area will require about six weeks of healing.

Other Options For Your Consideration

Additional procedures that may enhance your results are breast enlargement, breast lift, or reduction of the opposite breast and/or nipple (areolar) reconstruction.

Insurance Information

This procedure is usually covered by insurance. You must check with your own insurance company to determine your specific coverage and exclusions.

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