If you are considering a breast reconstruction, read all about it here.
What is breast reconstruction with latissimus dorsi flap?
A breast reconstruction is an operation to recreate a breast shape after you have had a mastectomy (removing all your breast). Your surgeon will recreate a breast shape using the latissimus dorsi muscle from the side of your back, usually with an implant.
What kind of breast implant should I choose?
All implants are made of an outer layer (shell) of silicone or polyurethane. They can be filled with silicone or saline. Softer silicone and saline implants give a softer and more natural feel but are more prone to kinking or rippling. More cohesive silicone implants give a firmer feel, hold their shape more and are less prone to kinking or rippling. If you do not have enough skin or you have already had a mastectomy, your surgeon may need to use a tissue expander.
Is silicone safe?
There is no evidence to suggest that women with silicone breast implants have a higher risk of developing diseases such as breast cancer and arthritis. There is a reported link between having an implant and a rare type of cancer called anaplastic large-cell lymphoma (ALCL) but the increase in risk is small and ALCL in this area is not as serious as it is when it happens elsewhere in your body.
What are the benefits of surgery?
You should get a breast shape again. Most women who have a successful breast reconstruction are more comfortable with their appearance.
Are there alternatives to breast reconstruction with latissimus dorsi flap?
Using padded bras or bra inserts can give the appearance of a breast shape when you are wearing clothes. It may be possible to have a reconstruction using only an implant. It is possible to use tissue from another area of your body, usually your lower abdomen or sometimes from your buttocks, inner thigh or side.
What does the operation involve?
The operation is performed under a general anaesthetic and usually takes 4 to 6 hours. Your surgeon will make an elliptical (oval) cut on your back, usually along the natural creases of your skin. They will lift the latissimus dorsi muscle along with a small patch of skin that will be used to replace the areola (the darker area around your nipple) and nipple. They will keep the blood supply to the muscle, and move it around to the front of your chest to use to create a breast shape. If you need an implant, your surgeon will create a pocket under the muscle to place the implant in.
What complications can happen?
Like all surgical procedures, there are some levels of risks to consider. Some of these can be serious and can even cause death. However, you can speak to your doctor about the following general and specific complications that may worry you.
General complications of any operation
- Unsightly scarring of your skin
- Blood clot in your leg
- Blood clot in your lung
- Infection of the surgical site (wound)
Specific complications of this operation
Breast reconstruction complications
- Developing a lump under your wound caused by fluid collecting
- Developing a lump under your wound caused by blood collecting
- Loss of the flap
- Skin necrosis, where some of the original breast skin at the edge of your wound dies leaving a black area
- Unnatural movement or twitching of the reconstructed breast
- Difference in shape and appearance
- Numbness or continued pain around your armpit or the inner part of your arm
- Permanent numbness around the scar in the back and on most of the surface of the
- reconstructed breast
- Stiff shoulder
- Arm weakness
- Developing a collection of fluid (seroma) in the pocket where the implant is
- Infection of the implant
- Capsule contracture, where scar tissue that your body naturally forms thickens and tightens around the implant
- Kinking and rippling
- Rupture of an implant
- Rotation of the implant
How soon will I recover?
You should be able to go home after 2 to 5 days. You should be able to return to normal activities after 4 to 6 weeks. It’s good to have regular exercise, which should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice. It’s very important not drive for at least 3 weeks. If your surgeon needed to use an expandable implant, you will need to come back to the clinic regularly. You will also need to bear in mind that the shape of your reconstructed breast takes several weeks to settle.
A breast reconstruction with latissimus dorsi flap is an operation to recreate a breast shape. You should consider the options carefully and have realistic expectations about the results. To find out more, call us on 0808 101 0337 or make an online enquiry.
Authors: Mr Eoin O'Broin MD FRCS (Plast.), Mr Graham Offer
MBChB FRCS (Eng) FRCS (Plast.), Miss Kalliope Valassiadou
MD, Consultant Breast and General Surgeon, Mr Paul Roblin MSc FRCS (Plast.)
Illustrator: Medical Illustration Copyright © Nucleus