Table of ContentsView AllTable of ContentsHow It WorksAdvantagesBest CandidatesTimingRisksHealth Insurance CoveragePreparing for SurgerySurgeryRecoveryNipple Reconstruction
Table of ContentsView All
View All
Table of Contents
How It Works
Advantages
Best Candidates
Timing
Risks
Health Insurance Coverage
Preparing for Surgery
Surgery
Recovery
Nipple Reconstruction
Alatissimus dorsiflap is a surgical procedure that uses part of an upper back muscle to reconstruct the shape of the breast. This surgery is typically done after amastectomy(surgical breast removal), and can be performed along with the insertion of a breast implant.
Latissimus dorsi flap is one option forbreast reconstructionafter surgery. People who smoke, have larger breasts, and/or have a condition that affects their circulatory system are not good candidates for this procedure.
Aflap techniqueis a type of plastic surgery used to repair or reconstruct parts of the body. It involves using a portion of muscle—as well as its fat, skin, and blood supply—to rebuild the shape of another part of the body. A flap technique is also known as autologous tissue reconstruction because it uses donor tissue from a person’s own body.
During a latissimus dorsi flap breast reconstruction, a surgeon moves a portion of the latissimus dorsi (a triangular-shaped muscle) from a person’s upper back to their chest. The blood vessels are left attached so the tissue can survive with its original blood supply in its new location.If there is not enough tissue to fully create a new breast, an implant may be inserted under a flap.
Women who have flap procedures report significantly greater satisfaction with their breasts, sexual well-being, and psychosocial well-being than women who undergo implant reconstruction, according to a 2018 study published inJAMA Surgery.
Other benefits of a latissimus dorsi flap include:
A breast surgeon and plastic surgeon will help determine the best surgical treatments and reconstruction options for you. You may be a candidate for latissimus dorsi flap if you:
This procedure is not usually recommended for the following people:
Breast reconstruction can be done at the same time as a mastectomy (immediate reconstruction) or at a later date, such as after cancer treatment.
If you needradiation therapyto the underarm or chest area, you may need to wait for reconstruction. Having a latissimus dorsi flap done before radiation treatment is complete may limit a radiation therapist’s ability to treat you properly.
Risks and Complications
The latissimus dorsi flap reconstruction is a major surgical procedure. It generally takes longer than breast implant surgery and also has a longer healing time because it involves two surgical sites.
Health risks from this surgery are rare, but include:
Rare, delayed complications may include:
Making Your Decision
Your surgeon will give you instructions to follow as you prepare for your procedure. These will include information regardingyour dietand medications.
Smokers, including recreational drug users, may be asked to quit at least four to six weeks before surgery to promote better healing. The American Society of Anesthesiologists recommends quitting smoking as soon as possible before surgery.
Pack loose or stretchy shirts that wrap or button up the front, as well as pull-on pants. After surgery, you’ll need to wear a camisole (not a bra) for support and to secure surgical drains.
Latissimus dorsi flap reconstruction is performed in a hospital and typically takes three to four hours. You may haveintravenous (IV) sedationin addition togeneralanesthesia. A latissimus dorsi flap isn’t painful because you are not conscious while it is being performed.
Here’s how a latissimus dorsi flap surgery works:
Post-surgery, you will likely stay in the hospital for at least one day.People heal at different rates, so hospital stays and recovery times vary.
Here’s what to expect as you recover:
Nipple Tattoo and Reconstruction
Because the donor site on the back has plain skin, many women have a nipple tattooed on their reconstructed breast or opt fornipple andareolareconstruction. (A reconstructed or tattooed nipple will not have sensitivity, but it provides a more natural appearance.)
These procedures are generally performed about three to six months after the primary breast reconstruction. The timing can vary considerably based on preference and the specific techniques used in both procedures.
Verywell / Brianna Gilmartin
Summary
A latissimus dorsi flap is one of a variety of options for breast reconstruction and can be performed either at the same time as a mastectomy or aftercancer treatment. It is performed in a hospital under general anesthesia, and recovery may take several weeks.
If you’re considering this procedure, discuss it with your breast and plastic surgeons. They should explain all your reconstruction options to help you make the best decision for your body.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Breastcancer.org.Latissimus dorsi flap reconstruction: what to expect.Sood R, Easow JM, Konopka G, Panthaki ZJ.Latissimus Dorsi Flap in Breast Reconstruction: Recent Innovations in the Workhorse Flap. Cancer Control. 2018;25(1):1073274817744638. doi:10.1177/1073274817744638Santosa KB, Qi J, Kim HM, Hamill JB, Wilkins EG, Pusic AL.Long-term Patient-Reported Outcomes in Postmastectomy Breast Reconstruction. JAMA Surg. 2018;153(10):891-899. doi:10.1001/jamasurg.2018.1677Breastcancer.org.Latissimus dorsi flap.Vincent A, Hohman MH.Latissimus Dorsi Flap. Updated 2024. National Library of Medicine: StatPearls.Yun JH, Diaz R, Orman AG.Breast reconstruction and radiation therapy.Cancer Control. 2018;25(1):1073274818795489. doi:10.1177/1073274818795489Wilkins EG, Hamill JB, Kim HM, et al.Complications in postmastectomy breast reconstruction: one-year outcomes of the mastectomy reconstruction outcomes consortium (MROC) study.Ann Surg. 2018;267(1):164-170. doi:10.1097/SLA.0000000000002033Billig JI, Lu Y, Momoh AO, Chung KC.A nationwide analysis of cost variation for autologous free flap breast reconstruction.JAMA Surg. 2017;152(11):1039. doi:10.1001/jamasurg.2017.2339American Cancer Society.Women’s health and cancer rights act.The American Society of Anesthesiologists.Smoking.Breastcancer.org.Latissimus dorsi flap surgery risks.Additional ReadingAmerican Cancer Society.Breast reconstruction using your own tissues (flap procedures).American Society of Plastic Surgeons.Breast reconstruction.Leonardis J, Diefenbach BJ, Lyons DA, et al.The influence of reconstruction choice and inclusion of radiation therapy on functional shoulder biomechanics in women undergoing mastectomy for breast cancer.Breast Cancer Res Treat. 2019;173:447–453. doi:10.1007/s10549-018-5003-8Santosa KB, Qi J, Kim HM, Hamill JB, Wilkins EG, Pusic AL.Long-term patient-reported outcomes in postmastectomy breast reconstruction.JAMA Surg. 2018;153(10):891–899. doi:10.1001/jamasurg.2018.1677Sood R, Easow J, Konopka G, Panthaki Z.Latissimus dorsi flap in breast reconstruction: recent innovations in the workhorse flap.Cancer Control.2018;25(1):1073274817744638. doi:10.1177/1073274817744638Yezhelyev M, Duggal CS, Carlson GW, Losken A.Complications of latissimus dorsi flap breast reconstruction in overweight and obese patients.Ann Plast Surg. 2013;70(5):557-562. doi:10.1097/SAP.0b013e31827a2c02
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Breastcancer.org.Latissimus dorsi flap reconstruction: what to expect.Sood R, Easow JM, Konopka G, Panthaki ZJ.Latissimus Dorsi Flap in Breast Reconstruction: Recent Innovations in the Workhorse Flap. Cancer Control. 2018;25(1):1073274817744638. doi:10.1177/1073274817744638Santosa KB, Qi J, Kim HM, Hamill JB, Wilkins EG, Pusic AL.Long-term Patient-Reported Outcomes in Postmastectomy Breast Reconstruction. JAMA Surg. 2018;153(10):891-899. doi:10.1001/jamasurg.2018.1677Breastcancer.org.Latissimus dorsi flap.Vincent A, Hohman MH.Latissimus Dorsi Flap. Updated 2024. National Library of Medicine: StatPearls.Yun JH, Diaz R, Orman AG.Breast reconstruction and radiation therapy.Cancer Control. 2018;25(1):1073274818795489. doi:10.1177/1073274818795489Wilkins EG, Hamill JB, Kim HM, et al.Complications in postmastectomy breast reconstruction: one-year outcomes of the mastectomy reconstruction outcomes consortium (MROC) study.Ann Surg. 2018;267(1):164-170. doi:10.1097/SLA.0000000000002033Billig JI, Lu Y, Momoh AO, Chung KC.A nationwide analysis of cost variation for autologous free flap breast reconstruction.JAMA Surg. 2017;152(11):1039. doi:10.1001/jamasurg.2017.2339American Cancer Society.Women’s health and cancer rights act.The American Society of Anesthesiologists.Smoking.Breastcancer.org.Latissimus dorsi flap surgery risks.Additional ReadingAmerican Cancer Society.Breast reconstruction using your own tissues (flap procedures).American Society of Plastic Surgeons.Breast reconstruction.Leonardis J, Diefenbach BJ, Lyons DA, et al.The influence of reconstruction choice and inclusion of radiation therapy on functional shoulder biomechanics in women undergoing mastectomy for breast cancer.Breast Cancer Res Treat. 2019;173:447–453. doi:10.1007/s10549-018-5003-8Santosa KB, Qi J, Kim HM, Hamill JB, Wilkins EG, Pusic AL.Long-term patient-reported outcomes in postmastectomy breast reconstruction.JAMA Surg. 2018;153(10):891–899. doi:10.1001/jamasurg.2018.1677Sood R, Easow J, Konopka G, Panthaki Z.Latissimus dorsi flap in breast reconstruction: recent innovations in the workhorse flap.Cancer Control.2018;25(1):1073274817744638. doi:10.1177/1073274817744638Yezhelyev M, Duggal CS, Carlson GW, Losken A.Complications of latissimus dorsi flap breast reconstruction in overweight and obese patients.Ann Plast Surg. 2013;70(5):557-562. doi:10.1097/SAP.0b013e31827a2c02
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Breastcancer.org.Latissimus dorsi flap reconstruction: what to expect.Sood R, Easow JM, Konopka G, Panthaki ZJ.Latissimus Dorsi Flap in Breast Reconstruction: Recent Innovations in the Workhorse Flap. Cancer Control. 2018;25(1):1073274817744638. doi:10.1177/1073274817744638Santosa KB, Qi J, Kim HM, Hamill JB, Wilkins EG, Pusic AL.Long-term Patient-Reported Outcomes in Postmastectomy Breast Reconstruction. JAMA Surg. 2018;153(10):891-899. doi:10.1001/jamasurg.2018.1677Breastcancer.org.Latissimus dorsi flap.Vincent A, Hohman MH.Latissimus Dorsi Flap. Updated 2024. National Library of Medicine: StatPearls.Yun JH, Diaz R, Orman AG.Breast reconstruction and radiation therapy.Cancer Control. 2018;25(1):1073274818795489. doi:10.1177/1073274818795489Wilkins EG, Hamill JB, Kim HM, et al.Complications in postmastectomy breast reconstruction: one-year outcomes of the mastectomy reconstruction outcomes consortium (MROC) study.Ann Surg. 2018;267(1):164-170. doi:10.1097/SLA.0000000000002033Billig JI, Lu Y, Momoh AO, Chung KC.A nationwide analysis of cost variation for autologous free flap breast reconstruction.JAMA Surg. 2017;152(11):1039. doi:10.1001/jamasurg.2017.2339American Cancer Society.Women’s health and cancer rights act.The American Society of Anesthesiologists.Smoking.Breastcancer.org.Latissimus dorsi flap surgery risks.
Breastcancer.org.Latissimus dorsi flap reconstruction: what to expect.
Sood R, Easow JM, Konopka G, Panthaki ZJ.Latissimus Dorsi Flap in Breast Reconstruction: Recent Innovations in the Workhorse Flap. Cancer Control. 2018;25(1):1073274817744638. doi:10.1177/1073274817744638
Santosa KB, Qi J, Kim HM, Hamill JB, Wilkins EG, Pusic AL.Long-term Patient-Reported Outcomes in Postmastectomy Breast Reconstruction. JAMA Surg. 2018;153(10):891-899. doi:10.1001/jamasurg.2018.1677
Breastcancer.org.Latissimus dorsi flap.
Vincent A, Hohman MH.Latissimus Dorsi Flap. Updated 2024. National Library of Medicine: StatPearls.
Yun JH, Diaz R, Orman AG.Breast reconstruction and radiation therapy.Cancer Control. 2018;25(1):1073274818795489. doi:10.1177/1073274818795489
Wilkins EG, Hamill JB, Kim HM, et al.Complications in postmastectomy breast reconstruction: one-year outcomes of the mastectomy reconstruction outcomes consortium (MROC) study.Ann Surg. 2018;267(1):164-170. doi:10.1097/SLA.0000000000002033
Billig JI, Lu Y, Momoh AO, Chung KC.A nationwide analysis of cost variation for autologous free flap breast reconstruction.JAMA Surg. 2017;152(11):1039. doi:10.1001/jamasurg.2017.2339
American Cancer Society.Women’s health and cancer rights act.
The American Society of Anesthesiologists.Smoking.
Breastcancer.org.Latissimus dorsi flap surgery risks.
American Cancer Society.Breast reconstruction using your own tissues (flap procedures).American Society of Plastic Surgeons.Breast reconstruction.Leonardis J, Diefenbach BJ, Lyons DA, et al.The influence of reconstruction choice and inclusion of radiation therapy on functional shoulder biomechanics in women undergoing mastectomy for breast cancer.Breast Cancer Res Treat. 2019;173:447–453. doi:10.1007/s10549-018-5003-8Santosa KB, Qi J, Kim HM, Hamill JB, Wilkins EG, Pusic AL.Long-term patient-reported outcomes in postmastectomy breast reconstruction.JAMA Surg. 2018;153(10):891–899. doi:10.1001/jamasurg.2018.1677Sood R, Easow J, Konopka G, Panthaki Z.Latissimus dorsi flap in breast reconstruction: recent innovations in the workhorse flap.Cancer Control.2018;25(1):1073274817744638. doi:10.1177/1073274817744638Yezhelyev M, Duggal CS, Carlson GW, Losken A.Complications of latissimus dorsi flap breast reconstruction in overweight and obese patients.Ann Plast Surg. 2013;70(5):557-562. doi:10.1097/SAP.0b013e31827a2c02
American Cancer Society.Breast reconstruction using your own tissues (flap procedures).
American Society of Plastic Surgeons.Breast reconstruction.
Leonardis J, Diefenbach BJ, Lyons DA, et al.The influence of reconstruction choice and inclusion of radiation therapy on functional shoulder biomechanics in women undergoing mastectomy for breast cancer.Breast Cancer Res Treat. 2019;173:447–453. doi:10.1007/s10549-018-5003-8
Santosa KB, Qi J, Kim HM, Hamill JB, Wilkins EG, Pusic AL.Long-term patient-reported outcomes in postmastectomy breast reconstruction.JAMA Surg. 2018;153(10):891–899. doi:10.1001/jamasurg.2018.1677
Sood R, Easow J, Konopka G, Panthaki Z.Latissimus dorsi flap in breast reconstruction: recent innovations in the workhorse flap.Cancer Control.2018;25(1):1073274817744638. doi:10.1177/1073274817744638
Yezhelyev M, Duggal CS, Carlson GW, Losken A.Complications of latissimus dorsi flap breast reconstruction in overweight and obese patients.Ann Plast Surg. 2013;70(5):557-562. doi:10.1097/SAP.0b013e31827a2c02
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