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What is the latissimus dorsi flap?

During latissimus dorsi flap breast reconstruction, the surgeon uses skin, fat and the latissimus dorsi back muscle beneath the shoulder blade to create a new breast shape. The pedicled flap is tunneled beneath the skin through the armpit towards the front of the chest with the blood vessels remaining attached to their primary source throughout. For this reason, there is no need for microsurgery.

The surgery is generally a second or third-line option since muscle sacrifice is required. It is usually appropriate for women who do not qualify for other types of flap reconstruction or are not candidates for implants alone. It is most often performed in combination with a tissue expander later converted to an implant for volume requirements. The reconstructed breast also can be accentuated and enhanced through fat grafting to help increase breast volume. 

While the surgery does leave a scar on the back, the incision is often successfully placed in a position where it can be covered by a bra strap or dress strap. The downside of the procedure is that it can affect a woman's ability to participate in certain sports. Latissimus flap reconstruction typically takes between three to six hours and may require nipple reconstruction after the surgery wounds have healed.

What are the advantages of latissimus flap surgery?

  • A good solution for patients who have undergone radiation and are not candidates for implants alone
  • A second-line solution for patients who are not candidates for microsurgical breast reconstruction
  • Variety in breast size is possible

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Latissimus flap surgery is not a good option for you if any of the following apply:

  • You had previous surgery in the chest wall
  • You are concerned about scarring on your upper back
  • You are an avid swimmer, skier or athlete that uses their latissimus dorsi area frequently

Who is a good candidate for latissimus flap surgery?

  • Women who have undergone radiation
  • Women who have sufficient tissue available overlying the latissimus dorsi
  • Women who do not have donor tissue available for free autologous flap reconstruction
  • Patients with hypercoagulability (tendency to form blood clots) or other medical conditions prohibiting microsurgical reconstruction
  • Women who desire to use part of their own tissue to recreate the breasts

What can I expect from my recovery?

After surgery, you will be monitored at the hospital overnight.  You will receive detailed instructions to follow regarding your recovery once you are released. It usually takes around four weeks to recover from the surgery. 

You should limit strenuous activities, heavy lifting, sexual activity and any other taxing movement for about four weeks as your body heals. The doctor may suggest a round of physical therapy to help you regain strength and range of motion in your back and shoulder.

Zampell Plastic & Reconstructive Surgery

Why choose Dr. Zampell in Beverly Hills?

Dr. Zampell is a highly compassionate and meticulously detailed reconstructive surgeon who tailors her technique to each patient's individual anatomical needs and aesthetic sensibilities. She's passionate about restoring her clients’ quality of life, self-confidence and self-image.

At the Ochsner Medical Center in Louisiana, Dr. Zampell worked closely with Dr. Robert Allen, an innovative pioneer in the field of autologous breast reconstruction. After graduating with honors from Ohio State University College of Medicine, Dr. Zampell continued her training at the prestigious New York University with an elite surgical residency. After this, she completed a demanding fellowship in microsurgery at the University of California Los Angeles.

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