Author: Dr. Gary Arishita
A latissimus (LAT) flap is a procedure where part of the muscle on the back is used to do a reconstruction. A small segment of skin is also included with that muscle to do a reconstruction of the breast on the same side. The majority of the time a tissue expander and implant is used on these cases because the muscle does not provide a huge amount of volume to the reconstruction. So if a woman undergoing breast reconstruction has a breast that is large (c or d cup), it probably won’t be sufficient to do the reconstruction solely with the LAT flap and tissue expander and implant would be required.
There is an alternative procedure where a slightly larger volume of fatty tissue is used with the LAT and that is called an extended LAT flap and in those cases we do not need a tissue expander and implant. The only drawback with this procedure is that it is associated with a slightly higher incidence of complication in the site where the LAT came from.
As far as the aesthetic appearance of the back after this procedure, we are usually able to place the scar along where a normal bra would be located; therefore if a woman wears a low cut dress, the scar would be hidden. So it wouldn’t have a negative impact on the aesthetics if a LAT flap is required.
A study published in Plastic and Reconstructive Surgery examined the abdominal recovery rates and patient satisfaction after breast reconstruction with different abdominal flaps: the DIEP, SIEA and muscle-sparing free TRAM.
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