Breast reconstruction with latissimus dorsi flap
6-minute read
This page will give you information about a breast reconstruction with latissimus dorsi flap. If you have any questions, you should ask your GP or other relevant health professional.
What is a 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.
The Therapeutic Goods Administration (TGA) continues to review and assess breast implants available in the Australian market.
In September 2019, the TGA decided to recall and suspend a number of breast implants and tissue expanders due to a small risk of breast implant-associated anaplastic large cell lymphoma. The list of these products can be found here. Consumer information on the recall and risks can be found here.
If you have symptoms such as pain, swelling, a rash or a lump in your breast, armpit or elsewhere or you are concerned about changes in your breast, please discuss these with your doctor (GP), surgeon or other appropriate medical professional as soon as possible.
For more information and the latest updates, see the TGA’s online breast implant hub.
Is silicone safe?
Many studies have been carried out to find if silicone breast implants are 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).
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 any alternatives to a 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?
Some complications can be serious and can even cause death.
General complications of any operation
- pain
- bleeding
- unsightly scarring of your skin
- blood clot in your leg
- blood clot in your lung
- infection of the surgical site (wound)
- allergic reaction to the equipment, materials or medication
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 when you use your arm
- 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
Implant complications
- 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
- ALCL
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.
Regular exercise 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.
Do 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.
The shape of your reconstructed breast takes several weeks to settle.
Summary
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.
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Last reviewed: September 2020
