LATISSIMUS FLAP RECONSTRUCTION
The latissimus muscle is the largest muscle in the body - it covers almost the entire back just below the scapula, or 'wing-bone' in layman's terms. The muscle is very commonly used in multiple kinds of reconstructive surgeries, and is generally safe, effective and relatively quick to harvest. It does not require special instruments when not used as a microsurgical flap (as is the case in breast reconstruction). The latissimus muscle with some overlying skin are taken together to reconstruct the breast, in most cases to cover implants or tissue expanders.The implants or expanders are used because the muscle and overlying skin are not usually large enough to reconstruct an entire breast. A common use of the latissimus reconstruction is to cover an implant when radiation of the chest has been performed, so that the implant can be protected from coming into contact with radiated skin.
The latissimus muscle and skin flaps are workhorses of reconstruction because they have an excellent blood supply, have a low complication rate and because they are widely performed by plastic surgeons. Therefore this procedure is available at most hospitals. The disadvantages of the latissimus flap are:
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Prominent back scar
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Change in appearance and shape of the back silhouette, especially in form fitting clothing. The 'V' shape of the back is lost, a drawback in terms of final appearance.
Breast reconstruction is performed to restore a more natural shape and appearance after cancer and mastectomy. The major reason we dislike this flap and form of reconstruction is because it changes the body shape of the back, something that is often very visible even in clothing and especially in fit patients. This flap is also often used to cover implants. If you are going to have a soft tissue reconstruction, why not have one that is aesthetically better with the added side benefit of a tummy tuck or thigh lift?