Aesthetic and Technical Refinements in Latissimus Dorsi Implant Breast Reconstruction: A 15-Year Experience

Abstract

The data demonstrated a successful outcome for latissimus dorsi and implant breast reconstruction for patients with a low or normal body mass index and a small (A to C cup) breast size. The aesthetic outcome of latissimus dorsi breast reconstruction has been improved over the past 15 years by the adoption of SSM and ASM techniques. Immediate nipple reconstruction and the placement of an adjustable saline implant potentially render this procedure a true single-stage reconstruction. Prepectoral implant position provides good aesthetics while preserving the subpectoral space for future management of capsular contracture if required.

Long-term outcomes of latissimus dorsi flap breast reconstructions: A single-centre observational cohort study with up to 12 years of follow up

“…The NMBRA audit reported 5% partial flap necrosis for all flap based reconstructions and <1% of them had a total failure of the flap with 9% implant loss. In contrast, there is a higher rate of implant loss in ADM/implant-based reconstruction, with studies showing rates of 7-24% 7,8,26,27 .…”

“…The majority were managed with simple aspiration. Most LDMF series report seroma as the most common complication with rates ranging from 4-80% 25,27,28,20 .…”

“…Interestingly, 41% (88) did not have any further corrective procedures, although some in this group did have filler port removal or surgery for cancer recurrence that were not directly related to the LDMF. Salvatore and colleagues reported that 80% (42/52) of cases who underwent elective revision surgeries were mainly for nipple reconstruction, implant exchange and fat grafting 27 . However, other retrospective series have reported up to 50% revision rates following LDMF reconstructions 15,25,31,32 .…”

Comparison of Patients Satisfaction with Direct to Implant versus Latissimus Dorsi Flap with Implant Breast Reconstruction Using Breast-Q

“…It shows better aesthetic results when there is ptosis or thin skin flap, provides additional skin, and shows low capsular contracture rate and infection rate. 1 3 The skin-sparing mastectomy technique, which leaves skin as much as possible, and ADM, which can reinforce lower pole, could solve the problem with skin flap. 4 ADM is also known to reduce capsular contracture.…”

Immediate nipple reconstruction with thoracodorsal artery perforator flap in breast reconstruction by latissimus dorsi myocutaneous flap in patients with Poland's syndrome

“…For breast reconstruction, the LD myocutaneous flap is a reliable and versatile choice in patients who are relatively thin in the lower abdominal region and have small to moderate breasts . Nowadays, as the psychological benefits of nipple–areola complex reconstruction have been receiving more attention, several authors began to reconstruct the nipple and breast in a single stage to improve the overall patient satisfaction .…”