Latissimus Dorsi Musculocutaneous Flap

The latissimus dorsi musculocutaneous flap (LDMF) is a breast reconstruction method which utilizes the patient�s own organic tissue to rebuild a damaged or lost breast. This procedure is commonly used for post-mastectomy reconstruction in conjunction with artificial breast implant prostheses. LDMF is an alternative approach to the TRAM flap method, especially indicated for women who do not make good TRAM procedure prospects.

What is the Latissimus Dorsi Musculocutaneous Flap Procedure?

The latissimus dorsi musculocutaneous muscle exists on both sides of the back covering the flanks over the lumbar and partial thoracic spinal levels. In this operation, parts of the muscle, skin and connective tissue from the mid back region are harvested as donor tissue to recreate the lost breast mound. The tissue is not completely removed from the body, but only repositioned through the axilla to the chest wall for permanent placement. The LDM Flap can be performed immediately, as part of the mastectomy procedure, or at some future time after the initial breast removal operation.

Latissimus Dorsi Musculocutaneous Flap Reconstruction Procedure

The operation begins by removing the donor tissue from the back and preparing the reconstruction site to receive the new LDM flap. This donor tissue is cut away with the vascular and neurological attachments intact and moved inside the body, to the reconstruction site. The flap might be large enough to create a small breast, but is commonly used in conjunction with submuscular implant placement to achieve a fuller look and feel. Once the tissue has been formed into the new breast mound, the donor site can be closed up and the patient is ready to begin the recovery process. Once the new breast is completely healed, secondary surgical procedures can be performed to even out any asymmetry with the non-operated breast, as well as create a new nipple and areola on the reconstructed breast.

Effects of the Latissimus Dorsi Musculocutaneous Flap

Loss of the Latissimus Dorsi muscle does not usually create any physical disability or significant loss of functionality. The tissue is well suited to create a breast form and usually offers excellent post-surgical results. The operation is very invasive and takes several hours to complete. Recovery is slow and often painful at both surgical sites. Some patients have a particularly difficult time in a reclined position, since surgical wounds exist on both the front and back of the anatomy. Physical activity is restricted for several weeks to a several months, depending on individual circumstances. Women who must use a breast implant to complete the reconstruction should be well aware of the potential risks of implant placement, including complications such as capsular contracture.

Recommendation on the Latissimus Dorsi Musculocutaneous Flap

This technique is a miracle of modern surgical technology. Witnessing the wonder of this procedure is simply awe inspiring and really makes you appreciate the genius of our most brilliant medical minds. The LDM flap is a good option for women who want to use their own tissue, as part, or all of the reconstruction, but do not qualify for TRAM flap due to a lack of abdominal tissue or some other reason. Women with small breasts can usually achieve complete reconstruction of a new breast without utilizing an implant of any kind. This is particularly nice for those who really prefer an all organic procedure. For women who do require an implant, results are excellent and recipients are generally thrilled with their results. Talk to your plastic surgeon about whether the LDMF procedure is right for your individual breast reconstruction needs.

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12/13/07 Revised 2/27/08