Latissimus flap breast reconstruction

Latissimus flap breast reconstruction is a breast reconstruction procedure in which muscle, fat, and skin from the back are used to reconstruct a new breast. Latissimus flap breast reconstruction is an option for patients in Los Angeles, especially women who have completed radiation therapy. Compared to a breast reconstruction using skin and fat from the belly, the latissimus flap breast reconstruction has less downtime and creates a shorter scar, although the scar is visible on the back. Because the latissimus muscle does not have enough bulk to fully recreate a breast, Dr. Hirsch will usually use a permanent implant or a tissue expander, along with the latissimus muscle, to complete the breast reconstruction.

During the latissimus flap breast reconstruction procedure, Dr. Hirsch will make an incision on the back over the top of the latissimus muscle. The incision will encircle a paddle of skin and fat, which will remain in place over the top of the latissimus muscle. Dr. Hirsch will then lift up the latissimus muscle and rotate it, along with the paddle of skin and fat, to the chest by tunneling it through the side. Once the latissimus muscle is secured in place onto the breast, Dr. Hirsch will place the tissue expander or permanent implant under the latissimus muscle, and then close the incisions.

Most patients will stay for one or two nights in the hospital following a latissimus flap breast reconstruction. Patients will experience some soreness in their chest and back, which will improve during the first post operative week. Patients may also experience bruising in both the chest and back, which will improve with time and generally will resolve within the first 2 weeks following surgery.

For existing patients, click here to download latissimus flap post-operative instructions.

Frequently asked questions about latissimus flap breast reconstruction:

Will I have arm weakness after latissimus flap breast reconstruction?

Because the latissimus muscle is harvested for breast reconstruction, it is no longer functional and does not help arm movement. As a result, certain arm movements are not as strong as they were before surgery. However, this decrease in strength is usually not noticed by patients unless certain activities such as swimming and rock climbing are performed. At the time of your consultation, Dr. Hirsch will discuss if latissimus flap breast reconstruction is a good option for you, depending on your physical activity level.

Will I have drains after latissimus flap breast reconstruction?

In most cases, you will have one or two drains placed in your breast and one or two drains placed in your back during latissimus flap breast reconstruction. Although the drains in your breast will usually be removed in a week or so, the drains in your back may need to stay in place a bit longer.

When can I start exercising again after latissimus flap breast reconstruction?

You may start walking the same night as your breast surgery!  In general, it will take a few weeks for you to resume your normal activities, especially activities involving your arms.