Autologous Latissimus Dorsi Breast Reconstruction

  • Emmanuel DelayEmail author
  • Oanna Meyer Ganz
  • Christophe Ho Quoc


Breast cancer surgical treatment causes important sequelae. Because of its psychological benefits, breast reconstruction has become an integral part of breast cancer. Therefore, an increasing number of patients undergo immediate or delayed breast reconstruction. Nevertheless, reconstruction can be challenging. The autologous latissimus dorsi flap is our technique of choice for optimal long-term results. It is always associated with a second stage of fat grafting (lipomodelling), as the latissimus dorsi flap is an ideal recipient matrix for fat grafts.

The anatomical concepts for the autologous latissimus dorsi flap and its surgical procedure will be presented in the following chapter. The indications and limitations of the technique will also be discussed.

In conclusion, autologous latissimus dorsi flap associated with fat grafting (lipomodelling) is our first choice in autologous breast reconstruction. It is a safe and reliable technique with optimal cosmetic results and can be considered today as the new gold standard in breast autologous reconstruction.


Breast reconstruction Latissimus dorsi flap Autologous breast reconstruction Lipomodelling Lipofilling Fat grafting 




Supplementary material

Video 41.1

(MP4 127239 kb)


  1. 1.
    Delay E, Ho Quoc C, Garson S, Toussoun G, Sinna R (2010) Reconstruction mammaire autologue par lambeau musculo-cutanéo-graisseux de grand dorsal pédiculé. In: EMC (Elsevier Masson SAS, Paris), Techniques chirurgicales—Chirurgie plastique reconstructrice et esthétique, 45-665-CGoogle Scholar
  2. 2.
    Delay E, Moutran M, Toussoun G, Ho Quoc C, Garson S, Sinna R (2011) Apport des transferts graisseux en reconstruction mammaire. In : EMC (Elsevier Masson SAS, Paris), Techniques chirurgicales—Chirurgie plastique reconstructrice et esthétique, 45-665-DGoogle Scholar
  3. 3.
    Tansini I (1906) Sopra il moi nuovo processo di amputazione della mamella. Gazetta Med Italiana 57:141Google Scholar
  4. 4.
    Olivari N (1979) Use of thirty latissimus dorsi flaps. Plast Reconstr Surg 64:654–661CrossRefGoogle Scholar
  5. 5.
    Hokin JA (1983) Mastectomy reconstruction without a prosthetic implant. Plast Reconstr Surg 72:810–818CrossRefGoogle Scholar
  6. 6.
    Marshall DR, Anstee EJ, Stapleton MJ (1984) Soft tissue reconstruction of the breast using an extended composite latissimus dorsi myocutaneous flap. Br J Plast Surg 37:361–368CrossRefGoogle Scholar
  7. 7.
    Delay E, Gounot N, Bouillot A, Zlatoff P, Rivoire M (1998) Autologous latissimus breast reconstruction. A 3-year clinical experience with 100 patients. Plast Reconstr Surg 102:1461–1478CrossRefGoogle Scholar
  8. 8.
    Gisquet H, Delay E, Toussoun G et al (2010) Efficacité du capitonnage dans la prévention du sérome après lambeau de grand dorsal. Ann Chir Plast Esthet 55:97–103CrossRefGoogle Scholar
  9. 9.
    Delay E, Jorquera F, Pasi P, Gratadour AC (1999) Autologous latissimus breast reconstruction in association with the abdominal advancement flap: a new refinement in breast reconstruction. Ann Plast Surg 42:67–75CrossRefGoogle Scholar
  10. 10.
    Delbaere M, Delaporte T, Toussoun G, Delay E (2008) Mastectomies avec conservation de l’étui cutané: comment éviter les souffrances cutanées ? Ann Chir Plast Esthét 53:208–225CrossRefGoogle Scholar
  11. 11.
    Delay E, Mojallal A, Vasseur C, Delaporte T (2006) Immediate nipple reconstruction during immediate autologous latissimus breast reconstruction. Plast Reconstr Surg 118:1303–1312CrossRefGoogle Scholar
  12. 12.
    Delay E (2006) Lipomodelling of the reconstructed breast. In: Spear SE (ed) Surgery of the breast: principles and art, 2nd edn. Lippincott Williams and Wilkins, Philadelphia, pp 930–946Google Scholar
  13. 13.
    Delay E, Garson S, Tousson G, Sinna R (2009) Fat injection to the breast: technique, results, and indications based on 880 procedures over 10 years. Aesthet Surg J 29:360–376CrossRefGoogle Scholar
  14. 14.
    Delay E (2010) Fat injections to the breast: the lipomodelling technique. In: Hall-Findlay E, GRD E (eds) Aesthetic and reconstructive surgery of the breast. Elsevier, New York, pp 171–192CrossRefGoogle Scholar
  15. 15.
    Delay E (2009) Breast deformities. In: Coleman SR, Mazzola RF (eds) Fat injection: from filling to regeneration. Quality Medical Publishing (QMP), Saint Louis, pp 545–586Google Scholar
  16. 16.
    Sinna R, Delay E, Garson S, Delaporte T, Toussoun G (2010) Breast fat grafting (lipomodelling) after extended latissimus dorsi flap breast reconstruction: a preliminary report of 200 consecutive cases. J Plast Reconstr Aesthet Surg 63:1769–1777CrossRefGoogle Scholar
  17. 17.
    Delay E, Jorquera F, Lucas R et al (2000) Sensitivity of breasts reconstructed with the autologous latissimus dorsi flap. Plast Reconstr Surg 106:302–309CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Emmanuel Delay
    • 1
    Email author
  • Oanna Meyer Ganz
    • 1
  • Christophe Ho Quoc
    • 1
  1. 1.Plastic Surgery DepartmentLeon Bérard CenterLyonFrance

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