Latissimus Dorsi Flap Reconstruction

Abstract

The latissimus dorsi (LD) flap is a reliable pedicled flap suitable for the reconstruction of moderate-to-large breasts in the immediate or delayed setting. The flap provides a substantial volume of tissue for reconstruction, especially when harvested with the surrounding fat zones, and the volume of the flap can be further enhanced by the use of an implant or lipomodelling.

The LD flap may be considered for breast reconstruction in patients who are not suitable for implant or free flap techniques, for example those with a high BMI or who have undergone previous abdominal surgery.

The major disadvantage of the LD flap is the related donor site morbidity, which can include pain, shoulder weakness, and persistent seroma formation. Appropriate patient selection and meticulous operative technique are therefore key to obtaining a successful outcome.

This chapter describes the relevant anatomy of the LD flap, criteria for patient selection, the operative technique, and the recognition and management of potential complications, illustrated by relevant clinical cases.