This natural breast reconstruction technique uses the latissimus dorsi muscle located on the side of the upper back to recreate a breast shape. The latissimus dorsi is the most harvested muscle in the back region. Plastic surgeons appoint a flap of skin, fat, muscle, and associated blood vessels for use in the reconstruction. This flap will be moved under the patient’s skin from the back to the chest area – where it is needed for the reconstruction. Blood vessels in the donor tissue are left attached to the original blood supply in the back. Since a portion of the muscle is used in this procedure, the latissimus dorsi flap is usually considered to be a muscle-transfer reconstruction type.
Phoenix plastic surgeon Dr. Tessler and Dr. Turin are seasoned specialists in the Latissimus Dorsi Flap (LDF) technique. Although the skin on the back has a slightly different color and texture than breast skin, LDF breast reconstruction can look very natural. Dr. Tessler and Dr. Turin take each patient as unique and develops a customized LAT dorsi reconstruction to suit their goals. He has helped many lumpectomy patients from Phoenix, Scottsdale, Gilbert, and surrounding AZ cities feel whole again after battling the scourge of cancer.
Who is a candidate for a Latissimus Dorsi Flap?
Since the donor site for this technique is closer to the chest than other donor sites, and since blood vessels in the back are usually strong, this type of breast reconstruction may be a great choice for women who are not good candidates for DIEP and other flap techniques for various reasons, such as:
- Lack of sufficient donor tissue in the abdomen
- They have had a previous flap surgery that failed, necessitating a secondary alternative
- Lack of access to plastic surgeons who can perform the microsurgery that is required for free flap techniques
LAT Dorsi breast reconstruction may be a good option for women who have small to medium breast size since there is not much fat on this part of the back. In many cases, a breast implant has to be placed below the flap in order to achieve the desired size, shape, and projection.
Lat flap surgery is performed at an accredited medical facility under general anesthesia or IV sedation. The surgeon will then create an elliptical incision on the back, usually along the natural creases of the skin. They will then lift the latissimus dorsi muscle along with a patch of skin that is to be used to replace the nipple-areola complex. The blood supply is kept intact as the donor tissue is moved around to the front of the chest to create the new breast shape. If an implant is needed to provide a complete result, then the surgeon will create a pocket under the muscle for the implant. Once the procedure is complete, the patient is moved to Dr. Tessler and Dr. Turin’s recovery room before being taken to a hospital room where they stay for about 3-5 days for further monitoring.
Drawbacks of the LAT Dorsi technique
While the LAT Dorsi breast reconstruction approach provides a natural outcome, some possible drawbacks include:
- Risk of partial strength loss – it is possible to have partial loss of function or strength because part of the muscle tissue is used in the reconstruction. This can make it harder to twist, lift things, and perform certain physical activities such as swimming, golfing, playing tennis, and turning objects.
- An implant – an implant may be needed in order to achieve the desired breast size and shape. Some women complain that the implant feels a little firmer than the tissue in front of it. (Volume can also be achieved by Fat Grafting, instead of an implant)
- Tighter feeling – since fat from the latissimus muscle is quite stiffer than fat from the belly area, some women complain that their LDF reconstructed breast feels a little tighter than their other breast.
Recovery after LAT Dorsi Surgery
Before you are discharged from the hospital, you will be told how to care for your dressings. Since you just had surgery on two sites (your chest and your back), you may feel worse than someone who had mastectomy alone. Soreness and swelling are common after this procedure but usually dissipate after a few weeks. Dr. Tessler and Dr. Turin will provide pain medication to increase your comfort level, as well as antibiotics to prevent infections. You will be required to commit as much time as possible to resting and recovery. Many patients are able to resume light daily activities within 4-6 weeks. However, intense activities such as strenuous sports, heavy lifting, and sexual activity should be avoided until after you get the green light from the surgeon. Scarring is usually hidden under bra lines and tends to fade well with time.
After your LAT dorsi surgery in Scottsdale, Phoenix, Gilbert, or surrounding Arizona cities, Dr. Tessler and Dr. Turin will ask that you attend a number of post-operative visits that are important to monitor your recovery progress. The surgeon will use these visits to check your incision points, check for abnormalities, and generally assess your recovery progress. It is paramount that you attend all post-operative appointments and firmly adhere to your surgeon’s recovery instructions in order to ensure speedy and optimal healing.
The Women’s Health and Cancer Rights Act (WHCRA) of 1998 requires all group health insurance plans that pay for mastectomy to also cover all stages of breast reconstruction, including corrective procedures, insertion of prosthesis, as well as post-mastectomy lymphedema. Your health insurer should pay for breast reconstruction, whether it is done at the same time as the mastectomy/lumpectomy, or years later. This includes reconstruction procedures that may be needed over time to improve the reconstructed breast or create a balance between the two breasts. Keep in mind though that government and church-sponsored plans are not always required to cover reconstruction, so you may need to check with your insurance provider.
Schedule your Breast Reconstruction in AZ
Working with a highly experienced, board-certified plastic surgeon is the first step towards ensuring a successful breast reconstruction procedure. Dr. Tessler was appointed assistant and associate professor of Plastic Surgery at LSU (Louisiana State University) and Tulane University. He has also served as Director of Plastic Surgery at University Medical Center, as well as contributed important research in the field and trained dozens of the upcoming plastic surgeons. Dr. Tessler’s passion lies in restoring form and function while improving the quality of life of his patients. He brings a friendly and personalized approach to reconstruction surgery while working with highly qualified anesthesiologists and other support staff who strive to deliver the best latissimus dorsi flap surgery Phoenix, AZ has to offer. Get in touch with Tessler Plastic Surgery to schedule your first appointment today.