ID Sein

Reconstruction with latissimus dorsi flap

reconstruction par lambeau

The procedure

The procedure involves transferring a range of skin, muscle and fat taken from the back, to the thorax. The flap provides sufficient tissue to ensure that the breast reconstruction has a natural curve. Depending on the thickness of the flap and the size of the breast that is being reconstructed, it might be necessary to add an implant.

This flap is called "pediculed" as it remains connected to its blood vessels (vascular pedicule) when it is transferred from the back to the thorax. The pedicule is located under the arm: the flap is passed from one side of the thorax to the other via the armpit, without being detached from its vessels.

intervention de recontruction par prothèse

Practical details

  • The procedure takes 2 to 3 hours.
  • General anaesthesia.
  • Hospitalisation for 2 to 5 days. The patient leaves the clinic with a Redon drain.
  • The after-effects of the operation are not very painful.
  • The dressings, changed regularly, are kept on for 15 days.
  • Convalescence lasts for 2 weeks to 1 month.
reconstruction par lambeau - post opération 1

Advantages

  • The cosmetic results are often very good even when the local conditions are not ideal
  • This technique is almost always possible
reconstruction par lambeau - post opération 2

Disadvantages

  • Removal of the flap does not cause functional impairment (arm movement is not limited), but it leaves a horizontal scar of about 15 cm on the patient's back, at the height of the bra strap. Around 30% of women complain of a persistent feeling of discomfort in their back.
  • The reconstructed breast is sometimes not very mobile in some movements.

Potential complications

  • The back drain can sometimes be left in place for quite a long time, sometimes up to 3 weeks after the surgery.
  • Flap necrosis is a rare complication.
  • Dehiscence (rupture) of the scar is a rare complication.

It is always possible to carry out a breast reconstruction, even years after removal.
In the absence of radiotherapy, reconstruction can take place 6 months after the mastectomy (after tissues are well healed).
In the case of radiotherapy, it is preferable to wait for one year. In the meantime, it is recommended to massage the chest area of the breast to soften the tissues.

 
  • Right breast reconstruction with latissimus dorsi flap

  • Immediate breast reconstruction with latissimus dorsi flap and prosthesis

  • Mastectomie Right breast mastectomy immediate reconstruction with left breast reduction

  • Mastectomie Immediate left breast reconstruction with latissimus dorsi and prosthesis

  • Delayed left buried by large dorsal reconstruction

  • Failed reconstruction using prosthesis: Infection and removal of prosthesis

  • Mastectomie Immediate left breast reconstruction with latissimus dorsi flap

  • Delayed right breast reconstruction with latissimus dorsi flap without prosthesis

  • Immediate breast reconstruction with latissimus dorsi flap and prosthesis