BACKGROUND: After mastectomy for breast cancer, especially when combined with radiation, inadequate wall thickness and insufficient elasticity of the skin are problems frequently encountered in breast reconstruction. We describe a reconstruction method using a latissimus dorsi muscle flap, followed by expansion, that creates no additional scar. METHODS: This retrospective study included 30 patients who underwent this 4-surgery reconstruction: the muscle flap was raised and drawn through the mastectomy scar; the expander was inserted; expander replacement with the definitive prosthesis and concomitant symmetrization of the contralateral breast; finally, reconstruction of the nipple-areola complex. RESULTS: Only 1 failure, prosthesis extrusion, was observed. A surgeon scored the outcomes as above average for 26 women, who were satisfied. DISCUSSION: We noted an overall lower complication rate and a lower reconstruction-failure rate compared with reported results. This approach obtained better tissue quality; the flap provided better covering thickness and expansion, yielding a larger muscle-skin pocket. CONCLUSIONS: This reconstruction procedure seems reliable and extends the indications of skin expansion, with satisfactory results.
BACKGROUND: After mastectomy for breast cancer, especially when combined with radiation, inadequate wall thickness and insufficient elasticity of the skin are problems frequently encountered in breast reconstruction. We describe a reconstruction method using a latissimus dorsi muscle flap, followed by expansion, that creates no additional scar. METHODS: This retrospective study included 30 patients who underwent this 4-surgery reconstruction: the muscle flap was raised and drawn through the mastectomy scar; the expander was inserted; expander replacement with the definitive prosthesis and concomitant symmetrization of the contralateral breast; finally, reconstruction of the nipple-areola complex. RESULTS: Only 1 failure, prosthesis extrusion, was observed. A surgeon scored the outcomes as above average for 26 women, who were satisfied. DISCUSSION: We noted an overall lower complication rate and a lower reconstruction-failure rate compared with reported results. This approach obtained better tissue quality; the flap provided better covering thickness and expansion, yielding a larger muscle-skin pocket. CONCLUSIONS: This reconstruction procedure seems reliable and extends the indications of skin expansion, with satisfactory results.
Authors: Cedar Slovacek; Malke Asaad; David Mitchell; Jesse C Selber; Mark W Clemens; Carrie K Chu; Alexander F Mericli; Geoffrey L Robb; Summer E Hanson; Charles E Butler Journal: Plast Reconstr Surg Glob Open Date: 2022-08-24