A 7-year experience in utilizing the latissimus dorsi myocutaneous flap for bilateral breast reconstruction.

Due to the benefits of prophylactic mastectomy in women at risk of breast cancer or recurrent disease, we have noted an increase in the number of women presenting for bilateral breast reconstruction. Current dogma stipulates that flaps of abdominal origin constitute the gold standard of breast reconstruction.However, women presenting for bilateral breast reconstruction may either have medical contraindications or be unwilling to undergo a procedure with a significant risk of donor site and/or flap complications. The latissimus dorsi musculocutaneous flap is an excellent flap in these circumstances. In the course of our experience in utilizing this flap, we have developed modifications in both the dissection and insetting of the flap that differ from earlier descriptions. Over the past 7 years, we have utilized the latissimus dorsi myocutaneous flap for bilateral breast reconstruction in 37 women with an acceptable complication rate and a high level of patient satisfaction.