Latissimus dorsi flap breast reconstruction

LD flaps have consistent vascular anatomy and do not require microsurgery for transfer; they also provide good soft tissue coverage over implants that potentially improves the cosmesis of the reconstructed breast while decreasing the infection and capsular contracture rates associated with implant-only breast reconstruction. The LD flap's skin paddle can be used to replace missing or deficient breast skin and enables immediate breast mound creation without the need for serial expansion of a tissue expander and subsequent placement of a permanent implant. In addition, LD flap-based breast reconstruction is an excellent option for women who are not candidates for or who do not wish to undergo abdominal flap-based breast reconstruction (Fig 12A-C). Variations of the LD flap, including the split-muscle flap and the thoracodorsal artery perforator flap, can be used to repair partial mastectomy defects with little donor site morbidity.