Latissimus Flap Breast Reconstruction
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This lady had previously undergone mastectomy of the right breast for cancer. She also had treatment with radiation. Because of the radiation treatment, reconstruction with tissue expansion was not possible, and we opted to perform reconstruction with a latissimus flap from her back. She also desired to make her left breast somewhat larger, if possible.
The image on the left was taken after mastectomy, but before reconstruction procedure. The image on the right was taken after aseconds stage reconstruction, in which implants were placed at both breasts to give more volume.
This lady had undergone bilateral mastectomy for breast cancer, and she had also had radiation treatment on the left. We decided to proceed with latissimus flap reconstruction on the radiated side, and tissue expander/implant on the right side.
The image on the left is a pre-operative image. The marks show the intended incisions to be made for the right expander placement and left latissimus flap. The image on the right show a result after second stage reconstruction, with permanent implant placement on the right.
This lady presented after a mastectomy and radiation for consideration for delayed breast reconstruction. Because she had received radiation, traditional tissue expansion was not an option. Therefore, she had a breast reconstruction performed with a latissimus flap, in which the back skin overlying the latissimus was used to replace the skin damaged by radiation. Because of her larger size, a breast implant was used to obtain greater volume in the reconstructed breast; the other breast was reduced in size to obtain breast symmetry.
This lady presented after mastectomy and radiation therapy. The first image shows the early result after latissimus breast reconstruction. The radiation damage to her skin is shown by the brown skin changes (black arrow); the non-radiated skin from her back (white arrow) makes up the inferior pole of her breast. The image on the right shows her results after other side breast reduction, and nipple/areola reconstruction.
This patient had originally had bilateral mastectomy with immediate reconstruction. The right breast had been previously radiated. Some time after completion of the second stage of the reconstruction, the right breast developed an opening and the implant was exposed. This required implant removal, and after several weeks of dressing changes the wound on her right reconstructed breast is shown in the image second from left. This underscores the difficulty in attempting breast reconstruction with tissue expansion in a radiated field. To reconstruct her breast, we then opted for a latissimus flap.
The image on the right shows her results, using latissimus on the right breast, breast implant on the left.