Latissimus Dorsi Flap for Total Autologous Immediate Breast Reconstruction without Implants

Pompeo, Fabio Santanelli di; Laporta, Rosaria; Sorotos, Michail; Pagnoni, Mario; Falesiedi, Federica; Longo, Benedetto

doi:10.1097/prs.0000000000000859

Cited by 80 publications

(49 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The easy strategy usually used to overcome the relative lack of volume following hemi‐DIEP flap harvest is to reduce the opposite breast to achieve symmetry. To preserve the unaffected breast, other options that have been already described are to augment DIEP flap with an implant or to perform latissimus dorsi flap with/without implant, but less desirable for patient who wishes to avoid the use of implants or to have a scar on the posterior wall …”

Section: Discussionmentioning

confidence: 99%

Tips and tricks for DIEP flap breast reconstruction in patients with previous abdominal scar

et al. 2015

Self Cite

View full text Add to dashboard Cite

The aim of this study was to analyze outcomes of patients who had prior abdominal operations and underwent DIEP flap breast reconstruction and to describe technical strategies to insure well-vascularized flap-harvest minimizing abdominal donor-site complications. All patients who underwent DIEP flap breast reconstruction between 2004 and 2014 were reviewed and divided into a control group (CG) and a scar group (SG). Patient demographics, operative details, flap and donor-site complications were analyzed and compared. For all of the scars, DIEP flap design was not modified, but a standardized approach was developed according to the type and location of the scar, available vascular pedicle, perforator locations, and the required flap tissue for breast reconstruction. Two hundred and eighty patients underwent 292 flaps in CG and 107 underwent 111 flaps in SG. Pfannenstiel, McBurney, laparoscopic, midline and subcostal were the most common previous incisions. There were no significant differences between groups regarding demographics, flap and mastectomy weight, active smoking, or radiation status (P > 0.05). No significant differences were observed in DIEP flap loss (P = 0.909), partial flap loss (P=0.799), or fat necrosis (P=0.871) and in the rate of abdominal donor-site complications between groups (P > 0.05). SG had a significantly higher mean operative time than CG (P=0.034). Medial raw was a negative risk-factor for flap complications, while BMI (>25.1 kg/m ) and smoking-history were significant predictors for donor-site complications. With careful preoperative planning and appropriate technical strategies, successfully DIEP flap breast reconstruction can be performed without increased flap and donor-site complications in patients with preexisting abdominal scars. © 2015 Wiley Periodicals, Inc. Microsurgery 37:282-292, 2017.

show abstract

Section: Discussionmentioning

confidence: 99%

Tips and tricks for DIEP flap breast reconstruction in patients with previous abdominal scar

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…The muscle is a suitable recipient tissue for fat transfer with a good blood supply and a reasonable volume of host tissue to inject into. 21 …”

Section: Discussionmentioning

confidence: 99%

“…Recently, Santanelli et al 21 have described primary fat-augmented latissimus dorsi flap as a new surgical technique for breast reconstruction. In this procedure, fat grafting was injected into the latissimus dorsi muscle during the same reconstruction procedure, showing good results.…”

mentioning

confidence: 99%

Primary Fat Grafting to the Pectoralis Muscle during Latissimus Dorsi Breast Reconstruction

Niddam

Vidal

Hersant

et al. 2016

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background:Latissimus dorsi flap is one of the best options for immediate and delayed breast reconstruction. However, this technique is limited by the tissue volume provided by the flap. To improve breast volume while reducing complications, fat grafting is now very often used in addition to latissimus dorsi flap. To the best of our knowledge, fat grafting was always performed as a second-line surgery, at least a few months after the flap procedure. We aimed to report our experience with an associated breast reconstruction technique combining musculocutaneous latissimus dorsi flap with intrapectoral lipofilling for totally autologous breast reconstruction.Methods:Between September 2014 and January 2015, 20 patients underwent this technique for unilateral autologous breast reconstruction (14 delayed and 6 immediate breast reconstructions). A mean harvested fat volume of 278 ml (range: 190–350 ml) and a mean injected fat volume of 228 ml (range: 170–280 ml) were used.Results:None of the patients experienced complications, such as flap necrosis, breast skin necrosis, hematomas, or infection. One of the patients developed a seroma, which was treated with 3 drainage punctions. Only 2 patients underwent delayed fat grafting procedure.Conclusion:Totally autologous breast reconstruction combining latissimus dorsi flap and intrapectoral fat grafting in the same procedure is a new technique allowing increased breast volume in a single surgery.

show abstract

“…1,2,25,28 The LD flap is reliable and easy to harvest; however, flap volume is limited and of concern for patients who desire a relatively larger breast augmentation. [65][66][67] Therefore, LD reconstruction often requires a prosthesis in addition to the flap. 65 A modification of this technique, the extended LD myocutaneous flap, was introduced as a method to avoid use of the implant.…”

Section: Alternative Options For Breast Reconstructionmentioning

confidence: 99%

Free Tissue Breast Reconstruction

Dibbs

Trost

DeGregorio

et al. 2019

Seminars in Plastic Surgery

View full text Add to dashboard Cite

Free tissue transfer serves as a modern workhorse for breast reconstruction. Advancements in microsurgical technique have allowed for the development of free flap procedures that produce an aesthetic breast while minimizing donor site morbidity. Here, the authors review the use of different free flap procedures for breast reconstruction with a focus on the preferred and most commonly used flap, the deep inferior epigastric perforator flap. Each flap has its advantages and drawbacks, and certain patient risk factors increase postoperative complications. Other techniques of breast reconstruction including pedicled flaps and adjunctive fat grafting are also briefly discussed.

show abstract

Latissimus Dorsi Flap for Total Autologous Immediate Breast Reconstruction without Implants

Abstract: To the best of the authors' knowledge, this is the first report in which fat transfer was used to achieve immediate latissimus dorsi flap volume augmentation as an alternative for total autologous reconstruction, avoiding implant-related complications.

Cited by 80 publications

References 39 publications

Tips and tricks for DIEP flap breast reconstruction in patients with previous abdominal scar

Tips and tricks for DIEP flap breast reconstruction in patients with previous abdominal scar

Primary Fat Grafting to the Pectoralis Muscle during Latissimus Dorsi Breast Reconstruction

Free Tissue Breast Reconstruction

Contact Info

Product

Resources

About