Post Nipple-Sparing Mastectomy Reconstruction: Renewed Popularity of Latissimus Dorsi Flap for More Cosmetically Appealing Results

Abstract

Background: Breast reconstruction became a dynamic continually progressing group of procedures. These procedures are aiming to provide the patients after mastectomy more symmetrical and an aesthetically pleasing recreated breast in the cases which are fulfilling multiple basic oncologic goals. The reconstruction must not impede the oncological safety or cause a delay in detection of local recurrence or adjuvant cancer management. The aim of the current study is to evaluate the surgical outcomes of the immediate breast reconstruction by latissimus dorsi flap in patients after nipple sparing mastectomy regarding the aesthetic results, post-operative complications and patient satisfaction.Patients and Methods: Eight consecutive patients having invasive breast cancer (7 patient have invasive duct carcinoma and a patient has invasive lobular carcinoma) underwent nipple sparing mastectomy. All patients had immediate breast reconstruction by latissimus dorsi flap at Zagazig University hospitals within three years. Surgical outcomes in terms of post-operative complications including hematoma, wound infection, scarring, dorsal seroma, skin necrosis, back pain, and aesthetic outcomes such as breast symmetry, visual difference of bilateral breasts, breast contour, and nipple cosmoses were assessed.Results: Surgical outcomes including post-operative complications; hematoma, wound infection were not detected. Marked back scarring (25%), dorsal seroma (12.5%) were reported. Aesthetic outcomes were satisfactory and 75% of patients reported excellent satisfaction with (2 cases) 25% were not satisfied due to the back scar or volume asymmetry.Conclusion: Following nipple sparing mastectomy, purely autogenous immediate breast reconstruction by latissimus dorsi flap is a valuable reconstructing technique in selected type of patients. It has low incidence of complications, considerable aesthetic outcomes with high patient satisfaction relieving the psychological postmastectomy trauma.