Useful vertical latissimus dorsi flap for partial breast reconstruction in every tumor location

Abstract

BackgroundWe conducted a prospective cohort study to evaluate effective technique for breast reconstruction after partial mastectomy due to breast cancer. Depending on the location of the cancer and the amount excised, what method to employ is often difficult to determine. Here, we present a new technique, using the vertical LD flap, that can be used in all partial mastectomies and can almost hide scarring. We also compare these results to the mini-LD flap. MethodsWe analyzed a total of 50 and 47 patients, who underwent breast reconstruction with the mini-LD flap and the vertical LD flap, respectively. Immediately after cancer excision, work on reconstruction began. The skin flap for vertical LD was designed in a planaria shape, such that it may be hidden as much as possible and minimize bulging during closure, and the LD muscle flap was designed with a sufficient distance in the inferior direction.ResultsOur finding showed that the vertical LD flap group required significantly less total operation time than the mini-LD flap group. While the mini-LD flap resulted in a scar that was difficult to hide, the donor site scar of the vertical LD flap could not be seen easily, and no scar was visible on the back. ConclusionsThe vertical LD flap is capable of all partial breast reconstruction, can reconstruct defects in all breast regions, and requires a rather small volume of the flap. The patients show relatively fast recovery after the operation and high patient satisfaction.