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This operation uses a muscle called the latissimus dorsi and some overlying fat and skin from your back, and is often referred to as the latissimus dorsi flap (LD flap).
The flap and its blood supply are tunnelled under the skin below your armpit and put into position on your chest to make a new breast shape.
Often, there isn’t enough tissue to form the new breast shapes with LD flaps, so an implant may be put behind each flap. Occasionally, a large amount of fat is taken with the muscle. This is called an extended latissimus dorsi flap and may be done so that implants aren’t needed.
A latissimus dorsi flap may be suitable for women who have small, medium or large breasts.
It may not be suitable for women who:
Skin-sparing bilateral prophylactic mastectomies using a latissimus dorsi flap and nipple reconstruction (with tattooing)
Front and back view two months after skin-sparing prophylactic mastectomies using a latissimus dorsi flap (without nipple reconstruction)
This is the most common problem soon after LD flap surgery. Seromas| usually get better with time as your body heals, although they may need to be drained a few times. Occasionally seromas persist (chronic seroma) and need extra treatment.
After the operation you will have some weakness in your back and shoulders. This will improve over time as there are many muscles in the back that can compensate for the loss of the LD muscle.
You should regain full shoulder strength for most activities 6–12 months after the surgery. But you may notice weakness during some movements, such as pushing up to get out of the bath.
Most women can return to daily activities, including sports such as swimming and tennis, without any problems. However, the ability to take part in sports such as rowing, rock climbing, cross-country skiing or playing competitive racquet sports at a high level are likely to be affected by LD flap surgery.
Content last reviewed: 1 September 2012
Next planned review: 2014
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