A Skin-Sparing Breast Reconstruction Technique

Breast reconstruction usually means that a patient has had all or part of their breasts removed via a mastectomy. Is there a way to preserve some of that breast tissue to allow for a less extensive reconstruction procedure?

Until recently, there haven’t been many great options for breast reconstruction due to the limitations of medical devices and techniques. However a technique called immediate breast reconstruction after mastectomy is available, allowing for a speedy reconstruction right after breast removal.

Traditional breast reconstruction usually involves the use of silicone or saline implants. Alternatively, tissue flap techniques may also be an option. This method harvests the patient’s own muscle and tissue and is used to reconstruct the breasts.

An immediate latissimus dorsi myocutaneous flap reconstruction or (LDMF) is one such tissue flap technique that uses the latissimus dorsi muscle. This is a flat, broad muscle on your upper back located by the shoulder blades. This tissue can be transferred as a myofascial flap, a myocutaneous flap or as a composite osteomyocutaneous flap afterwards which allows for greater flexibility. In fact, this method can be combined with other subscapular flaps including serratus anterior, scapular and parascapular flaps.

The procedure has two main benefits in comparison to all the other breast reconstruction alternatives. First, it gets two birds with one stone by allowing immediate reconstruction at the same time as the procedure which eliminates any downtime in between the mastectomy and reconstruction. Secondly, this method also preserves some of the original breast tissue which makes the reconstruction process a lot less extensive. This technique can also be used in conjunction with pedicled flap approaches since it allows for larger volumes of flap tissue to be extracted.

Furthermore, this method is not limited to treating the breast wall. In fact, the latissimus dorsi mycutaneous flap can be used for head and neck reconstruction which allows for easy access to defects in the temporoparietal area. Additionally, patients who undergo LDMF breast reconstruction are known to experience improved shoulder strength and range of motion after full recovery.

Up until now, the process of breast reconstruction after mastectomy involved a lot of waiting in between procedures. This can definitely have a negative impact on one’s social life and overall self-esteem. This is perhaps one of the major advantages of the procedure which people often overlook. With this approach, patients can be treated for breast cancer and actually come out of the operating room with better looking breasts without having to wait for the mastectomy to heal and then having to undergo another surgery for reconstruction.

Although it is a relatively new procedure, an immediate latissimus dorsi myocutaneous flap reconstruction is significantly more advantageous. A shortened reconstruction process, coupled with effective results, makes this operation something to consider if you are looking for fast results after a mastectomy.

- KT