Breast Reconstruction with Latissimus Muscle Flap (The James)

Breast Reconstruction with Latissimus Muscle Flap (The James)

 

The goal of any breast reconstruction surgery is to help you feel comfortable with the shape of your breasts in clothing. One type of breast reconstruction surgery uses muscles called the latissimus dorsi from your back to make a new breast. This surgery is called a latissimus dorsi musculocutaneous flap. To make this flap, the muscle, fat and skin located on one side of your back over your ribs is moved to your chest to make a new breast. The muscle flap has its own blood supply to feed the tissue that is moved to your chest wall.

At times, a device (tissue expander or breast implant) may be used in addition to the muscle to make a new breast. Your doctor will talk with you about whether or not a device will be needed. This device can be placed during surgery or at a different time. A breast implant is a balloon which contains a jelly-like substance that can be put under the muscle to make a breast shape. A tissue expander is like a deflated balloon that can slowly be filled over time to make a breast shape in the area where your breast was reconstructed. This may help make your breast look and feel more natural.

 

How long will the surgery take?

This surgery will take 4 to 6 hours. This does not include the time it will take to remove the breast during your mastectomy.

If a tissue expander is used, a second surgery will be needed later to remove the expander and replace it with a breast implant.

 

How long will I be in the hospital?

You will be in the hospital for 2 to 3 days after your surgery.

 

Where will my scar be?

The plastic surgeon will make a diagonal incision (cut) on one side of your back along your bra line. Once it is healed, your bra may hide a portion of the scar line.

 

What are the risks?

The most common risks with breast reconstruction with latissimus muscle flap include:

  • Short-term risks
    • Infection
    • Fluid build-up
    • Bleeding
    • Slow healing
    • Partial or total flap loss – the flap tissue dies after it has been moved to your chest and will need to be removed. If there are signs of partial or total flap loss, your doctor will do surgery right away to try to save the tissue.
  • Long-term risks
    • Capsular contracture - scar tissue that tightens around the implant and causes your breast to change shape and become hard.
    • Asymmetry - the size, shape or level of your breasts look uneven.
    •  Malposition - the breast implant is not in the correct position.
    • Breast Implant-Associated Anaplastic Large Cell Lymphoma (ALCL) - a rare type of cancer that can happen with breast implants.

 

What type of support will I need at home?

  • You will need to have a family member or friend drive you home after your surgery and hospital stay. They should stay with you at least 24 hours after you are home to make sure you are recovering well.
  • After your surgery, you will not be able to lift, push or pull anything over 3 pounds. You will need help doing laundry, cooking and other housework.
  • You need to wait until your drains are removed and your doctor says it is okay for you to drive. You will also not be able to drive while you are taking opioid pain medicines.

 

 

© June 10, 2022. The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care.