Reconstruction with own tissue and implant

In a delayed or secondary breast reconstruction, not only volume is needed, but skin too. The Latissimus Dorsi flap uses the muscle from the back of the shoulder blade which is then brought around to the breast mound to create the new breast. As the muscle itself doesn't provide sufficient volume for an entire breast, an expander implant is also necessary, which is inserted at the same time underneath the latissimus dorsi. The expander is then replaced by a permanent implant during a second stage surgery. The scar is either placed horizontally under the bra straps or, slightly vertically. 

Why is the muscle from the back necessary?

Expansion of the skin after radiotherapy is not advisable, therefore the LD flap is necessary in order to gain sufficient skin. Furthermore, using the LD flap reduces the time of expansion in comparison to an expander only. Ostensibly, the aesthetic result is superior and the rate of complication, lower.

Who are candidates for this reconstruction type?

Women who would prefer not to have scarring on their tummy, buttocks, or thigh might opt for this procedure. As well as larger breasted women who perhpas won't be able to recreate a  full breast using autologus tissue only.

What are the disadvantages of this procedure?

There is a possibility of some weakness in the arm and back muscles which could need physical therapy. Women who are very active in sports need to know that this procedure can reduce their ability to play golf and tennis, swim or climb.