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What is extended latissimus dorsi flap surgery?

What is extended latissimus dorsi flap surgery?

Many women choose to have breast reconstruction after a mastectomy, a surgery often used in breast cancer treatment that removes one or both of the breasts. There are several types of reconstruction surgery available, including implants, TRAM flap, DIEP flap and latissimus dorsi flap procedures.

Extended latissimus dorsi flap reconstruction is the method used by surgeons to reconstruct the breast in the normal anatomical plane, in front of the pectoralis major muscle. This article will guide you through exactly what extended latissimus dorsi (ELD) flap surgery is, who it is for and what the process involves.

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What is extended latissimus dorsi flap surgery?

ELD flap surgery is a method of autologous breast reconstruction. It aims to reconstruct the breast by taking an oval flap of skin from the latissimus dorsi muscle, which is located in your back and just below your shoulder.

The surgery uses the oval flap of skin from this area as well as blood, muscle and fat to create a natural breast reconstruction. Because of the amount of fat in the skin that is used in reconstruction, the ELD flap surgery does not require implants. This is different from the standard LD flap reconstruction procedure which does use implants to recreate the breast.

The flap is placed under your skin and around the breast to rebuild its shape and size. Any blood vessels in the flap will remain attached to their original blood supply. The final result will look very natural because the skin from the latissimus dorsi flap has a similar texture and colour to that on your breasts.

ELD flap surgery can be used for immediate or delayed reconstruction after mastectomy and is overall a reliable procedure. However, this surgery can be intensive and is not suitable for everyone.

Who is extended latissimus dorsi flap surgery suitable for?

To undertake ELD flap surgery, you must have sufficient back fat, skin and muscle to adequately build the breast. If you do not have enough fat, muscle or skin on your latissimus dorsi muscle, it will be more difficult to rebuild the breast using this operation. Ideal candidates for ELD flap surgery will not have any existing medical conditions that may increase the risk of complications during or after the surgery.

Most cancer patients who have had a mastectomy will be offered—or at least informed about—ELD flap surgery. If you are not suitable for the procedure, your surgeon should make you aware of this and tell you why.

The operation is generally safe to conduct in conjunction with radiotherapy treatment, so undergoing this type of cancer treatment will not affect your chances of getting extended latissimus dorsi flap surgery. You should fully discuss all reconstruction options with your surgeon before deciding on a procedure.

What is the surgery process?

Before the surgery

Before embarking on ELD flap surgery, you should meet with your plastic surgeon to discuss and develop a good strategy for your breast reconstruction. During this stage, you should ask any questions that you have about the surgery and make sure that all of the options available have been fully discussed with you. Your surgeon should also disclose any implications that you may experience as a result of the surgery.

Usually, your doctor will give you guidelines to follow before the surgery takes place. These guidelines may cover diet, exercise, drinking and smoking habits. Adopting good lifestyle habits before your surgery will make for an easier recovery and will ensure that your body is healthy enough to go through the procedure.

During the surgery

During the ELD flap surgery, an incision will be made into your back, near the shoulder blade. Then, a section of skin, blood fat tissue and latissimus muscle is slid under your arm to the chest, where it is then formed into a breast shape. Surgeons are careful to leave blood vessels attached to their original blood supply. The ELD flap surgery will last around three-four hours.

After the surgery

Once the procedure is complete, you will be moved to a recovery room, in which nurses will monitor your heart rate, blood pressure and body temperature. You will also be frequently asked whether you are experiencing any pain or discomfort. It is recommended that you stay in the hospital for two to four days after the surgery.

Recovery from the surgery can take around four weeks. You will be given instructions by your surgeon to follow during this recovery process. You will have had surgery on two sides of your body, which means that you will have to take care of both areas. Most recovery involves rest and a good diet. You may also be told not to lift anything heavy, to avoid strenuous sports or sexual activity and to see a physiotherapist to help with your recovery.

Frequently asked questions

What is a mini LD breast reconstruction?

The mini latissimus dorsi flap surgery is another form of autologous reconstruction but is used for smaller breast reconstructions. In this surgery, the underlying tissue is not always taken from the latissimus dorsi, so no loss of function is experienced in the muscle.

What are the possible complications of latissimus flap breast reconstruction?

Many of the risks involved with latissimus flap surgery are much the same as those presented by having a mastectomy. The main risks include tissue breakdown, muscle weakness and lumps in the reconstructed breast.

If you are considering extended latissimus dorsi breast reconstruction surgery but still have some questions about the procedure, feel free to contact our team today. Deciding whether or not to have breast reconstruction surgery can be a difficult process and we are here to help you every step of the way.