Breast Reconstruction With Extended Latissimus Dorsi Flap and Silicone Implant

Abstract

Breast carcinoma is the most common female malignancy. Mastectomy and breast reconstruction are indicated to treat the disease and to improve quality of life. The aim of this study was to compare the esthetic results of breast reconstruction with extended latissimus dorsi flap and implant for breast cancer with and without denervation of latissimus dorsi muscle.  
Our study was a retrospective review of prospectively collected data. Surgery was performed as primary reconstruction in 24 (75%) and secondary reconstruction in 8 patients (25%). All patients were consecutively divided in two equal groups (with 16 patients each) with latissimus dorsi muscle intact or denervated. Their average age was 46.2 years. Primary reconstruction was done for stages I and IIA, and secondary reconstruction one year after the completion of oncologic treatment. Postoperative follow-up was two years.
Early complications (hematoma, infection) were not observed and dorsal seroma was observed in four women (12.5%). Partial flap necrosis was found in one case, but complete flap necrosis was not found. In six patients (18.7%), unacceptable scarring at the donor site required correction.Two years after reconstruction the patients assessed the procedure as very good or excellent. Excelent grade was often statisticaly significant in the group with innervated flap.  
Primary or secondary breast reconstruction should become an integral part of breast cancer treatment. Extended latissimus dorsi flap with implant is a safe and relatively simple reconstruction technique and should be preferred to other similar  techniques. We suggest the reconstruction with innervated musle flap for better esthetic results. 

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