Latissimus Dorsi Reconstruction

In Brief The majority of patients with breast carcinoma are being treated with breast conservation therapy (BCT): lumpectomy and postoperative radiation. Local recurrence reported at 8% to 11% is often treated with salvage mastectomy. This has led to a growing group of patients requiring breast reconstruction after failed BCT. Reluctance to use the latissimus dorsi flap (LDF) has resulted from reports of high implant capsular contracture rates. We present a series of 12 patients who underwent LDF reconstruction after the development of recurrent breast cancer after BCT. All 12 patients had a satisfactory esthetic result. Despite previous radiation, the capsular contracture rate was 12.5% (median follow up, 50 months; range, 20–93 months). The most common complication was donor site seroma in 25% (3 of 12) of cases. The LDF yielded satisfactory esthetic results with a low capsular contracture rate. Despite prior radiation, LDF remains a good option for breast reconstruction after failure of BCT. A review of 100 latissimus/expander breast reconstructions disclosed generally satisfactory outcomes accompanied by 1 partial flap loss, 2 inframammary fold revisions, 6 capsular contractures, 34 donor site seromas, and 6 operative revisions.