2022 Volume 7 Issue 4 Pages 97-107
The latissimus dorsi myocutaneous (LD) flap has advantages of a reliably low complication rate and technical ease in autologous breast reconstruction. However, this flap is frequently used only in relatively small breast reconstruction because of the thin subcutaneous fat layer of the flap. For larger breast reconstruction, the LD flap is elevated with a small skin island and additional subcutaneous fat tissue. However, vascularity of the extended fat flap is not reliable, and the depression around the donor scar on the back is conspicuous. To avoid these disadvantages and reconstruct a larger, more natural breast without silicone implants or fat injection, we devised a new method, "Twin Birds Transformer (TBT) LD flap" .
In this method, we elevate and de-epithelialize a long, narrow S-shaped skin island on the back. The de-epithelialized skin island is divided into two flaps shaped like flying birds and combined to create a dome-shaped breast mound. The donor scar of the TBT LD flap is relatively long but not conspicuous with no depression deformity surrounds the scar on the back.
We performed 48 procedures using the TBT LD flap and believe that this technique will become one of the most useful methods in autologous breast reconstruction.
