Total Breast Reconstruction Using Fat-augmented Latissimus Dorsi Flap

Abstract

The latissimus dorsi flap has advantages, such as not requiring microsurgery and allowing for quick and easy flap elevation. However, regarding total breast reconstruction after mastectomy, one frequent drawback is an insufficient tissue volume. The fat-augmented latissimus dorsi flap is a technique that increases the flap volume by performing immediate fat grafting into the flap. This method makes it possible to achieve total breast reconstruction even in cases where the breast size is beyond the capability of a conventional latissimus dorsi flap or in underweight patients who are not suitable for traditional flap reconstruction. Furthermore, in situations where skin replenishment is unnecessary, such as after nipple-sparing mastectomy or when skin expansion is carried out with a tissue expander, it is possible to avoid back incisions by elevating the flap as a muscle flap. This paper discusses important points when performing total breast reconstruction using the fat-augmented latissimus dorsi flap.