Breast reconstruction using your own tissue without the use of implants is called autologous (referring to your own tissue) flap surgery. An autologous flap procedure uses a combination of skin, fat, and/or muscle that is moved from areas such as your abdomen, upper back, upper hip, or buttocks to the chest where it is shaped into a new breast. Not every woman is a candidate for this type of breast reconstruction, and it is best to discuss the pros and cons of these procedures with your surgeon.
The LAT (latissimus dorsi) flap procedure uses muscle and skin from your upper back to create a new breast mound after a mastectomy. In this procedure, an ellipse-shaped area of skin and your latissimus dorsi muscle will be elevated and moved from your upper back to your mastectomy area to create your reconstructed breast. This flap provides a source of soft tissue that can help create a more natural looking breast shape compared to an implant alone. Your reconstructed breast will not look and feel exactly the same as your natural breast, and you will need additional surgery to create a nipple and areola, if your own cannot be saved.
The LAT procedure is most commonly combined with a tissue expander or implant to give the surgeon additional options and more control over the aesthetic appearance of the reconstructed breast.
Is this a good option for you?
You should consider a LAT flap reconstruction if you:
Are thin with small breast volume
Have excess back tissue
Have had previous radiation and are having an implant reconstruction
Are not a candidate for other autologous procedures involving your own tissue
Are having partial breast reconstruction to correct a lumpectomy defect
Have thin skin that requires extra coverage for an implant
Desire a more natural appearance than that of an implant alone.
Breast augmentation: Also known as augmentation mammaplasty; breast enlargement by surgery.
Breast lift: Also known as mastopexy; surgery to lift the breasts.
Breast reduction: Reduction of breast size and breast lift by surgery.
Capsular contracture: A complication of breast implant surgery which occurs when scar tissue that normally forms around the implant tightens and squeezes the implant and becomes firm.
DIEP flap: Deep Inferior Epigastric perforator flap which takes tissue from the abdomen.
Donor site: An area of your body where the surgeon harvests skin, muscle and fat to reconstruct your breast – commonly located in less exposed areas of the body such as the back, abdomen or buttocks.
Flap techniques: Surgical techniques used to reposition your own skin, muscle and fat to reconstruct or cover your breast.
General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
Grafting: A surgical technique to recreate your nipple and areola.
Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
Latissimus dorsi flap technique: A surgical technique that uses muscle, fat and skin tunneled under the skin and tissue of a woman’s back to the reconstructed breast and remains attached to its donor site, leaving blood supply intact.
Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
Mastectomy: The removal of the whole breast, typically to rid the body of cancer.
SGAP flap: Superior Gluteal Artery perforator flap which takes tissue from the buttock.
Tissue expansion: A surgical technique to stretch your own healthy tissue and create new skin to provide coverage for a breast implant.
TRAM flap: Also known as transverse rectus abdominus myocutaneous flap, a surgical technique that uses muscle, fat and skin from your own abdomen to reconstruct the breast.
Transaxillary incision: An incision made in the underarm area.