I can’t say enough good things about Dr. Gupta and his team. As a healthcare worker, I strongly feel that, when looking for a good surgeon, you should always ask the surgical nurses who to go to. The nurses I work with all said that Dr. Gupta would be their first choice for a plastic surgeon.
— Verve Patient
Latissimus Flap
What Is a Latissimus Flap?
The latissimus muscle is one of the largest muscles of your back. It spans the width of your back and helps control the movement of your shoulders.
A latissimus flap is considered a pedicle flap, this means that the blood supply remains attached at its original location. In this case the blood supply comes from the thoracodorsal artery which will remain connected near your axilla or armpit. The latissimus muscle, skin and fat will pivot from its original location, around to the front of your chest where it will be formed into your new breast.
Who Is a Good Candidate?
- You plan to have a mastectomy and do not want breast implants.
- History of radiation therapy.
- Have failed implant reconstruction and/or other autologous reconstruction.
- You should be at or close to your ideal weight, with a BMI less than 35.
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- The best candidates are non-smokers. Smoking increases the chance of complications including impairment in wound healing.
The Procedures
- You will see Dr. Gupta prior to the surgery, he will outline his surgical plan and put marks on your body.
- This is an inpatient surgery; you will just stay over 1 night in the hospital. We will see you the next morning prior to your discharge from the hospital.
- The surgery duration is typically 2.5-3.5 hours.
- During the surgery you will be carefully placed on your side. This will allow Dr. Gupta to view your back and your breast in the same position.
- He will start by creating the incisions on the back and raising the latissimus muscle which will remain connected to your skin and subcutaneous tissue.
- The latissimus muscle will be lifted off the back starting from midline (near your spine).
- It remains attached right under the axilla – this is where the blood supply originates from.
- This is where the pivot point will be when rotating the flap from the back to the front.
- An incision will be created on the breast and tissue will be lifted.
- A tunnel will be created along the lateral chest, this will allow space to pivot the latissimus muscle from the back to the front.
- The latissimus muscle and skin island will be repositioned in the chest.
- Once we have ensured there is no compromise to the blood supply, the back incision can be closed.
- The back will be closed in multiple layers ensuring that there is a strong supportive wound closure.
- 2 drains will be placed in the back.
- The latissimus muscle and skin island will be positioned in the chest and sutured into place in multiple layers.
- 1 drain will be placed in the breast.
- You will not be able to put any pressure on the new breast OR on the side of the chest. Since this flap is only staying alive with one blood vessel it is essential to prevent damage to the area under the armpit.
The Incisions
- There will be a diagonal incision along one side of your back.
- There will be another elliptical incision on the breast where the skin from the back will visible.
FAQs
You will lose ~10-15% of your pulling capability.
Yes. You will spend 1 night in the hospital to ensure you are comfortable and that the flap remains healthy after surgery.
Yes. Typically additional revisions are required to contour the shape of the breast.
Request an Appointment
Call (760) 436-7600 or fill out the form to schedule an appointment to discuss your needs in detail