Breast Reconstruction with a Latissimus Dorsi Flap
A way to rebuild the breast using tissue from your own back, helping you slowly find your familiar shape again and feel more at ease when you look in the mirror.
Is this right for you?
This method uses a flap of tissue made up of skin, fat, and the latissimus dorsi muscle (a large muscle in your upper back), rotated to the front to rebuild the breast. It is one option when you have had, or will have, a mastectomy. Whether it fits you depends on your overall health, how much tissue is available, and what you hope for, so an in-person consultation is the clearest way to find out.
This may be a good fit if
- You have had a mastectomy (for cancer or to lower your risk) or are about to have one, and you want to rebuild the breast.
- You do not have enough abdominal tissue for an abdominal flap, or you would rather keep your abdomen as it is.
- You need extra tissue and healthy skin for coverage, especially after radiation has left the skin on your chest thin or tight.
- You understand that an implant may be needed alongside the flap to reach the volume you want, and you are open to talking this through with your doctors.
This may not be right if
- Your latissimus dorsi muscle has been damaged or divided during an earlier operation, which leaves the flap without a reliable blood supply.
- Your job or sport relies heavily on the strength of your back and shoulder, since taking this muscle can affect some of that function.
- You have an underlying condition that is not yet well controlled, or you smoke heavily, which raises the risk of wound problems and tissue that does not heal.
- You expect an immediate, finished result without accepting a recovery period and the possibility of further adjustments later.
How it works
Everything begins with a consultation. Your doctors examine your chest and your back, assess how much skin and tissue can be used, review your treatment history (especially any radiation), and listen to what you hope for in shape and size. Together with your doctor, you decide whether to use the back flap on its own or to add an implant, and whether reconstruction happens during the same operation as the mastectomy or afterward.
The surgery is usually done under general anesthesia, which means you are fully asleep and feel nothing during the operation. How long it takes varies from case to case and depends on whether an implant is placed.
Your doctor makes an incision on your back and lifts a block of skin, fat, and latissimus dorsi muscle along with its feeding blood vessel. This tissue is passed through a tunnel under the skin at the armpit and rotated to the front of the chest — the blood vessel stays connected so the tissue keeps its supply and stays alive. There, your doctor shapes it into a breast that balances with the other side.
If more volume is needed, your doctors can place an implant behind the flap. The incisions on your back and chest are closed, and small drains are usually placed to let fluid escape in the first few days. Rebuilding the nipple and areola, if you want it, is usually done as a separate step once the tissue has settled.
Realistic expectations
The goal of this method is to rebuild a breast that looks natural and balanced under clothing, not to make an exact copy of the breast you had before. Understanding this clearly from the start helps you and your doctors set realistic expectations together.
What this will not do
- It will not restore normal feeling in the rebuilt breast; the skin that is moved usually has reduced or lost sensation.
- It will not recreate the nipple during the same operation that rebuilds the breast — that is a separate step if you want it.
- It will not remove scars entirely; you will have scars on your back and chest, even though your doctor works to place them discreetly.
- It will not replace your cancer follow-up; you still need your regular check-ups as set out in your treatment plan.
Recovery
Recovery happens in stages, and it looks different for everyone. The points below are rough guides, not fixed numbers; your doctor will give you specific guidance based on your own situation.
- The first few days
- You stay in hospital for monitoring, with pain relief and wound care. Feeling tight and sore across your back and chest is normal. The drains are usually kept in during this time.
- Weeks 1 to 2
- The drains are usually removed once the fluid slows down. You move gently, limit raising your arm overhead, and avoid carrying anything heavy. Many people take time off work during this stretch, depending on what their job involves.
- Weeks 3 to 6
- You gradually return to everyday activities and light work. The incisions keep healing; it is still wise to avoid strenuous activity and exercise that puts heavy strain on your back and shoulder.
- Around 6 weeks onward
- Most people return to exercise and normal activity once their doctor gives the go-ahead. Some may notice mild weakness in the shoulder or a change in back strength early on.
- Several months
- Scars fade and the breast shape settles further over time. If a small revision or nipple reconstruction is needed, this step is usually planned once the tissue has healed.
Risks & safety
This is major surgery, and like any operation, it carries risks. Your doctors will talk through the points below honestly so you can decide with a clear understanding.
- Bleeding, a collection of blood (hematoma), or a fluid collection (seroma) under the skin that needs draining or further treatment.
- Infection of the wound, which may need antibiotics and sometimes another operation.
- The flap losing some or all of its blood supply, leading to tissue death (necrosis) that has to be removed.
- Slow healing, wound edges separating, or a lasting fluid collection on the back — a fairly common site for seroma.
- Weakness or a change in shoulder and back function from taking the latissimus dorsi muscle, varying from person to person.
- Widened scars, raised (keloid) scars, sides that are not fully symmetrical, and reduced or lost feeling in the rebuilt area.
- If an implant is used: the specific risks of implants, such as capsular contracture, rupture, or the need for replacement later.
How we do it
At The Gioi Dep, breast reconstruction is approached as a personal medical decision, not a one-size-fits-all procedure. Your doctors take time to review your whole treatment journey — including any history of radiation and earlier operations — then weigh the back flap on its own, the flap combined with an implant, or other options alongside you, to choose what suits your body and what you hope for.
Lifting and transferring the latissimus dorsi flap calls for careful technique to protect the tissue's blood supply and to limit the effect on your back and shoulder function. The team stays close to you before surgery, through your days in hospital, and at every follow-up and drain check, working with your cancer doctor when needed.
Frequently asked questions
Is this procedure painful?
You will feel nothing during the operation because you are under general anesthesia. Afterward, pain and a tight, sore feeling across both your back and chest are normal in the first few days, and they are managed with pain relief. The intensity eases over time.
What scars will I have?
You will have a scar line on your back (usually placed so clothing can cover it) and a scar on your chest. Scars fade over many months but do not disappear completely. Your doctor will talk through where the scars sit and how they run before surgery.
How long will I need off work?
Many people take a few weeks off, depending on what their job involves. Light office work usually resumes sooner than heavy work that calls for lifting, carrying, or using the back and shoulder. Your doctor will advise based on your situation.
Will the rebuilt breast look and feel natural?
Because it uses your own tissue, the breast usually feels soft and looks natural under clothing, matching the other side. That said, the skin that is moved often has reduced or lost feeling, and the result is a new breast rather than an exact copy of the one you had before.
Will taking muscle from my back make me weaker?
The latissimus dorsi takes part in some shoulder and back movements. Many people adapt well because other muscles take up the work, but you may feel weaker early on, and some jobs or sports that rely heavily on this muscle group can be affected. Talk this through in detail with your doctors.
Will I need an implant as well?
Not always. If the back flap has enough volume to balance with the other side, you may not need an implant. When more volume is needed, your doctor can place an implant behind the flap. This is decided together with you during planning.
Can I have reconstruction during the same mastectomy operation?
In some cases it can be done at the same time (immediate reconstruction); in others it is better done later (delayed reconstruction), especially if you need radiation. The right timing depends on your cancer treatment plan and will be discussed carefully beforehand.
Am I too old to have this done?
Age on its own is not the deciding factor. What matters more is your overall health, any underlying conditions, and your ability to recover. Your doctors will assess these during the consultation so you can weigh the decision together.
When can I have the nipple rebuilt?
Rebuilding the nipple and areola, if you want it, is usually a separate step done after the breast has healed and settled, often after a few months. Some people choose not to take this step, and that is a reasonable choice too.
Does this method affect cancer follow-up later on?
Reconstruction with your own tissue does not replace the check-ups and cancer follow-up set out in your plan. You still need to keep to the schedule your treating doctor sets. Be open about your history with your doctors so you get complete advice.
The next step
The next step is a conversation - book a consultation.
The content on this page is for reference only and does not replace a direct examination and consultation with a specialist physician. Surgical outcomes vary from person to person.