Background and Objective

The Latissimus Dorsi (LAT) flap represents one of the pillars in breast reconstruction; although TRAM (transverse rectus abdominis myocutaneous) flap and, in recent years, the rise of deep inferior epigastric perforator (DIEP) flap has decreased its use, it continues to constitute a basic tool of breast reconstruction, which increases its application when associated with the adipose tissue graft, not needing the use of breast implants.

We present and analyze our results in the use of the LAT flap associated with the adipose tissue graft (ATG) as an alternative to other techniques of autologous reconstruction.

Methods

We retrospectively collected 35 cases of patients with LAT flap reconstruction followed by several ATG sessions over a period of 5 years at the Plastic Surgery Department of the Hospital Clínico Universitario de Valencia (Spain).

Results

Patients´ average age was 49.17 years. All of them have undergone a radical or subcutaneous mastectomy and subsequent radiotherapy. The average number of adipose tissue graft sessions to achieve the desired volume was 3.23, with 3 being the most frequent number of sessions required (15 patients, 42.86% of the total). The graft volume ranged between 30 and 365 cc per session, with an average of 177.52 cc of graft per session. The average waiting time between sessions was 5 months.

The final aesthetic result has been very satisfactory, obtaining an evident improvement in the sequels of radiotherapy. No major complications were reported.

Conclusions

In our experience, the use of ATG associated with the LAT flap achieves an adequate final volume in the breast and improves the quality of the radiated tissues, assuming an alternative comparable to abdominal microsurgical flaps and minimizing surgical complexity of the procedure.

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