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Latissimus Dorsi Flap Breast Reconstruction
Autologous reliability with prosthetic precision—the latissimus dorsi flap (LDF) is back for a reason. In this episode we break down how to optimize LD flap breast reconstruction using “volume-added” harvest and smart expander/implant strategy.
We cover the operative setup from markings and skin paddle design to subfascial dissection to capture deep fat, high axillary tunneling, and inset strategies that improve contour while protecting the pedicle. We also clarify when to use expander as an intelligent spacer vs. immediate implant—and how Stage 2 refinement (4–6 months) improves final implant selection and symmetry.
Key Takeaways:
Markings: center the skin island on the muscle; align to relaxed skin tension lines to reduce ugly scars.
Volume-added harvest: stay just under thoracic fascia to bring deep fat for better mastectomy-edge camouflage.
Preserve lateral contour: respect the upper anterior “zone of adherence;” tunnel high in the axilla.
Protect perfusion: keep serratus branch intact—critical collateral if thoracodorsal is compromised.
Seroma is the enemy: quilting/progressive tension sutures + drains can reduce chronic drainage.
Disclaimer: This content is for educational purposes only and is not medical advice.
#PlasticSurgery #BreastReconstruction #LatissimusDorsiFlap #Microsurgery #PRS #Residency
Links:🎧 Full episodes available now:
Instagram: https://www.instagram.com/plasticsinpractice/
Spotify: https://open.spotify.com/show/4Ct8jOgYXP9QJin7QOuG3Z?si=JNcBxQmwT2mfz1LSJZEFKA
Apple: https://podcasts.apple.com/us/podcast/plastics-in-practice-resident-review/id1835564216
YouTube: https://youtube.com/@plasticsinpractice?si=tqLInp5vvsJFKlRO
Amazon: https://music.amazon.com/podcasts/8bef056e-7c87-4224-978e-7e691b04554a/
📘 Free Study Guides: → https://drive.google.com/drive/u/0/folders/12BUldPbCmihG-ndZh6992WqhRYyxw8ZZ
References :
Hammond DC, Loffredo MA. Latissimus Dorsi Flap Breast Reconstruction. In: [Chapter 60].
Rios J, Adams WP, Pollock T. Progressive tension sutures to decrease latissimus donor site seroma. Plast Reconstr Surg. 2003;112:1779.
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By Plastics in PracticeAutologous reliability with prosthetic precision—the latissimus dorsi flap (LDF) is back for a reason. In this episode we break down how to optimize LD flap breast reconstruction using “volume-added” harvest and smart expander/implant strategy.
We cover the operative setup from markings and skin paddle design to subfascial dissection to capture deep fat, high axillary tunneling, and inset strategies that improve contour while protecting the pedicle. We also clarify when to use expander as an intelligent spacer vs. immediate implant—and how Stage 2 refinement (4–6 months) improves final implant selection and symmetry.
Key Takeaways:
Markings: center the skin island on the muscle; align to relaxed skin tension lines to reduce ugly scars.
Volume-added harvest: stay just under thoracic fascia to bring deep fat for better mastectomy-edge camouflage.
Preserve lateral contour: respect the upper anterior “zone of adherence;” tunnel high in the axilla.
Protect perfusion: keep serratus branch intact—critical collateral if thoracodorsal is compromised.
Seroma is the enemy: quilting/progressive tension sutures + drains can reduce chronic drainage.
Disclaimer: This content is for educational purposes only and is not medical advice.
#PlasticSurgery #BreastReconstruction #LatissimusDorsiFlap #Microsurgery #PRS #Residency
Links:🎧 Full episodes available now:
Instagram: https://www.instagram.com/plasticsinpractice/
Spotify: https://open.spotify.com/show/4Ct8jOgYXP9QJin7QOuG3Z?si=JNcBxQmwT2mfz1LSJZEFKA
Apple: https://podcasts.apple.com/us/podcast/plastics-in-practice-resident-review/id1835564216
YouTube: https://youtube.com/@plasticsinpractice?si=tqLInp5vvsJFKlRO
Amazon: https://music.amazon.com/podcasts/8bef056e-7c87-4224-978e-7e691b04554a/
📘 Free Study Guides: → https://drive.google.com/drive/u/0/folders/12BUldPbCmihG-ndZh6992WqhRYyxw8ZZ
References :
Hammond DC, Loffredo MA. Latissimus Dorsi Flap Breast Reconstruction. In: [Chapter 60].
Rios J, Adams WP, Pollock T. Progressive tension sutures to decrease latissimus donor site seroma. Plast Reconstr Surg. 2003;112:1779.