Breast Reconstruction with the Latissimus Dorsi Flap

Latissimus dorsi muscle and myocutaneous flaps provide a versatile means of providing both implant-based and pure autologous breast reconstructions. The technique is well suited to lean patients and those with contraindications to the use of the lower abdomen as a donor site. The technique has been progressively refined over time to provide concealed scars and to reduce donor site morbidity. The use of endoscopic assistance, robotic flap harvest, muscle-sparing flap design, and perforator flaps based on the thoracodorsal vascular access (the thoracodorsal artery perforator flap or TAP-flap), continue to increase the utility of this donor site for breast reconstruction.