Latissimus

The latissimus dorsi myocutaneous flap is an option that may be used for reconstruction, with or without an implant. This type of flap is not a microsurgical flap; in other words, the tissue is kept attached and rotated from the back area to the breast. This flap utilizes tissue from the back using a small ellipse of skin, as well as the back muscle. The latissimus muscle is a fan-shaped muscle that originates from the shoulder and extends into the back area. This thin tissue does not have any function related to the back, but it does act on the shoulder as an accessory muscle. However, there are other muscles in the rotator cuff area that assume the function of the latissimus dorsi for normal activities. When this muscle is used, there is a slight limitation in such actions as climbing or pushing off with the arm, but that limitation is not noticeable during normal activity. The latissimus muscle allows complete coverage of the implant that protects it from infection, scarring, and exposure while the ellipse of skin replaces the area where the nipple has been removed. Usually, the implant is an adjustable one that can be filled more when the tissue has healed after the mastectomy. This adjustable implant can eventually be replaced by a silicon gel implant, which has a more natural feel.