The LD flap incorporates the latissimus dorsi, the broadest muscle of the back, and is one of the oldest options available for breast reconstruction. The flap’s risk of failure is minimal because of its reliable blood supply, and it may be particularly suited to patients who have undergone past radiation treatments. In addition, the LD flap is a workhorse for salvage of failed previous reconstructions.
In this case, the surgeon tunnels muscle, fat and skin tissue from the middle of the woman’s back to the front of her chest. Because the supply of spare back tissue is limited, an implant may be placed under the flap for more volume.
When used to reconstruct one breast, the transfer of the LD flap generally takes 1½-2 hours and is followed by a three-day hospital stay. The procedure leaves a diagonal scar, about 10-15 cm long, in the middle of the woman’s back, below the shoulder blade and following the course of the ribs.
Image via the American Society of Plastic Surgeons