LD Flap Procedure
The most commonly used breast reconstruction options don’t work equally well for all women simply because every woman comes into the reconstruction process having had unique experiences—though that does not discount their common trials and common goals. In most cases, reconstructive surgeons recommend using donor tissues from the abdomen to reconstruct the breast, but that’s not an option for every woman. In some cases where the abdomen lacks the necessary fat and muscle tissue—or in some cases where the first reconstruction procedure was unsuccessful—a Latissimus Dorsi (LD) Flap procedure may be the best bet.
What Happens During a LD Flap Procedure?
As with most natural breast reconstruction procedures, a donor site is selected from somewhere on your body. Tissue—including fat, muscle, and blood vessels—are moved from that donor area and configured to form a natural breast implant. The goal of these procedures is to recreate a natural look and natural feeling to the reconstructed breast. LD Flap procedures accomplish this by selecting a donor site on the back, just below the shoulder. The advantage of this site is that the plastic surgery team does not have to move the blood vessels to accommodate the new breast area. Rather, in most cases, only the muscle, tissue, and fat are moved.
The muscle used for this procedure, located in the back, is generally responsible for lifting and twisting motions, so some women who have undergone LD Flap procedures do notice a slight decrease in the strength of those motions. However, due to the modest size of the donor area, LD Flap procedures may be best for women who are looking for a small or medium-sized breast. Indeed, this donor area is rarely used as the sole source of implant material. Rather, the back tissues are often used as a supplement to give the reconstructed breast a more natural look. While the consistency of the fat in the back is slightly firmer than the belly fat that is more traditionally used, the skin donated from the back area does generally make for a very natural-looking breast once reconstruction is complete.
Am I a Good Candidate for an LD Flap Procedure?
Because every procedure has specific strengths and drawbacks, the plastic surgeons at East Coast Advanced Plastic Surgery generally look for the following characteristics in LD Flap candidates:
- You are in generally good physical condition and can withstand the stresses of major surgery
- You have undergone or are planning to undergo a mastectomy
- Your breasts have been damaged or are missing due to lumpectomy, radiation, injury, or birth defect
- Your breast abnormality or trauma causes you to feel less feminine or simply makes you unhappy or unsatisfied
- Your abdominal muscles have been eliminated as a potential donor site
- You are comfortable with a possible slight loss in twisting and lifting strength
- You desire small or medium sized breasts as your final result, or you are comfortable with augmenting natural implants with artificial implants, such as saline or silicone implants
- You desire a more natural look than an implant alone would provide
Special Considerations for an LD Flap Procedure
Everyone has a unique path that has led them to seek an LD Flap Procedure in New Jersey at East Coast Advanced Plastic Surgery, but there are some broader considerations your plastic surgeon may take into consideration:
Age: You can get breast cancer at any age, so there is no minimum age for breast reconstruction, but it highly recommended that you wait until your breast tissues have finished developing before undergoing surgery.
Cancer Treatment: As always, your breast reconstruction is secondary to your ongoing cancer treatment. Sometimes, especially if you are still receiving targeted radiation therapy in your arms or chest area, it may be too early to complete full reconstruction. Your ECAPS plastic surgeon will ask to discuss your plastic surgery with your surgeon or oncologist to ensure that you get the best treatment possible in all arenas.
Pregnancy: Because pregnancy in general causes major bodily changes, it’s important to notify your ECAPS plastic surgeon if you plan on becoming pregnant or you are currently pregnant, as this can impact the results of your surgery and your ECAPS surgeon may have special instructions in this case.
Surgery and Recovery
LD Flap procedures are nearly always performed in a hospital setting, and require a stay of one to three days in a hospital for recovery. LD Flap surgery does not necessarily require a microsurgery skill set, as the blood vessel remains in its original placement. The operation itself generally takes two to three hours. Most surgeons attempt to place the back scar that is a necessary artifact of this procedure in an area in which it will be covered by a bra strap.
While you will receive personalized care instructions for your recovery, there are some timelines that you could generally base your recovery around. It may take two to three weeks to get past the initial recovery phase, so plan on having some help around for that duration, as you may need assistance with some daily tasks. Once that recovery period is over, it may be several months before you wish to undergo any additional surgical procedures, including those that may improve breast symmetry or begin the nipple reconstruction process.