Breast reconstruction using latissimus dorsi flap and fat transfer

Latissimus dorsi flap breast reconstruction has been widely used for 30 years in Switzerland and France. This method recreates a natural breast using tissue from the back, providing a personalised solution adapted to your needs and morphology. It was traditionally performed with a prosthesis in delayed reconstruction, one year after radiotherapy. Numerous technical advances have simplified this approach, which is now performed without placing a breast implant, favouring fat transfer to provide the necessary volume.

This option is recommended when the skin is not flexible enough or when implant-based reconstruction is not desired. It involves taking skin from the back, close to the treated breast, and positioning it correctly to rebuild the breast. Latissimus dorsi flap reconstruction is particularly useful when the breast skin is tight or after radiotherapy.

Breast reconstruction with a latissimus dorsi flap consists of removing a portion of the back muscle along with some of the overlying skin, then rotating it forward into the breast area, passing under the armpit to recreate the breast. This technique provides a strong foundation for reconstruction while maintaining arm mobility without major functional impact in most cases. 

It results in an additional scar on the back, which can be minimal thanks to endoscopic harvesting techniques. Once the muscle and skin are in place, the final breast volume is achieved through fat transfer to enhance the shape and provide a soft and natural appearance.

The surgery takes place in a clinic under general anaesthesia. The procedure lasts about 3 hours and the hospital stay is 3 to 4 days for optimal monitoring. This period ensures that recovery progresses smoothly and that the transferred tissues adapt correctly.

This reconstructive breast surgery is generally well tolerated, and progressive recovery is expected with careful postoperative follow-up. A sick leave of 3 weeks is recommended for optimal healing, and sports activities should be avoided for 3 months. After this period, a gradual return to physical activity is advised.

Soon after the operation, physiotherapy sessions are very helpful to regain flexibility and sensitivity. Physical rehabilitation plays a key role in restoring the mobility and sensation of the reconstructed breast. Postoperative follow-up is established to detect any potential complications and ensure a satisfactory long-term result.

The results of latissimus dorsi flap breast reconstruction are immediately visible, but it takes around two months to feel truly satisfied, allowing time for sensitivity to improve and for the scars and muscle tension to diminish.