title: Latissimus dorsi breast reconstruction utilizing functional muscle transfer and tissue expansion.
abstract: Latissimus dorsi breast reconstruction with implants has been criticized for Baker III or IV capsular contractures in as many as 30% of patients. Also criticized is muscle atrophy and loss of breast volume and definition. This study evaluated 2 modifications of the classic latissimus reconstruction: muscle transferred as an innervated functional unit and tissue expansion posterior to the latissimus but anterior to the pectoralis muscle. After expansion, a permanent prosthesis was placed (46 silicone gel and 3 saline). Forty-nine such reconstructions were done in 32 patients (17 bilateral and 15 unilateral), with average follow-up of 19 months. Only 4 Baker III capsular contractures (8%) and no Baker IV contractures occurred. All patients demonstrated excellent retention of breast shape/definition. This study demonstrates that functional muscle transfer and tissue expansion results in low capsular contracture rates and excellent retained breast shape.
authors.affiliation: aCCent Plastic and Cosmetic Surgery, Gainesville, FL 32653, USA. bmast@accentphysicianspecialists.com
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Mast
authors.forename: Donna K
authors.initials: DK
authors.lastname: Simoneau
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D018482:Muscle, Skeletal / Q000637:transplantation*; D013524:Surgical Flaps; D015626:Tissue Expansion / Q000379:methods*