title: Latissimus dorsi muscle flap and tissue expansion for breast reconstruction.
abstract: BACKGROUND
  After mastectomy for breast cancer, especially when combined with radiation, inadequate wall thickness and insufficient elasticity of the skin are problems frequently encountered in breast reconstruction. We describe a reconstruction method using a latissimus dorsi muscle flap, followed by expansion, that creates no additional scar.
  
  
  METHODS
  This retrospective study included 30 patients who underwent this 4-surgery reconstruction: the muscle flap was raised and drawn through the mastectomy scar; the expander was inserted; expander replacement with the definitive prosthesis and concomitant symmetrization of the contralateral breast; finally, reconstruction of the nipple-areola complex.
  
  
  RESULTS
  Only 1 failure, prosthesis extrusion, was observed. A surgeon scored the outcomes as above average for 26 women, who were satisfied.
  
  
  CONCLUSIONS
  We noted an overall lower complication rate and a lower reconstruction-failure rate compared with reported results. This approach obtained better tissue quality; the flap provided better covering thickness and expansion, yielding a larger muscle-skin pocket.
  
  
  CONCLUSIONS
  This reconstruction procedure seems reliable and extends the indications of skin expansion, with satisfactory results.
authors.affiliation: Plastic, Aesthetic, Reconstructive and Burn Surgery Unit, Rothschild Hospital, Paris, France.
authors.forename: Maurice
authors.initials: M
authors.lastname: Mimoun
authors.forename: Marc
authors.initials: M
authors.lastname: Chaouat
authors.forename: Bruno
authors.initials: B
authors.lastname: Lalanne
authors.forename: Stéphane
authors.initials: S
authors.lastname: Smarrito
mesh_terms: D000328:Adult; D019928:Breast Implantation; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D009558:Nipples / Q000601:surgery; D012189:Retrospective Studies; D013524:Surgical Flaps; D015626:Tissue Expansion