The Kite Latissimus Dorsi Flap for Breast Reconstruction: An Attempt to Reduce Lateral Chest Wall Deformity and Axillary Bulking.
The latissimus dorsi flap is a commonly used tissue transfer for volume replacement in partial or total breast reconstruction. In this era of cosmetic awareness and oncoplastic breast surgery, two main defects are related to the conventional technique: the back scar and the bulkiness on the lateral chest wall, under the axilla. Axillary bulking, a disturbing defect for the majority of patients, is a persistent consequence, independent of the technique used, even when the proximal tendon is cut. We describe a new approach, the kite latissimus dorsi flap, consisting of harvesting the flap, partially or totally, with pedicle dissection from the muscle, extending dissection, perforator style if needed, until the external border of the breast (anterior axillary line) is reached. The muscle is then cut at that level, leaving no unnecessary volume under the axilla, which would cause bulkiness and chest wall deformity.


METHODS
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Champalimaud Clinical Center, Breast Unit, Champalimaud Foundation, Av. Brasilia, 1400-038, Lisbon, Portugal. joao.anacleto@fundacaochampalimaud.pt.|Hospital da Trindade, Porto, Portugal. joao.anacleto@fundacaochampalimaud.pt.
J
J
Correia Anacleto
Champalimaud Clinical Center, Breast Unit, Champalimaud Foundation, Av. Brasilia, 1400-038, Lisbon, Portugal.|Hospital da Trindade, Porto, Portugal.
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Mavioso
Champalimaud Clinical Center, Breast Unit, Champalimaud Foundation, Av. Brasilia, 1400-038, Lisbon, Portugal.
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PF
Gouveia
Hospital da Trindade, Porto, Portugal.
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A
Magalhães
Plastic Reconstructive Surgery Departement, Hospital Sao Jose, Lisbon, Portugal.
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J
Bastos Martins
Hospital da Trindade, Porto, Portugal.
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A
Moura
Champalimaud Clinical Center, Breast Unit, Champalimaud Foundation, Av. Brasilia, 1400-038, Lisbon, Portugal.
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Pinto
Champalimaud Clinical Center, Breast Unit, Champalimaud Foundation, Av. Brasilia, 1400-038, Lisbon, Portugal.
M J
MJ
Cardoso
D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006085:Graft Survival; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy / Q000379:methods*; D064171:Superficial Back Muscles / Q000601:surgery* / Q000637:transplantation; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation*; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome
Axillary bulking; Breast reconstruction; Lateral chest wall deformity; Latissimus dorsi flap