What Can Be Done to Fix a LAT Flap That is Painful and Twitchy?

I agree with the other surgeons who have responded. Putting the muscle back is not even a possiblity at this point. The best solution is a fairly small procedure to divide the nerve to the muscle. This does cause the muscle to shrink somewhat, but it will still stay in position and keep the implant covered (it will just thin out). Over time the pain in your back will probably diminish. If the muscle thins out, a relatively non invasive way to add some bulk to the reconstruction is fat... more

I am sorry to hear about your experience with the breast reconstruction. You are Better off to try to salvage the Lat. flap with cutting the nerve supply to the muscle. Reattachment of the Lat.muscle is possible but nit practical.

I do not think the answer is to return the Latismus Dorsi muscle back and reattach it. It is a big surgery and will not help with the pain or twitching. The twitching can be alleviated by transecting the nerve to the latismus Dorsi. But it may atrophy and the breast become smaller. As far as other options in breast reconstruction, there are other free flaps like the gluteus maximus free flap. However you already have a Latismus muscle, work with your plastic surgeon... more