I am about 50 lbs overweight and my plastic surgeon wants me to have a latissimus flap with an implant. Is it a good choice for me?
Latissimus Flap the Right Breast Reconstruction for Me?
Doctor Answers (8)
It might be.
Larger patients who want a tissue-based reconstruction after mastectomy do better in general with a Latissimus flap than a tummy-based flap. Your doctor should explain the options and why one might be better than another in your case. This is individual.
John Di Saia MD
Breast reconstruction options
There are so many different options for breast reconstruction. The latissimus with an implant is just one option. Without examining you and reviewing your medical history it would be difficult to tell. A latissimus is not my first choice. I usually prefer autologus tissue without an implant.
Breast Reconstruction Options for you
It is very difficult to answer your question without knowledge of your breast cancer history, your breast cancer treatment(i.e. need for radiation therapy), and of course a physicial exam. Obesity does increase the potential risks associated with any breast reconstruction. However, that does not mean that the latissimus flap is your only option.
For a generic introduction, there are two major categories for breast cancer reconstruction:
(1) implant-based and
(2) using your own tissue (autologous).
There are pro’s and con’s to each reconstructive modality. No one reconstruction is the best. Both implants-based and tissue-only autologous reconstruction can provide outstanding results. It is important to tailor a reconstructive plan that meets the goal of each individual patient and also respects the breast cancer treatment plan.
In terms of autologous (tissue reconstruction), my preference is to look to the excess skin and fat in your abdomen (tissue normally thrown away in a tummy tuck) as a donor site for breast reconstruction - through procedures such as a DIEP or muscle sparing TRAM flap. However, if the obesity in your abdomen is too great (i.e. high BMI body mass index), this may not be a good option. In which case, a latissimus flap may be the safest option.
I hope this helps.
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It really depends. Are we talking about immediate breast reconstruction or is this a delayed procedure. Meaning have you had your mastectomy or are you going to have it. It depends on if you have been irradiated, how big your breasts are, and the type of the tumor.
There is no straight forward answer, which is why I spend 1 hour during the consultations with my patients when they are undergoing breast reconstruction.
We just need more info. But if that is what your plastic surgeon is recommending, there must be a reason for it.
Breast reconstruction when over ideal body weight
That is probably the reconstructive option with the lowest complication rate in an overweight individual other than no surgery at all. Of course, you could consider a staged expander and implant reconstruction as an alternative.
Latissimus breast reconstruction
While a latissimus flap and implant combination is a common reconstructive method following mastectomy, you do not give enough information to make a suggestion. The fact that you are overweight makes planning difficult without knowing if you are stable or in the process of gaining or losing weight. Also the state of the good breast, which becomes the template or goal for the reconstruction, is unknown.
You should careful plan out your alternatives. How stable your weight is will be important and what to do, if anything, about your good breast is also important to address prior to planning the reconstruction. There are also methods to use the latissimus alone without an implants and this would be a definite advantage since then you wouldn't have to worry about the risks and complications of the implant.
It is a choice but without photos there is no way to determine which breast reconstructive operation option to recommend you chose.
Regards from MIAMI
Breat reconstruction options
There are several options available for breast reconstruction which should be presented and discussed with the patient. The final decision depends on several factors.
Option one: is Reconstruction with tissue expander, then an implant
Option two: TRAM Flap
Option three: Latismus Dorsi Flap with or without implant
Option four: Autologus Free tissue Transfer (Free Flap), There are now many types of free flaps.
The final decision depend on if you had radiation or not. your body build, and your preference, after thorough discussion of the risks and complications of each procedure.