Is a Lat Flap with implant a good way to go after failed sgap procedure?

I'm 37, no chemo or rad, bi lateral mastectomy, delayed. I had an sgap that started to clot as he was preforming microsurgery. Heparin drip and needed blood transfusion. Flap looked great for 2 days then failed. His suggestion is Lat Flap with small implants in a few months after healing. I also only attempted one breast with the sgap. Is the Lat flap more successful? He states it will work. I really would like to give it a go but would like any feedback. Thank you.

Doctor Answers 3

Failed SGAP

It should be evaluated.  More importantly I perform a series of tests to look for a genetic predisposition or factors that could have led to your SGAP failure.  If you are reconstructing one side there are plenty of options besides a DIEP flap.

Lat flap for breast recon

The Lattisimus or "Lat" flap is a work horse for breast reconstruction. There are many options for autologous reconstruction and each of these options should be discussed with your plastic surgeon. A failed attempt at microsurgery should not rule out another attempt at a free flap unless you have an underlying clotting disorder. My question to you is the lat flap going to be a free flap like your sgap or a pedicled flap?  Either are fine but the most common is a pedicled flap. 

The Lat flap alone is usually not an adequate volume for most women so we are usually supplementing with an implant. For the patients who prefer not to have an implant, fat grafting is a great alternative with excellent aesthetic results. 

Chet Mays, MD
Louisville Physician
5.0 out of 5 stars 11 reviews

Yes, lat flaps are great!

A "lat dorsi " flap can add skin and volume to a breast reconstruction. This helps shape and provides extra soft tissue. The soft tissue covers an implant better and minimizes hardness. Bilateral lat flaps can be done by an experienced plastic surgeon to minimize recovery time. There are pros and cons to immediate use of implants or expanders. Look at some of our photos  to see results. I hope this helps.

William C. Rigano, MD
Dayton Plastic Surgeon
4.4 out of 5 stars 10 reviews

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