Latissimus Dorsi Flap Reconstruction
A time-tested reconstructive procedure that uses healthy muscle, skin, and fat from your upper back to rebuild a soft, natural breast mound after cancer surgery.
A time-tested reconstructive procedure that uses healthy muscle, skin, and fat from your upper back to rebuild a soft, natural breast mound after cancer surgery.
For women seeking a natural, durable way to rebuild a breast after mastectomy surgery, Latissimus Dorsi (LD) flap reconstruction remains one of the most versatile and reliable procedures in plastic surgery. While some patients choose synthetic implants alone or lower abdominal tissue (like a DIEP flap), others need healthy, well-vascularized tissue brought in to cover the chest wall—especially if they have had prior chest radiation therapy or lack sufficient abdominal tissue. At Align Plastic Surgery, board-certified plastic surgeon Dr. Tosan Ehanire performs latissimus dorsi flap reconstruction in Austin with surgical precision and compassion. Working alongside your oncology team, she uses tissue from your upper back to restore a soft, warm, and natural shape so you can feel complete in your body again.
Latissimus dorsi flap reconstruction is a pedicled flap procedure that uses your own tissue (autologous reconstruction) to recreate a breast mound.
The latissimus dorsi is a broad, flat muscle located in your upper back, resting just below your shoulder blade. During this procedure, Dr. Ehanire carefully frees a section of this muscle along with an oval island of overlying skin and fat.
Crucially, the tissue remains attached to its original blood supply (the thoracodorsal blood vessels). Dr. Ehanire tunnels under the skin near your armpit and rotates the tissue to the front of your chest wall. This brings fresh, well-vascularized tissue to create a natural, soft breast shape.
Performed under general anesthesia in an accredited hospital or surgical suite, your care day is structured for safety, comfort, and peace of mind. Prior to surgery, Dr. Ehanire marks your back donor site along your bra line or natural body folds while you are comfortably standing.
Your surgical oncologist performs the mastectomy first. Immediately following tumor removal, Dr. Ehanire steps in to begin the reconstructive phase. She makes a horizontal incision across your upper back, carefully releases the latissimus muscle and skin island while preserving its primary blood supply, and tunnels the flap forward to your chest wall.
The back donor site is closed in fine, multi-layer sutures to leave a horizontal scar easily hidden beneath a bra or swimwear. Dr. Ehanire then shapes the transferred muscle and skin to form your new breast mound, placing an implant underneath if planned. Surgical drains are placed in both the back and chest, and a supportive surgical bra is applied before you rest comfortably in recovery.
With latissimus dorsi flap reconstruction Austin patients can address complex reconstructive challenges across the chest wall following cancer surgery:
Brings healthy, un-radiated tissue with its own robust blood supply to repair thin or tight chest skin compromised by radiation therapy.
Provides a dependable autologous tissue option for women who are not candidates for abdominal flap surgery (like a DIEP flap) due to prior tummy tucks, lack of belly fat, or medical history.
Provides a protective muscle-padding layer over silicone implants, preventing implant rippling, skin thinning, or device displacement.
Rebuilds one or both breasts after cancer surgery, restoring balanced clothing fit and body outline.
Latissimus dorsi flap reconstruction simultaneously treats two major areas: the back donor site (upper back muscle, bra-line skin envelope, and latissimus fascia) and the chest wall (rebuilding the breast mound, lower pole fold, and skin coverage).
Choosing a latissimus dorsi flap for breast reconstruction provides distinct physical, structural, and aesthetic advantages:
Because the latissimus muscle remains attached to its original blood vessels during transfer, the flap has an exceptionally high success rate, making it one of the safest autologous techniques available.
When paired with an implant, the transferred back muscle acts as a soft internal blanket, providing natural warmth, softening implant borders, and significantly reducing the risk of capsular contracture.
Under the Women's Health and Cancer Rights Act (WHCRA), health insurance plans that cover mastectomies are required by law to cover all stages of reconstruction, including latissimus flap surgery, implants, and symmetry procedures on the opposite breast.
Back donor incisions are designed to sit horizontally along your natural bra line or swimsuit boundaries. Supported by Dr. Ehanire's evidence-based scar protocols, incisions are actively managed to heal thin, flat, and discreetly.
A good candidate for latissimus dorsi breast reconstruction is any woman undergoing or recovering from mastectomy surgery who needs extra healthy skin and tissue on her chest wall.
Good Candidates Include:
Who May Need Special Considerations:
Recovery requires structured aftercare as both your upper back and chest heal simultaneously.
While initial shape preservation is visible right after surgery, your final refined contours unfold gracefully over 3 to 6 months as swelling resolves completely.
Because the transferred muscle tissue maintains its living blood supply, your results are long-lasting and resilient. Your reconstructed breast mound will provide a soft, warm, and natural shape that moves comfortably with your body for decades to come.
Rebuilding a breast using latissimus dorsi tissue requires a skilled plastic surgeon who deeply respects tissue mechanics, microvascular safety, and human geometry.
At Align Plastic Surgery in Austin, TX, board-certified plastic surgeon Dr. Tosan Ehanire approaches latissimus flap surgery with clinical rigor and human empathy. Bringing elite reconstructive training from Duke, Johns Hopkins, and the University of Florida, Dr. Ehanire collaborates closely with your oncology team, taking the extra time needed to deliver reliable, beautiful outcomes.
Most women do not notice a major loss of back function in daily life, as surrounding back and shoulder muscles easily compensate for everyday movements such as reaching, driving, or lifting. However, elite athletes who rely heavily on upper body pulling power (such as rock climbers) may notice subtle differences.
The donor scar is placed horizontally across your upper back, positioned carefully so it stays hidden beneath your bra band or swimsuit.
Both are very safe in experienced hands. However, because the latissimus dorsi flap is a "pedicled" flap (remaining attached to its original blood supply) rather than a "free" flap that requires microvascular reattachment under a microscope, it carries an even lower risk of total flap failure.
Yes. In fact, latissimus dorsi flap reconstruction is one of the preferred techniques for women who have had radiation therapy, as it brings fresh, healthy skin and blood supply to repair radiated chest wall skin.
Yes. Under the federal Women's Health and Cancer Rights Act (WHCRA), health insurance plans that cover mastectomies are required by law to cover all reconstructive stages—including latissimus dorsi flap surgery, implants, and symmetry procedures on the opposite breast.
