Arch Plast Surg.  2019 Mar;46(2):135-139. 10.5999/aps.2017.01690.

Volumetric change of the latissimus dorsi muscle after immediate breast reconstruction with an extended latissimus dorsi musculocutaneous flap

• Nam SB
• Oh HC
• Choi JY
• Bae SH
• Choo KS
• Kim HY
• Lee SH
• Lee JW

• KMID: 2446814
• DOI: http://doi.org/10.5999/aps.2017.01690

Abstract

BACKGROUND
In immediate breast reconstruction using an extended latissimus dorsi musculocutaneous (eLDMC) flap, the volume of the flap decreases, which causes a secondary deformity of the breast shape. Since little research has investigated this decrease in muscle volume, the authors conducted an objective study to characterize the decrease in muscle volume after breast reconstruction using an eLDMC flap.
METHODS
Research was conducted from October 2011 to November 2016. The subjects included 23 patients who underwent mastectomy due to breast cancer, received immediate reconstruction using an eLDMC flap without any adjuvant chemotherapy or radiotherapy, and received a computed tomography (CT) scan from days 7 to 10 after surgery and 6 to 8 months postoperatively. In 10 patients, an additional CT scan was conducted 18 months postoperatively. Axial CT scans were utilized to measure the volumetric change of the latissimus dorsi muscle during the follow-up period.
RESULTS
In the 23 patients, an average decrease of 54.5% was observed in the latissimus dorsi muscle volume between the images obtained immediately postoperatively and the scans obtained 6 to 8 months after surgery. Ten patients showed an average additional decrease of 11.9% from 6-8 months to 18 months after surgery.
CONCLUSIONS
We studied changes in the volume of the latissimus dorsi muscle after surgery using an eLDMC flap performed after a mastectomy without adjuvant chemotherapy or radiotherapy. In this study, we found that immediate breast reconstruction using a latissimus dorsi muscle flap led to a decrease in muscle volume of up to 50%.

Keyword

Mammaplasty; Superficial back muscles; Myocutaneous flap

MeSH Terms

Breast Neoplasms
Breast*
Chemotherapy, Adjuvant
Congenital Abnormalities
Female
Follow-Up Studies
Humans
Mammaplasty*
Mastectomy
Myocutaneous Flap*
Radiotherapy
Superficial Back Muscles*
Tomography, X-Ray Computed