During latissimus dorsi flap reconstruction surgery, an incision is made in your back near your shoulder blade. Then, an oval section of skin, fat, blood vessels, and muscle is slid through a tunnel under the skin under your arm to your chest and formed into a breast shape. The blood vessels are left attached to their original blood supply in your back. If any blood vessels do have to be cut, they are matched to blood vessels in your chest and carefully reattached under a microscope.
If you're also receiving an implant, the surgeon will insert that as well.
A latissimus dorsi flap procedure lasts about 3 or 4 hours.
After latissimus dorsi flap reconstruction surgery: You'll be moved to the recovery room after surgery, where hospital staff members will monitor your heart rate, body temperature, and blood pressure. If you're in pain or feel nauseated from the anesthesia, tell someone so you can be given medication.
You'll then be admitted to a hospital room. For a latissimus dorsi flap, you usually stay in the hospital for about 4 days.
Your doctor will give you specific instructions to follow for your recovery. For detailed information on what to expect after mastectomy and/or reconstruction surgery, including how to care for the dressings, stitches, staples, and surgical drains, visit the Mastectomy: What to Expect page.
It can take about 4 weeks to recover from latissimus dorsi reconstruction surgery. Because you've had surgery at two sites on your body (your chest and your back), you might feel worse than someone who had mastectomy alone and it will probably take you longer to recover. You'll have to take care of two incisions: on your breast and your back. You may need to arrange for help to take care of the incision on your back. You also may be healing from axillary node dissection (an incision under your arm where lymph nodes were removed) if your doctor recommended it.
It's important to take the time you need to heal. Follow your doctor's advice on when to start stretching exercises and your normal activities. You usually have to avoid lifting anything heavy, strenuous sports, and sexual activity for about 4 weeks after latissimus dorsi flap reconstruction. It’s worth having a short course of physical therapy with a qualified breast cancer physical therapist to strengthen and maintain range of motion in your shoulder. Ask your doctor for recommendations.