Like all surgery, latissimus dorsi flap surgery has some risks. Many of the risks associated with latissimus dorsi flap surgery are the same as the risks for mastectomy. If you've had an implant inserted along with latissimus dorsi reconstruction, there are also risks unique to implant reconstruction. However, there are some risks that are unique to latissimus dorsi flap reconstruction.
Tissue breakdown: In rare instances, the tissue moved from your back to your breast area won't get enough circulation and some of the tissue might die. Doctors call this tissue breakdown “necrosis.” Some symptoms of tissue necrosis include the skin turning dark blue or black, a cold or cool-to-the-touch feeling in the tissue, and even the eventual development of open wounds. You also may run a fever or feel sick if these symptoms are not addressed immediately. If a small area of necrosis is found, your surgeon can trim away the dead tissue. This is done in the operating room under general anesthesia or occasionally in a minor procedure setting. If most or all of the flap tissue develops necrosis, your doctor may call this a “complete flap failure,” which means the entire flap would need to be removed and replaced. Sometimes the flap can be replaced within a short timeframe, but in most cases the surgical team will remove all the dead tissue and allow the area to heal before identifying a new donor site to create a new flap.
Lumps in the reconstructed breast: If the blood supply to some of the fat used to rebuild your breast is cut off, the fat may be replaced by firm scar tissue that will feel like a lump. This is called fat necrosis. These fat necrosis lumps may or may not go away on their own. They also might cause you some discomfort. If the fat necrosis lumps don't go away on their own, it's best to have your surgeon remove them. After having mastectomy and reconstruction, it can be a little scary to find another lump in your rebuilt breast. Having them removed can give you greater peace of mind, as well as ease any discomfort you might have.
Muscle weakness: In some cases, you may have some weakness in your back, shoulder, or arm after latissimus dorsi flap breast reconstruction because some of your back muscle has been moved to your chest. You may have partial loss of strength or function that makes it hard to lift things and twist. This can affect your ability to perform certain swimming, golf, or tennis stokes, or turn and manipulate objects. If you have muscle weakness that is problematic and persistent, talk to your doctor to see if you can work with a physical therapist on these issues. Also, ask about exercises you can do to help strengthen the area.
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