Breast reconstruction – lattisimus dorsi and implant
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Breast reconstruction – lattisimus dorsi and implant

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As an alternative to TRAM flap for breast reconstruction, LD myocutaneus flap with implant was used satisfactorily

As an alternative to TRAM flap for breast reconstruction, LD myocutaneus flap with implant was used satisfactorily

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    Breast reconstruction – lattisimus dorsi and implant Breast reconstruction – lattisimus dorsi and implant Presentation Transcript

    • Breast reconstruction –Lattisimus Dorsi and Implant Shailesh Nisal Ramya Nisal Sparsh Clinics Nagpur India www.sparshclinics.com
    • 50 yr old, DCIS high grade central quadrant tumor with few subcentimeter axillary nodes
    • Plan - MRM with reconstruction by LD + Implant
    • MRM Defect, turned for LD harvest
    • Lat Dorsi Myocutaneus flap raised, ready to be tunnelled
    • Closure of back, flap on chest
    • Implant in position after closure and the next day
    • Day 4Flap doing wellProjection adequateInframammary creasein correct position
    • Week 2 – Oedema reducing, Flap and implant doing well
    • DELAYED BREASTRECONSTRUCTION
    • Mastectomy for Cystosarcoma Phylloides 3 yrs ago
    • Planning…. Marking for Lat Dorsi and skinSize of implant paddle
    • Landmarks in standing position
    • Harvest of Latissimus Dorsi Myocutaneus Flap
    • Thoracodorsal Pedicle dissected and skeletonized
    • Flap tunneled to chest, implant readied for insertion
    • Implant placed, covered with muscle from all sides, closure
    • Supported Bra
    • Good volume, IMF in correct position. Absent nipple-areola, no ptosis.
    • Projection of breast equal, donor scar acceptable
    • Massage inward and upward for implant comfort
    • Before and after
    • Thanks …. Questions? Shailesh nisal Ramya nisal sparsh clinics nagpur india www.sparshclinics.com