Immediate implanting breast reconstruction with combined muscle flap of pedicled latissimus dorsi and pectoralis major muscle

Abstract

Objective To explore immediate implanting breast reconstruction after subcutaneous mastectomy by through breast lateral curved incision with combined muscle flap of pedicled latissimus dorsi and pectoralis major muscle covering the breast prosthesis. Methods 30 patients were selected in clinical stage Ⅰ or Ⅱ , and without involvement of skin and pectoral muscle. After subcutaneous mastectomy through breast lateral curved incision, by the same incision the latissimus dorsi muscle flap was removed and transferred, and the submuscular interspace was dissected, and the inferior border of the pectoralis major muscle was cut off. The pedicled latissimus dorsi and pectoralis major muscle flap were sutured and the combined muscle flap was formed to cover the breast prothesis.Results The shape and feeling were satisfactory in 30 reconstructive breasts, and 22 cases were excellent (73.3 %), and 8 cases were good (26.7 %). All the patients survived without tumor recurrence after following-up more than half a year. Conclusions The method has advantages of good cosmetic breast shape, without appendant incision, and larger breast prosthesis could be insertted. It is a good method of immediate breast reconstruction for the young women with early stage breast cancer without axillary lymph node metastasis. Key words: Breast prothesis; Breast reconstruction; Subcutaneous mastectomy; Combined muscle flap