The Lateral Thoracodorsal Flap in Delayed Bilateral Breast Reconstruction for an Obese Patient with Redundant Lateral Chest Wall Soft Tissue

Abstract

Over the past 30 years, surgical methods for breast reconstruction have evolved and numerous studies have been conducted with the aim of improving aesthetic goals. However, risk factors such as smoking, diabetes, huge breast increase the postoperative complication that causes unsatisfactory result to both surgeon and patient [1,2]. Obesity (body mass index [BMI] ≥30 kg/m), one of the main risk factors, not only leads to postoperative reconstruction failure but also prolongs the operating time. It makes surgeon hesitate to choose a single ideal surgical technique. Compared to transverse rectus abdominis myocutaneous flap and latissimus dorsi flap, standard methods for autologous breast reconstruction, local flaps have some advantages in terms of aesthetic results and surgical morbidity. The technique is simpler that reduces the operating time, the surgery is less aggressive, the skin color and texture are similar, and the patient has a shorter recovery period. Described as a fasciocutaneous flap in the 1980s, the lateral thoracodorsal flap is a well studied procedure for late breast reconstruction following radical surgery. It relies on the redundancy of skin that can be pinched together without transferring tension on the mammary region [1-4]. We report the case of bilateral thoracodorsal flap with cohesive gel implant performed to woman who had redundant lateral chest wall soft tissue after modified radical mastectomy. We demonstrated the successful use of the technique, which achieved satisfactory result improving the contour of lateral chest wall.