Revision surgery following extended latissimus dorsi flap and implant based breast reconstruction: a district general hospital experience (2018)

Type of publication:
Conference abstract

Dube M.; *Sheikh H.; *Rastall S.

European Journal of Surgical Oncology; Jun 2018; vol. 44 (no. 6); p. 902-903

Introduction: Extended latissimus dorsi (ELD) flap breast reconstruction has been a very well-established reconstruction modality after mastec-tomy. Although recently number of ELD flap operation has decreased due to popularity of implant based reconstruction we found rate of revisional surgery were less with ELD reconstruction. Rates of revisional surgery have been quoted between 30%-75% in the literature. After 5 years we evaluate our rates of revision surgery. Methods: Analysis of a prospectively maintained breast reconstruction database. Types of initial surgery, complications and rate of revision sur-gery after radiotherapy specifically noted. Results: Total Reconstructions: 127 Immediate Reconstructions: 90 (78 ELD flap, 12 Implant only with acellular dermal matrix (ADM) Total patients who had further surgery 5 Fat grafting after ELD Flap 3 Fat grafting after implant only 1 Changeofimplant 1 *Patients with ELD reconstruction also had post-operative radiotherapy and 1 had small skin breakdown of the breast after primary surgery. Delayed Reconstructions: 37 Fat grafting after ELDflap Reconstruction 1 Symmetrisation surgery: 9 Total Patients requiring contralateral symmetry surgery 9 Augmentation mastopexy after immediate ELD 2 Mastopexy after delayed ELD 1 Reduction mastopexy after immediate ELD 4 Reduction mastopexy after delayed ELD 2 Time from primary surgery to symmetrisation or corrective surgery was between 8 months to 3 years. Conclusions: About 1.5% of patients required corrective surgery to the reconstructed or contralateral breast. High level of patient satisfaction found with ELD flap breast reconstruction than implant as only small number of patient required corrective surgery even after postoperative radiotherapy.