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 4

Flap doing well

Projection adequate

Inframammary crease in correct position

Week 2 – Oedema reducing, Flap and implant doing well

DELAYED BREAST RECONSTRUCTION

Mastectomy for CystosarcomaPhylloides 3 yrs ago

Planning….

Size of implantMarking for Lat Dorsi and skin paddle

Landmarks in standing position

Harvest of Latissimus DorsiMyocutaneus 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

Shailesh nisalRamya nisal

sparsh clinics nagpur indiawww.sparshclinics.com

Thanks …. Questions?