The latissimus dorsi flap brings healthy skin, fat and muscle from the upper back to the chest. It is a dependable technique, particularly when the chest skin is thin, tight or affected by radiotherapy.
Medically reviewed by Dr. Fatih KılıçUpdated 6 November 20263 min read
How the LD flap works
The latissimus dorsi is a broad muscle of the back. In this pedicled flap, a portion of the muscle — with or without an island of overlying skin — is rotated to the front of the chest while remaining connected to its original blood supply in the armpit. Microsurgery is not required.
Flap forms the new breast
Skin island
Latissimus muscle
Rotated under the arm
Figure 1Latissimus dorsi flap: muscle and a skin island from the back are rotated beneath the arm to the chest.
With or without an implant
For many women the back provides coverage but not enough volume on its own. The flap is then combined with an implant or expander, with the muscle adding a protective, well-vascularised layer. An extended LD flap, which also harvests additional fat, or staged fat grafting may allow an implant-free reconstruction in suitable patients.
Port
Figure 2The flap is often combined with an expander or implant to provide both coverage and volume.
Time to ask questions — your options are explained clearly and without pressure.
When an LD flap is often considered
After radiotherapy, to bring non-irradiated tissue to the chest
When abdominal tissue is not available for a DIEP flap
To salvage or revise a previous implant reconstruction
For partial breast defects after breast-conserving surgery
Tight, irradiated skin
Healthy flap tissue
Figure 3Bringing non-irradiated tissue to the chest makes implant reconstruction more reliable after radiotherapy.
Recovery
Hospital stay is usually two to three nights. A drain at the back is common for one to two weeks, and a seroma (fluid collection) at the donor site is the most frequent minor complication. Most people adapt well to the loss of the muscle in daily life; those who rely heavily on climbing, rowing or similar sports discuss this in advance.
01TechniquePedicled flap
02Donor areaUpper back
03Hospital stay2–3 nights
04Stay in IstanbulAbout 10–14 days
Figure 4Latissimus dorsi flap recovery at a glance.
Most women return to light daily activities within days to a few weeks.
The back scar
The donor scar is placed, where possible, so that it lies within the bra strap line and is hidden by most clothing.
Abdomen — diep / ms-tram
Back — latissimus dorsi
Thigh — tug / pap · buttock — gap
Breast reconstructed with own tissue
Figure 5The back donor scar is planned within the bra-strap line wherever possible.
Latissimus dorsi flap reconstruction in Turkey
The latissimus dorsi flap does not require microsurgery, which keeps the hospital stay short. Most international patients stay 10–14 days in Istanbul, until the back drain has been removed and the wounds have been checked.
Figure 6From online assessment to follow-up at home: the latissimus dorsi flap pathway for international patients.
Frequently asked questions
Will I lose strength after a latissimus dorsi flap?
Most patients do not notice a significant difference in everyday activities, as other muscles compensate. Some reduction may be felt in specific strenuous movements.
Can a latissimus dorsi flap be used after implant failure?
Yes. It is a common option for revising implant reconstructions affected by thin tissue, exposure or radiotherapy-related contracture.
Medically reviewed by Dr. Fatih Kılıç, Plastic, Reconstructive and Aesthetic Surgeon. This page is for general information and does not replace an individual consultation.
You do not need to decide on a surgical technique before contacting us. Share your treatment history and what you hope to achieve — your case will be assessed individually.
