BREAST RECONSTRUCTION WITH LATISSIMUS DORSI FLAP AND FAT GRAFT WITHOUT IMPLANT: OUR EXPERIENCE

Wanessa Pedroso Neves, Cesar Romero S. Sousa, Ana Luisa Miranda-Vilela, João Paulo Longo, Giseli L. S. Santos, Paulo E. N. de Souza, Zulmira G. M. Lacava

 

Institution: Faculdade de Ciências Médicas de São Paulo

“Objective: This study aims to show the technique for breast reconstruction with latissimus dorsi flap (LDF) without implant, using autologous fat to obtain adequate breast volume. Method: Patients were from the clinic of the Hospital Santa Casa de Misericórdia de São Paulo, diagnosed with breast cancer and indication to perform mastectomy or adenectomia with reconstruction with latissimus dorsi muscle, as well as patients who wished to perform delayed reconstruction after previous mastectomy . The fat used was taken from the side of the thigh, under low pressure, prepared and injected into the flap during the surgery, prior to resection. Results: Eleven patients underwent these technique, 5 cases delayed reconstruction and 6 immediate reconstruction, a unilateral reconstruction was performed in all cases. The average fat injected on the flap was 184ml (80-275ml); average time of surgery was 3hr41min (3hr – 4hr30min), 3hr56min on immediate reconstruction and 3hr37min on delayed reconstruction. Patients had a mean age of 43 years old and body mass index (BMI) of 24.8 (30.4-18.45). Patients who underwent immediate reconstruction 4 of 5 patients were submitted to radiotherapy without complications so far. The most common complication was seroma 4 of 11 patient on the donor area, but no major complication was seen, with an average follow-up of 7.5 months (2-14 months). Conclusion: This technique proved to be of great value, with opportunity to perform reconstruction of the breasts without the use of implant, with excellent results through the injection of autologous fat.

Key word: breast reconstruction; breast cancer; autologous fat.”