Immediate reconstruction is an integral part of the treatment algorithm for women with breast cancer undergoing mastectomy. An optimal reconstructive technique would result in reasonable cosmesis, with minimal peri-operative complications, shorter recovery times and excellent return of function. With the evolution of skin-sparing mastectomy, the latissimus dorsi flap reconstruction has become more popular as the primary reconstruction as it meets all of these goals.

The technique of unilateral immediate reconstruction using latissimus dorsi flap with tissue expander will be described. The patient had a Stage I invasive ductal breast cancer, diagnosed by co-staged with sentinel node biopsy. This reconstruction was preceeded by a skin-sparing mastectomy by the breast surgeon.

At Jefferson, approximately 70% of patients treated with mastectomy have immediate reconstruction. Over two thirds of these are latissimus dorsi flap reconstructions with tissue expanders. This procedure takes less tha n four hours and patients are discharged in 2 to 4 days.

Latissimus dorsi flap reconstruction with tissue expander compares favorably to other reconstructive techniques. All patients undergoing mastectomy should be considered for immediate reconstruction. Latissimus dorsi flap reconstruction following skin-sparing mastectomy is our preferred method for women who do not require post-mastectomy radiation.