Delayed breast reconstruction with transverse latissimus dorsi myocutaneous flap using Becker expander implants in patients submitted to radiotherapy: A series of cases.

Abstract

BACKGROUND\nBreast reconstruction with a latissimus dorsi myocutaneous flap associated with a breast implant is a well-established procedure. However, there are few published articles regarding latissimus association with expanders and radiotherapy. This study assess data of breast reconstructions using a latissimus dorsi myocutaneous flap associated with Becker expander implant (TLDMF/E) in patients submitted to radiotherapy.\n\n\nMETHODS\nThis is a descriptive study consisting of a series of cases. Inclusion criteria were patients who underwent mastectomy, radiotherapy, and delayed LDMF/E breast reconstruction. A minimum 6-month follow-up period was established, and descriptive variables were analyzed.\n\n\nRESULTS\nOne hundred twenty-three patients were selected. The mean age of the patients was 45.1 years. Contralateral breast procedures were performed in 68 patients to achieve symmetry with substitution of the expander for an implant, with the majority of patients with an implant larger than the expander (74.0%) The nipple-areola complex was reconstructed in 77 patients (62.6%). In the donor site area, 116 patients (94.3%) had no complications. Minor complications were seroma in one patient and partial dehiscence in another patient. In the reconstructed breast, 11 patients (8.9%) had minor complications such as hematomas, partial necrosis of the native irradiated breast skin (3\u202fcm or smaller), local infections, and partial exposition of the injection port. Major complications in the reconstructed breast were necrosis (larger than 3-5\u202fcm) of the native irradiated breast skin in 5 patients (4.0%) who needed repair to avoid exposure of the expander. One patient needed expander removal due to a larger exposition.\n\n\nCONCLUSIONS\nDelayed breast reconstruction with TLDMF/E is a reliable option to selected patients with mastectomy and radiotherapy sequel.