Immediate breast reconstruction with latissimus dorsi flap and implant: audit of outcomes and patient satisfaction survey.

Abstract

A retrospective case-note study of immediate breast reconstruction using the pedicled latissimus dorsi flap with a silicone implant and a patient-satisfaction survey were carried out. Fifty-four reconstructions were performed in 52 patients between March 2001 and October 2006. Major complications included capsular contracture requiring capsulotomy (7.4%); minor complications included donor-site seroma (20.4%) and superficial wound problems (13%). The average score out of 10 for the appearance of the reconstructed breast whilst wearing a bra was 8.35; score for appearance whilst out of a bra was 7.0 and overall symmetry was 6.6. On the basis of the scores, 16 patients were grouped as excellent; 15 as good; seven as fair and two as poor. Significantly, more of the patients without a contralateral matching procedure graded their reconstruction as good or excellent (p=0.024). The pedicled latissimus dorsi flap with a silicone implant gives the majority of patients a satisfying reconstruction, without necessarily requiring a contralateral matching procedure, whilst minimising postoperative complications.