Immediate Breast Reconstruction With Extended Latissimus Dorsi Fat Flap After Nipple-areola Complex Sparing Modified Modified Radical Mastectomy In28Cases Of Breast Cancer

Objective:The extended latissimus dorsi fat flap（ELDFF） canprovide autogenous tissue replacement of breast volume without an implant.Nevertheless, experience with the extended latissimus dorsi fat flap forbreast reconstruction is relatively limited. In this study, the authorsevaluated their experience with the extended latissimus dorsi fat flap forbreast reconstruction to better understand its indications, limitations,complications, and clinical outcomes．Methods：From January2008to August2011，The NAC sparingmodified radical mastectomy was carried out in28Patients， andimmediately breast reconstruction with extended latissimus dorsi fat flapwere performed after the surgery. All patients underwent unilateral breastreconstruction. The operation time， blood loss， postoperativecomplications，and cosmetic outcome were assessed.Results：The mean operation time was217±75min and blood loss was126±82ml. There were10cases surfered under-flap hydration,2cases of partial nipple necrosis. All the patients were followed up for6～38months(mean22months), all the patients survived, but1cases foundlocal recurrence of breast subcutaneous and lung, bone metastases in the21months after surgery,and the remaining patients had no local recurrenceand distant metastasis. Degree of satisfaction with the cosmetic effect ofthe reconstructed breasts follow-up by telephone was “excellent”and“good” for78.6%of patients．Conclusion：In autologous reconstruction,the extended latissimusdorsi fat flap alone, without an implant, can provide good to excellentcosmetic outcome of small to medium sized breasts. The breastreconstruction of extended latissimus dorsi fat flap is a reliablemethod,providing another good option for autologous reconstruction，andshould be considered more often as a primary choice for breastreconstruction.