Back Tissue Breast Reconstruction

Back tissue flap reconstruction, also called latissimus dorsi flap reconstruction, uses muscle, skin and fat from your upper back to rebuild your breast after you’ve had mastectomy or lumpectomy to treat breast cancer. It’s a reliable technique that can be used alone or along with an implant.

At Banner MD Anderson Cancer Center, our surgeons have extensive experience in reconstructive microsurgery and work closely with your cancer care team to plan the best way to meet your needs. Request a consultation.

Learn more about autologous (tissue flap) reconstruction.

How back tissue breast reconstruction works

During latissimus dorsi breast reconstruction, your surgeon takes tissue from the upper back, beneath your shoulder blade, and moves it to your chest.  Depending on the need, the amount of skin varies in size and shape.  Typically, the entire latissimus muscle is moved to the chest area for reconstruction.

The blood vessels remain attached to the tissue, which is called a pedicled flap procedure. This makes the surgery less complex and quicker as compared to an abdominal flap breast reconstruction.

Your surgeon moves the back tissue to your chest and shapes it to form the new breast. Most times, a tissue expander or implant is added, so the breast is the right shape and matches your other breast.

Your surgeon will carefully close the incisions with hidden or low-visibility stitches. The incision on your back may be positioned in a way that the scar falls under your bra strap or along the natural curves of your back.

Before back tissue reconstruction, you may need to use a tissue expander for several months to create space for the tissue in your chest.

When this procedure is recommended

This type of muscle flap reconstruction may be a good option for you if:

• You have damaged or unhealthy breast skin that needs to be replaced with healthy tissue
• You don’t have enough abdominal tissue for a DIEP or TRAM flap
• You’ve had surgery or radiation that limits blood supply in other parts of your body where tissue would be removed
• Implant-based reconstruction alone isn’t suitable for you
• You need partial breast reconstruction after a lumpectomy

If you’re deciding between options, your surgeon may also discuss abdominal tissue reconstruction (DIEP or TRAM flaps) or implant-based reconstruction.

Benefits of back tissue reconstruction

This type of natural breast reconstruction after mastectomy has a few advantages:

• It gives you consistent blood flow that can help you heal well
• Surgery and recovery time can be shorter than with abdominal tissue breast reconstruction
• It can be performed with or without an implant
• There’s less risk of hernia or abdominal weakness than with abdominal flaps
• It’s an option for a wide range of body types and different treatment histories, including radiation therapy

For many people, back tissue reconstruction is a safe, effective choice that gives them a natural shape and smooth contour.

Risks and considerations

Most people have good results, with no major long-term problems. But, as with any surgery, there are potential risks, including:

• Nausea after surgery, from anesthesia
• Fluid buildup (seroma) under the incision
• Back tightness or shoulder weakness
• A visible scar on the upper back, although it usually can be hidden by a bra strap
• Tissue breakdown, if the tissue doesn’t get enough blood circulation
• Scar tissue in the breast that can feel like a lump
• Longer recovery time if an implant is part of the procedure
• Risks from the implant, if that’s part of the procedure

Your surgical team will explain how these risks apply to your situation and how they’ll help manage them.

Learn more about risks and complications.

Recovery and aftercare

Here’s what to expect after this type of autologous breast reconstruction:

• You will probably spend two to three days in the hospital after surgery. 
• Some tightness or soreness in the back and chest is normal for several weeks.
• Your care team will teach you gentle stretches to maintain shoulder flexibility and prevent stiffness.
• You should avoid lifting heavy objects or reaching overhead until your surgeon clears you, which is usually around four weeks after surgery.

See what to expect during recovery and aftercare.

Who may be a good candidate

You may be a good candidate for back tissue reconstruction if you:

• Have had radiation therapy and need healthy tissue that has good circulation
• Don’t have enough abdominal tissue for a DIEP or TRAM flap
• Want a shorter operation than abdominal tissue reconstruction
• Are in good overall health 
• Do not smoke

If this procedure isn’t right for you, your surgeon may recommend implant-based reconstruction or abdominal tissue reconstruction.

Learn how to compare your options in deciding what’s right for you.

Why choose Banner MD Anderson Cancer Center?

At Banner MD Anderson, our reconstructive surgeons specialize in reconstructive flap procedures, so you’re in good hands no matter which technique is right for you. Our team works side by side with your cancer care specialists to make sure your reconstruction is safe and aligned with your cancer treatment plan.

We’re committed to restoring not just your appearance but your confidence and comfort. 

Request an appointment