Latissimus Dorsi flap enhancement by lipofilling as an immediate breast reconstruction technique for skin-preserving mastectomy

Aim: To evaluate Latissimus Dorsi flap (LD) enhancement by lipofilling as an immediate breast reconstruction technique, for skin-preserving mastectomy regarding oncological safety, fat graft resorption after radiotherapy, and patients' satisfaction.

Patients and methods: This is a prospective study that included female patients complaining of breast cancer. Patients were subjected to skin-preserving mastectomy associated with Latissimus Dorsi flap enhancement by lipofilling using the multisite, and multilayer fat grafting technique of injection. Patients were followed up for early and late postoperative complications including recurrence. Volumetric CT was performed before and after the radiotherapy to detect the percentage of fat resorption. Postoperative patients' satisfaction was assessed using the Kyungpook National University Hospital (KNUH) Breast Reconstruction Satisfaction Questionnaire.

Results: The study included 25 female patients with a mean age of 36.48 ± 5.87 years. The mean period of follow-up was 30.32 ± 5.82 months. Local recurrence was encountered in 1 patient (4%). The mean volume reduction of the injected fat graft was 27.36 ± 8.58%. Twenty-three patients (92%) declared their satisfaction after the operation, one of them was satisfied only after she underwent a second session of lipofilling.

Conclusions: Skin-preserving mastectomy with the enhancement of the LD by lipofilling for immediate reconstruction of the breast seems to be a safe and simple technique for the achievement of autologous breast reconstruction. It has an acceptance rate of locoregional recurrence and minor postoperative complications. The procedure showed high postoperative patients' satisfaction and a reasonable percentage of fat resorption as confirmed by volumetric CT imaging techniques.