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The Kite Latissimus Dorsi Flap for Breast Reconstruction: An Attempt to Reduce Lateral Chest Wall Deformity and Axillary Bulking

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The latissimus dorsi flap is a commonly used tissue transfer for volume replacement in partial or total breast reconstruction. In this era of cosmetic awareness and oncoplastic breast surgery, two main defects are related to the conventional technique: the back scar and the bulkiness on the lateral chest wall, under the axilla. Axillary bulking, a disturbing defect for the majority of patients, is a persistent consequence, independent of the technique used, even when the proximal tendon is cut. We describe a new approach, the kite latissimus dorsi flap, consisting of harvesting the flap, partially or totally, with pedicle dissection from the muscle, extending dissection, perforator style if needed, until the external border of the breast (anterior axillary line) is reached. The muscle is then cut at that level, leaving no unnecessary volume under the axilla, which would cause bulkiness and chest wall deformity.

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HSJ CPR Breast Neoplasms/pathology Breast Neoplasms/surgery Esthetics Graft Survival Mammaplasty/methods Mastectomy/methods Superficial Back Muscles/surgery Superficial Back Muscles/transplantation Surgical Flaps/blood supply Surgical Flaps/transplantation Tissue and Organ Harvesting Treatment Outcome

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Aesthetic Plast Surg. 2016 Aug;40(4):514-6.

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Springer Verlag

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