The Latissimus Dorsi Flap in Breast Reconstruction: A Timeless Workhorse Through History and Innovation

Abstract

The latissimus dorsi myocutaneous flap (LDMF) is a pivotal surgical technique for breast reconstruction, celebrated for its reliable anatomy and minimal morbidity. Initially introduced by Iginio Tansini in 1896, the latissimus dorsi flap involved a dorsal skin flap for closing breast cancer surgeries. Despite early challenges, Tansini’s insights into vascular anatomy established a foundation for its use. After a decline due to radical mastectomy approaches, the flap was revitalized in 1939 by Elliot Hutchins, who demonstrated its efficacy in restoring axillary lymphatic drainage. The LDMF regained popularity in the late 1970s for immediate breast reconstruction, often paired with silicone implants. Subsequent innovations, including fat grafting and robotic dissection techniques, have further enhanced its applications. While the transverse rectus abdominis myocutaneous (TRAM) flap has become a popular alternative, the LDMF remains a versatile and effective option in reconstructive surgery, consistently providing satisfactory aesthetic outcomes.