Medicina Fluminensis, Vol. 61 No. 3, 2025.
Case report, case study
https://doi.org/10.21860/medflum2025_332194
Advantages of Combining the Latissimus Dorsi Flap with a Silicone Implant in Immediate Reconstruction of Medium and Large-Sized Breasts Compared to Retropectoral and Prepectoral Silicone Implant-Based Reconstruction: A Case Report
Domagoj Vrbanić
orcid.org/0009-0001-3838-5837
; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
*
Aleksandra Pirjavec Mahić
; Klinički bolnički centar Rijeka, Klinika za kirurgiju, Odjel za plastičnu, rekonstrukcijsku i estetsku kirurgiju, Rijeka, Hrvatska
* Corresponding author.
Abstract
Aim: A case of a female patient is presented, where both breasts were reconstructed due to surgical treatment of cancer, using different methods for each breast. The aims of this case report are to compare two different techniques of immediate reconstruction in terms of aesthetic outcomes and patient satisfaction, as well as to highlight the importance of an individualized approach to the patient, and the significance of the surgeon's experience, knowledge, and technical capabilities in selecting the optimal reconstructive option. Case report: A 37-year-old patient with cancer of the left breast underwent reconstruction with a 145 cc silicone implant after a mastectomy. Nine years later, the patient was diagnosed with cancer in the right breast, and after the mastectomy of the right breast, immediate reconstruction was performed using a combination of a latissimus dorsi flap and a 375 cc silicone implant. At a routine check-up three months after the right breast surgery, the patient complained of asymmetry and pain in the left breast. Additionally, a change in the shape of the left breast and nipple retraction on the same side were noticeable. Due to the different reconstruction techniques and the volume of the reconstructed breasts, the asymmetry was very pronounced, and a corrective secondary surgery on the left breast was scheduled for the patient. The procedure was successful, and the patient was extremely satisfied with the final outcome. Conclusion: Breast reconstruction after mastectomy is a complex surgical procedure that undoubtedly increases the quality of life of cancer patients. However, there is no perfect method that will suit all patients, and the final aesthetic result largely depends on the operator. The method of using the LD flap in combination with a silicone prosthesis is a safe reconstruction option and has its own advantages in selecting certain cases. Besides, it is extremely important to individualize the approach to such treatment and adapt it to the patient's wishes, further treatment plan and constitution.
Keywords
breast neoplasms; mammaplasty; myocutaneous flap; surgical flaps
Hrčak ID:
332194
URI
Publication date:
1.9.2025.
Visits: 348 *