Breast Reconstruction by Latissimus Flap with Implant Cases

This patient presented with severe mastectomy deformity after loss of implant/expander from an infection.  I performed Latissimus Flap and implant reconstruction to match her right side breast reconstruction.  An amazing transformation shown again shortly after nipple reconstruction.

This patient presented with a need to undergo bilateral mastectomy. She preferred a method to achieve as complete a reconstruction in one step as possible, so a bilateral latissimus flap and implant reconstruction was chosen. Preop joint planning between breast surgeon and myself allowed for the entire mastectomy to be done through only the areola, and through which I was able to do the entire reconstruction using such limited exposure. This photo shows her prior to nipple reconstruction which will hide all evidence of mastectomy. An amazing result.


Latissimus flap and implant reconstruction is a safe, reliable way of doing “direct to implant” single stage reconstruction with long lasting stable results. Amazing result including total reconstruction of nipple and areola and 3D tattooing on top of nipple reconstruction.

This patient underwent bilateral total mastectomy for left breast cancer including right nipple sparing and left non-nipple sparing by immediate single stage direct to implant with bilateral latissimus flap and smooth silicone gel implants. An amazing result after BILATERAL total mastectomy! Left nipple reconstruction to follow…

This patient underwent latissimus flap and implant reconstruction after bilateral mastectomy. Shown after nipple tattooing. A fine result.

This patient underwent latissimus flap and implant breast reconstruction after mastectomy. I am highlighting her final reconstruction and the nipple areola reconstruction in particular. I reconstruct the nipple using local flaps, reconstruct the entire areola as a unit using micro-pigmentation tattooing techniques, I add the final colors. This results in a very realistic and lifelike nipple areola complex.

i perform nipple reconstruction as a two step process. First, I make a nipple from the local tissue and surround it with a graft from a donor area (non hair bearing). Second procedure is to add pigment (a tattoo) approximately four months after the reconstruction. I use 3-5 colors  to create a natural appearance and highlight the 3d effect. this is a great example of my two step nipple reconstruction.

This patient had left breast cancer and underwent bilateral mastectomy (see purple markings outlining skin excision component).  She underwent immediate bilateral breast reconstruction with latissimus flaps and implants, later followed by nipple reconstruction and tattooing.  A fine result.

Unilateral mastectomy and breast reconstruction can be very challenging. Especially, involving symmetry issues and mastectomy camouflage. Sometimes latissimus flap and implant and opposite breast surgery (augmentation here) is the best solution. This patient desired a more full breast overall. A great outcome!

This case demonstrates the two stages of latissimus flap reconstruction after mastectomy. Her skin sparing mastectomy, latissimus flap with implant, followed by nipple reconstruction create a balanced camouflage and fine aesthetic result after breast cancer surgery.