Tissue from the Back
Transferring parts of the large back muscle (Latissimus dorsi muscle) represents the oldest and best known method of breast reconstruction following breast cancer. With this muscle the breast can be reconstructed safely. Often an implant has to be placed beneath the relocated muscle to achieve a volume corresponding to the healthy side. The removal of the muscle from the back does not have any effects on the function of the shoulder joint worth mentioning; nevertheless, a scar remains on the back.
The so called TDAP-flap is a further development. TDAP stands for ThroacoDorsal Artery Perforator; using this technique the latissimus muscle is left in place, but only skin and nourishing vessels are transferred. While the operation takes a little bit longer the results are more rewarding.
The operation takes place under general anaesthetic. The muscle is taken from the back together with its vessels and the skin covering it and remodelled as a new breast at the front. An implant can be placed under the muscle accordingly. A tube is used to let wound secretion drain off in the first days after the operation.
In rare cases blood circulation in the transplanted tissue might cause problems. This might lead to the relocated tissue dying off. However, this risk is very low with this technique. Often a certain asymmetry remains because enough volume can only be achieved with a relatively small breast. The above mentioned risk of developing capsular fibrosis of course also applies if an implant is inserted additionally. A wound cavity appears quite frequently at the back that might produce secretion for several weeks.
As with all operations you should not smoke in order to avoid putting blood supply of the tissue at risk. Patients should avoid strenuous activities for some weeks after the operation. They should wear a special support bra for about 3 months, as recommended.