The latissimus dorsi flap combined with a silicone implant has been a popular method of breast reconstruction since its description by Bostwick and his coworkers in 1978. The authors, who have avoided using silicone implants because of their disadvantages such as capsule contracture, have used the latissimus dorsi myocutaneous flap and additional fat over the iliac crest. The clinical experience with 174 patients who have undergone breast reconstruction with this extended latissimus dorsi flap between October of 1981 and January of 1997, the technical details, and long-term results are reported in this paper. There was no patient who experienced total flap necrosis and only four patients had recognized partial flap necrosis. The advantages of the extended latissimus dorsi flap are: (1) less complications due to stable circulation; (2) excellent restoration of the anterior of the axillary fold and infraclavicular area; (3) possible reconstruction of small and moderately sized breast and ptotic breast; and (4) simple technique and no nessecity of anastomosis of the vessels.
We strongly recommed this flap that demands no implant in almost patients.