Surgeons employ the latissimus dorsi flap (LDF) for reconstruction of a large variety of breast cancer surgery defects, including quadrantectomy, lumpectomy, modified radical mastectomy, and others. The LDF may be used in delayed or immediate reconstruction, in combination with tissue expanders for a staged reconstruction, with implant-based immediate reconstruction, or alone as an autogenous flap.
The authors discuss the historical uses and more recent developments in the LDF. More recent advancements, including the “scarless” approach and augmentation with the thoracodorsal artery perforator flap, are discussed.