Breast Reconstruction after Mastectomy, Flap-Based
Dr. Schwartz has extensive experience with the Latissimus Dorsi flap for breast reconstruction. In most instances, he can use a less invasive muscle-preserving approach (where only ~ 20 % of the muscle is needed and the rest is left in place, in the back). This minimizes pain and recovery time and complications. Dr. Schwartz has published extensively on the muscle-sparing latissimus dorsi flap for total breast reconstruction using your own tissues. This is especially relevant if the patient is a bit heavier, with a body mass index of greater than 35. For these patients, Dr. Schwartz can usually perform a total breast reconstruction using their own tissue from the back, avoiding an implant and the prolonged surgery and recovery and complications associated with reconstructing the breast with tissues from the abdomen. In some instances, Dr. Schwartz may use this flap to save a breast reconstruction, typically done with an implant, that is not healing or may have developed an infection. In some cases, cancer may be too close to the skin to save and Dr. Schwartz has published an approach to removing skin that is close to the cancer, and immediately replacing this skin with that from Muscle Sparing Latissimus Flap, still often saving the nipple and providing the patient with a definitive implant-based reconstruction in one surgery, typically without requiring a hospital admission.