Background: Breast reconstruction became a dynamic
continually progressing group of procedures. These procedures
are aiming to provide the patients after mastectomy more
symmetrical and an aesthetically pleasing recreated breast in
the cases which are fulfilling multiple basic oncologic goals.
The reconstruction must not impede the oncological safety
or cause a delay in detection of local recurrence or adjuvant
cancer management. The aim of the current study is to evaluate
the surgical outcomes of the immediate breast reconstruction
by latissimus dorsi flap in patients after nipple sparing mastectomy
regarding the aesthetic results, post-operative complications
and patient satisfaction.
Patients and Methods: Eight consecutive patients having
invasive breast cancer (7 patient have invasive duct carcinoma
and a patient has invasive lobular carcinoma) underwent
nipple sparing mastectomy. All patients had immediate breast
reconstruction by latissimus dorsi flap at Zagazig University
hospitals within three years. Surgical outcomes in terms of
post-operative complications including hematoma, wound
infection, scarring, dorsal seroma, skin necrosis, back pain,
and aesthetic outcomes such as breast symmetry, visual
difference of bilateral breasts, breast contour, and nipple
cosmoses were assessed.
Results: Surgical outcomes including post-operative
complications; hematoma, wound infection were not detected.
Marked back scarring (25%), dorsal seroma (12.5%) were
reported. Aesthetic outcomes were satisfactory and 75% of
patients reported excellent satisfaction with (2 cases) 25%
were not satisfied due to the back scar or volume asymmetry.
Conclusion: Following nipple sparing mastectomy, purely
autogenous immediate breast reconstruction by latissimus
dorsi flap is a valuable reconstructing technique in selected
type of patients. It has low incidence of complications, considerable
aesthetic outcomes with high patient satisfaction
relieving the psychological postmastectomy trauma.