The latissimus dorsi is a large quadrilateral muscle on the back.
The extended latissimus dorsi flap (ELD) involves harvesting the fat surrounding the muscle and gives more volume than the standard flap, which uses the muscle alone.
The standard flap is suitable to fill a partial breast defect following a wide local excision but when it is used as to reconstruct the breast following mastectomy, an implant is always required beneath the flap to give sufficient volume. The extended flap can be used without an implant to reconstruct a small breast (around a B cup). For a larger breast reconstruction, an implant may be needed, or alternatively, fat injections can be performed at a later stage to increase the size of the reconstructed breast.
The benefit of using your own tissue rather than an implant is that the look and feel of the breast is more natural than with an implant alone and there are none of the limitations and complications associated with implant surgery. The operation is always done under a general anaesthetic and the average length of hospital stay is 5 days.