The lateral thoracodorsal flap in breast reconstruction: A long term follow up study

Fifty-four patients were studied a mean of five years after their breasts h ad been reconstructed between 1984 and 1990 using the lateral thoracodorsal (LTD) flap in combination with either a thin shell, non-low-bleed (n = 35) or a thick shell, low bleed (n = 19) silicone gel implant. The rate of cap sular contracture (Baker III-IV) was 11% in the first group and 10% in the second according to a modified Baker classification. Open capsulotomy was c ommon in both groups of patients (15/35 in the first group and 13/19 in the second). Investigation by applanation tonometry of the capsular contractur e agreed with the modified Baker classification. The cosmetic results were evaluated clinically and from photographs. Best scores were recorded for sc ars and ptosis in both evaluations. There were no significant differences b etween the general cosmetic results in the two groups. The patients graded their estimations of the final outcome of their breast reconstruction on a 10-point visual analogue scale (VAS): the mean for the first group was 8.7 and for the second 9.2. None of the patients regretted her operation and th ey would all recommend the procedure to another patient.