The lateral thoracodorsal flap as a salvage procedure for partial transverse rectus abdominis myocutaneous or deep inferior epigastric perforator flap loss in breast reconstruction

The transverse rectus abdominis musculocutaneous flap and deep inferior epigastric perforator flap are the flaps of choice for autologous breast reconstruction. The better understanding of the vascular anatomy of these flaps has reduced the incidence of flap loss and fat necrosis, and positioning the flap's least vascularized zone laterally in the newly reconstructed breast may limit partial flap loss to that area. Still, the resulting defect of such partial loss remains a challenge. We introduce the use of the lateral thoracodorsal flap as an easy and straightforward salvage procedure in such cases and present the history of 4 of our patients with a mean age of 45 years to illustrate this use. The procedure can be done as early as 6 weeks after initial reconstruction, reducing the burden of daily wound care for the patient and offering her an immediate restoration of the lateral contour of the reconstructed breast.