Skip to main navigation menu Skip to main content Skip to site footer
Brazilian Journal of Clinical Medicine and Review

Health Review

Vol. 4 No. 1 (2026): January/December - 2026

Use of the Lateral Thoracodorsal Flap for Post-Mastectomy Breast Reconstruction

DOI
https://doi.org/10.52600/2965-0968.bjcmr.2026.4.1.bjcmr69
Submitted
June 15, 2026
Published
2026-07-28

Abstract

Breast cancer is the most common malignancy among women and represents a major public health concern. With the advancement of breast-conserving surgery and oncoplastic breast surgery, breast reconstruction has become an integral component of surgical treatment, aiming to combine oncological safety with satisfactory aesthetic and functional outcomes. In this context, thoracolateral flaps, particularly the lateral thoracodorsal flap, have emerged as important options for partial breast reconstruction and the correction of small- to medium-volume defects. This study aimed to analyze, through a systematic review of the literature, the use of these flaps in breast surgery, with emphasis on their indications, surgical techniques, and clinical applicability. The findings demonstrate that this technique is associated with low morbidity, high reproducibility, and high patient satisfaction rates, being particularly suitable for small- to medium-volume breast reconstructions, especially following breast-conserving surgery and for defects located in the lateral breast quadrants. Furthermore, patient selection, surgical planning, and technical variations directly influence both clinical and aesthetic outcomes. In conclusion, the lateral thoracodorsal flap represents an effective, safe, and versatile option for oncoplastic breast reconstruction, providing favorable functional and aesthetic results when used in appropriately selected patients.

References

  1. Instituto Nacional de Câncer. Estimativa 2023: incidência de câncer no Brasil. Rio de Janeiro: INCA; 2022. Available from: https://www.inca.gov.br/sites/ufu.sti.inca.local/files/media/document/estimativa-2023.pdf. Accessed 2026 Jun 10.
  2. Carvalho MVH, Rebeis EB, Marchi E. Reconstrução da parede torácica nos defeitos adquiridos. Rev Col Bras Cir. 2010;37(1):64-69. doi: 10.1590/S0100-69912010000100013.
  3. Munhoz AM, Montag E, Arruda E, et al. Immediate locally advanced breast cancer and chest wall reconstruction: surgical planning and reconstruction strategies with extended V-Y latissimus dorsi myocutaneous flap. Plast Reconstr Surg. 2011;127(6):2186-2197. doi: 10.1097/PRS.0b013e318213a038.
  4. Park JS, Ahn SH, Son BH, Kim EK. Using local flaps in chest wall reconstruction after mastectomy for locally advanced breast cancer. Arch Plast Surg. 2015;42(3):288-294. doi: 10.5999/aps.2015.42.3.288.
  5. Gebrim LH, Silveira Junior VF, Broetto J, et al. Safety and viability of a new format of thoracoepigastric flap for reconstruc-tion of the chest wall in locally advanced breast cancer: a cross-sectional study. Rev Bras Cir Plást. 2016;31(1):2-11. doi: 10.5935/2177-1235.2016RBCP0002.
  6. Almeida NRCD, Bentes LGDB, Lemos RS, Araújo VMM, Fernandes MRN, Braga JP, et al. Perfil das cirurgias oncológicas e reparadoras de mama no norte do Brasil: análise da última década. Rev Bras Cir Plást. 2023;38(3). doi: 10.5935/2177-1235.2023RBCP0718-PT.
  7. Martin TA, Berrettini Júnior A. Perfil das cirurgias para tratamento do câncer de mama realizadas em um hospital terciário do interior paulista. J Med Resid Rev. 2025;4:e076. doi: 10.37497/JMRReview.v4i00.76.
  8. Lossing AE, Gewalli F, Holmström H. The lateral thoracodorsal flap in breast reconstruction: a long-term follow-up study. Scand J Plast Reconstr Surg Hand Surg. 2001;35(2):183-192. doi: 10.1080/028443101300165327.
  9. Blomqvist L, Malm M, Holmström H. The lateral thoracodorsal flap in breast reconstruction: a comparison between two plastic surgical centres. Scand J Plast Reconstr Surg Hand Surg. 2000;34(4):327-330. doi: 10.1080/028443100750059101.
  10. Lossing AE, Holmström H, Malm M, Blomqvist L. Clinical follow-up of the lateral thoracodorsal flap in breast reconstruc-tion: comparative evaluation from two plastic surgical centres. Scand J Plast Reconstr Surg Hand Surg. 2000;34(4):331-338. doi: 10.1080/028443100750059110.
  11. Woerdeman LAE, Van Schijndel AW, Hage JJ, Smeulders MJC. Verifying surgical results and risk factors of the lateral thoracodorsal flap. Plast Reconstr Surg. 2004;113(1):196-203. doi: 10.1097/01.PRS.0000097257.47540.D0.
  12. Yang JD, Ryu DW, Lee JW, Choi KY, Chung HY, Cho BC, et al. Usefulness of a lateral thoracodorsal flap after breast-conserving surgery in laterally located breast cancer. Arch Plast Surg. 2013;40(4):367-373. doi: 10.5999/aps.2013.40.4.367.
  13. Rose M, Svensson H. Tunnelled lateral fasciocutaneous thoracodorsal flap with a skin island in breast reconstruction in oncoplastic breast surgery. J Plast Surg Hand Surg. 2012;46(6):404-409. doi: 10.3109/2000656X.2012.722095.
  14. Pontes R, Pontes GH, Serpa NP, Monte AR, Collado CL, Silva FN. Modified lateral thoracodorsal flap: a way out of a diffi-cult problem. Aesthetic Plast Surg. 2006;30(3):363-368. doi: 10.1007/s00266-005-0077-1.
  15. Monte ALR, Ranzolin BA, Castel MD, Ribeiro RN, Previtali LFA. Retalho de transposição toracodorsal lateral fasciocutâneo e seu uso na reconstrução mamária. Arq Catarin Med. 2025;54(1):144-149. doi: 10.63845/3qyd3k35.
  16. Marwan A, Saad D. Auto skin expansion in delayed breast reconstruction using flaps without expander: a new concept. Rev Bras Cir Plást. 2015;30(2). doi: 10.5935/2177-1235.2015RBCP0134.
  17. Hernández VV, Ventos L, Giachero V, Pérez N, Jacobo O. Reconstrução mamária com retalho Holmström. Arq Catarin Med. 2022;51(1):190-201. Available from: https://revista.acm.org.br/arquivos/article/view/1232. Accessed 2026 Jun 10. doi: 10.63845/asap8x97.
  18. Munhoz AM, Montag E, Arruda EG, Aldrighi C, Gemperli R, Aldrighi JM, et al. The role of the lateral thoracodorsal fasciocutaneous flap in immediate conservative breast surgery reconstruction. Plast Reconstr Surg. 2006;117(6):1699-1710. doi: 10.1097/01.PRS.0000209943.13682.42.
  19. Abboud M, Saad D, Baroudi R. Retalho toracodorsal desepitelizado: um novo conceito para a reconstrução autóloga da mama. Rev Bras Cir Plást. 2013;28(1):65-71. doi: 10.1590/S1983-51752013000100012.
  20. Holmström H, Lossing C. The lateral thoracodorsal flap in breast reconstruction. Plast Reconstr Surg. 1986;77(6):933-943. PMID: 3714889.
  21. Hamdi M, Spano A, Van Landuyt K, D’Herde K, Blondeel P, Monstrey S. The lateral intercostal artery perforators: anatom-ical study and clinical application in breast surgery. Plast Reconstr Surg. 2008;121(2):389-396. doi: 10.1097/01.prs.0000298317.65296.cf.
  22. McCulley SJ, Schaverien MV, Tan VKM, Macmillan RD. Lateral thoracic artery perforator flap in partial breast reconstruc-tion. Plast Reconstr Surg. 2015;135(2):334e-343e. doi: 10.1097/PRS.0000000000000913.
  23. Mangialardi ML, Salgarello M, Baldelli I, Raposio E. Breast reconstruction using the lateral thoracic, thoracodorsal, and intercostal arteries perforator flaps. Microsurgery. 2021;41(3):289-296. doi: 10.1002/micr.30663.
  24. Mangialardi ML, Baldelli I, Salgarello M, Raposio E. Thoracodorsal artery perforator flap in partial breast reconstruction: a systematic review. Plast Reconstr Surg Glob Open. 2020;8(10):e3104. doi: 10.1097/GOX.0000000000003104.
  25. Soumian S, Parmeshwar R, Chandarana M, Marla S, Narayanan S, Shetty G. Chest wall perforator flaps for partial breast reconstruction. J Plast Reconstr Aesthet Surg. 2020;73(11):2055-2066.
  26. Bailey SH, Oni G, Guevara R, Wong C, Saint-Cyr M. The combination of quilting and fibrin sealant reduces drainage in the extended latissimus dorsi donor site. Plast Reconstr Surg. 2012;129(1):61-67. doi: 10.1097/PRS.0b013e3182361e3f.
  27. Arikawa M, Miyamoto S, Fujiki M, Sakuraba M. Comparison of donor-site drainage duration and seroma formation rates between latissimus dorsi musculocutaneous flaps and thoracodorsal artery perforator flaps. Ann Plast Surg. 2017;79(2):183-185.

Most read articles by the same author(s)