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CC BY-NC 4.0 · Arch Plast Surg 2015; 42(01): 73-77
DOI: 10.5999/aps.2015.42.1.73
Idea and Innovation

The Axillary Approach to Raising the Latissimus Dorsi Free Flap for Facial Re-Animation: A Descriptive Surgical Technique

Jonathan Leckenby
Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK
,
Daniel Butler
Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK
,
Adriaan Grobbelaar
Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK
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The latissimus dorsi flap is popular due to the versatile nature of its applications. When used as a pedicled flap it provides a robust solution when soft tissue coverage is required following breast, thoracic and head and neck surgery. Its utilization as a free flap is extensive due to the muscle's size, constant anatomy, large caliber of the pedicle and the fact it can be used for functional muscle transfers. In facial palsy it provides the surgeon with a long neurovascular pedicle that is invaluable in situations where commonly used facial vessels are not available, in congenital cases or where previous free functional muscle transfers have been attempted, or patients where a one-stage procedure is indicated and a long nerve is required to reach the contra-lateral side. Although some facial palsy surgeons use the trans-axillary approach, an operative guide of raising the flap by this method has not been provided. A clear guide of raising the flap with the patient in the supine position is described in detail and offers the benefits of reducing the risk of potential brachial plexus injury and allows two surgical teams to work synchronously to reduce operative time.

Keywords

Facial palsy - Facial reanimation - Free flap - Latissimus dorsi


Publication History

Received: 15 May 2014

Accepted: 23 June 2014

Article published online:
05 May 2022

© 2015. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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