The TDAP (Lastissimus Dorsi) is another option if there are patients that can not undergo DIEP or SIEA techniques. The TDAP is a good option for breast reconstruction that replaces the skin on the breast tissue by mobilizing the woman's back to the breast through a cutaneous tunnel.Blood vessels and muscles maintain their functional characteristics when surgery is performed.
Outcomes are more natural although TDAP is not adequate to provide the volume and contour required. Maybe this proceudre combined with small implants will be required so as to optimize the volume and shape of the breast.The advantages of the dorsal flap lead the few disadvantages:the scar is hidden by the bra and swimwear or the constant vascular anatomy. The operation requires general anesthesia.
In cases where ipsilateral latissimus dorsi muscle or myocutaneous flap cannot be used to reconstruct the breast as there is not enough abdominal wall tissue, we can use the contralateral TDAP flap for reconstruction.
The TDAP flap qualities clearly outweigh its few disadvantages. Fairly constant vascular anatomy, high density of myocutaneous perforators, blood vessels of high-caliber and the ease of flap elevation with low morbidity to the donor site make this technique an important option in breast reconstruction.
This technique, like the Dorsi Flap, uses a type of skin on the back that has not the same texture of the breast, so there may exist differences between the reconstructed and natural breast. However, it's difficult to appreciate the differences.This technique may be limited to patients who play sports with a high level of exigeance. It may be a technique that limits mobility when practicing sports such as skiing.
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