Anterior transposition of the latissimus dorsi muscle through minimal incisions.

Latissimus dorsi transposition is a useful procedure for the correction of various congenital and acquired thoracic deformities. The authors describe a surgical technique which allows anterior transposition of the whole muscle through minimal incisions. The technique has been used in 33 patients with post-mastectomy or post-subcutaneous mastectomy deformities, Poland's syndrome, deep radionecrosis, quadrantectomy, or breast underdevelopment following burns. The technique has proven safe and reliable, although the control of bleeding is difficult. Results are evaluated and compared with those obtained using traditional techniques; the absence of any significant posterior deformity is pointed out. The authors also suggest the use of this technique for breast reconstruction in patients presenting skin deficiencies: a tissue expander placed under the muscular flap makes it possible to avoid the transposition of a skin island.