Release of axillary scar contracture with a latissimus dorsi flap.

A case is presented of a patient who underwent an elective axillary augmentation that was complicated by hematoma, capsular contracture, and a staphylococcal wound infection. Attempts to correct the deformity with multiple capsulotomies and axillary contracture releases were unsuccessful. Following these procedures, a thick axillary scar contracture formed that was adherent to the breast capsule and severely limited abduction of the arm. The patient underwent release of the axillary scar contracture with a latissimus dorsi muscle flap. The superiorly based lateral portion of the muscle was transposed to fill the dead space between the axillary scar and adherent breast capsule. A Z-plasty was also used to lengthen the cutaneous scar. Abduction of the arm improved to 130 degrees postoperatively. Lengthening of the skin contracture could be provided by a Z-plasty, but separation of the deeper scar matrix required normal soft-tissue interposition. The lateral portion of the latissimus dorsi muscle was chosen to fill this dead space.