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Latissimus dorsi denervation should include resection of more than 4 cm to prevent twitching

Researchers found that the denervation of the latissimus dorsi is a safe, reliable procedure that should be performed at the time of breast reconstruction and should include a resection of more than 4 cm to achieve a nontwitching breast with a stable volume and shape.

Data were retrospectively collected from 74 patients who underwent partial or total breast reconstruction with a latissimus dorsi flap alone or with an implant between January 1999 and October 2011. They also collected follow-up data at 12 and 24 months after the procedure.

The latissimus dorsi muscle was denervated at time of surgery in 56 patients, whereas in 18 patients, the thoracodorsal nerve remained intact. The researchers observed no partial or total flap loss.

All patients who had intact thoracodorsal nerves showed muscle twitching at 12- and 24-month follow-up. Of the denervated patients, 50% showed twitching at 12 months, and at 24 months, 67.9% showed twitching.

No patient showed twitching if more than 4 cm of the nerve was excised at 12 or 24 months postoperatively, according to the researchers. – by Abigail Sutton

Disclosure: The authors have no relevant financial disclosures.