The design of the lateral thoracodorsal flap

Although some of the aspects of the preoperative markings of the lateral thoracodorsal flap have been mentioned by its originators and subsequent authors, we get ongoing inquiries regarding the details of the design of the flap. These markings are made respecting the level of the contralateral nipple, with the convex inferior border of the flap extending up to the anterior axillary line, and with the straight superior border extending more medially over this line. We have used 200 lateral thoracodorsal flaps in 180 patients with no cases of more than marginal flap loss provided that the length of the flap was limited to a maximum of 17 cm. We found that this flap fills a therapeutic gap and provides a sound alternative to more extensive surgery.