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We would like to thank Drs Niddam and Meningaud1 for their interest in our paper entitled “Maximizing the Volume of Latissimus Dorsi Flap in Autologous Breast Reconstruction with Simultaneous Multisite Fat Grafting.”2The decision to perform additional fat grafting following the initial reconstruction is multi-factorial and based on individual patient characteristics and expectations. We always try to harvest the largest skin area possible in order to maximize not only immediate available volume, but also a larger surface area to fat graft into. For the same reasons, the entire latissimus muscle (LD) is harvested. Patients with a relatively high body mass index (BMI) and large fat compartments in the back may not require very much fat grafting both primarily or secondarily. Factors such as; patient BMI, available skin paddle size, LD muscle thickness, previous radiation therapy, thickness of the mastectomy skin flap, timing of reconstruction, size of the ideal contralateral breast and reconstructed breast, and patient expectations, …

aesthetic surgery journal

Response to “Comments on ‘Maximizing the Volume of Latissimus Dorsi Flap in Autologous Breast Reconstruction with Simultaneous Multisite Fat Grafting’”