Breast reconstruction can be done without implants, using a flap of tissue. A "flap" is typically a combination of muscle, fat, and skin tissues and can be taken from the patient's abdomen, back, or other parts of the body.

A latissimus flap involves the surgeon taking tissue from the patient's back (in an area below the scapula or "shoulder blade"). The tissue is rotated around and used to construct a new breast. In most cases a Latissimus flap is used in conjunction with an implant in order to achieve the desired size or to protect the implant (see Flap Reconstruction With Implants). However, it is sometimes possible to do a breast reconstruction using a Latissimus flap without an implant. Because of the amount of tissue available on the back, the reconstructed breast will typically be small. However, depending upon the patient's preferences, this may be an option.

• Since the reconstruction involves using the patient's own tissues, the risks of implant reconstruction are avoided.
• It is typically easier to match the contralateral breast with natural tissue than with an implant.

• Flap reconstruction may require a longer and more difficult surgery at the first stage when compared with implants. This may mean a longer recuperation for most patients.
• When a latissimus flap is used patients may experience some weakness initially in the use of the arm on the reconstructed side. However, the shoulder and arm have numerous muscles involved in motion and most patients quickly overcome this weakness with the use of the other muscles in the area.
• Patients will have an additional scar at the site where the flap is obtained. For a Latissimus flap, the scar is typically 6-8 inches long and runs along the scapula or "shoulder blade" on the reconstructed side(s).