Breast reconstruction with the latissimus dorsi flap: Women's preference for scar location

Background: Refinements made in latissimus dorsi breast reconstruction have improved the aesthetic appearance of the breast without changing the donor-site location. The optimal location for donor-site placement, from a patient's perspective, is still unknown. The purpose of this study was to assess women's preference for the latissimus dorsi donor-site location; the reasons for donor-site choice; and the correlation between donor-site location preference and factors such as, age, body mass index, body image, and clothing options. Methods: Two hundred fifty women between the ages of 20 and 80 years were surveyed. Participants analyzed patients' pictures and ranked the scar locations from most desirable to least desirable. The reason for preference and additional factors were assessed. The data were then collected and analyzed using contingency tables with p < 0.005. Results: The low and middle transverse donor sites were the most preferred sites, 54 percent and 22 percent, respectively. The most common reasons for choosing a donors site were ability to conceal the scar in a low-back top and contour improvement. Women younger than 50 years were more concerned about the ability to conceal the scar (64 percent). Women older than 50 years were focused on contour improvement (40 percent) and concealing the scar while clothed (42 percent) (p < 0.05). No direct correlation with age, body mass index, body image, or clothing options was seen. Conclusions: Women overwhelmingly prefer the low and middle transverse scar locations. Physicians should consider using these locations primarily in suitable patients, as this may improve overall patient satisfaction following breast reconstruction.