Boomerang-shaped extended latissimus dorsi flap for combined breast reconstruction and body contouring following massive weight loss.

We present a massive weight loss case who sought a correction for her left-sided implant-based breast reconstruction using an autologous approach. She had previously received a left-sided mastectomy as an infant. The initial implant-based breast reconstruction led to repeated corrective procedures. The cosmetic result was poor due to thin skin flaps, poor shape and inadequate volume; moreover, the patient experienced significant and persistent pain.An abdominal-based free flap was not feasible due to a prior vertical abdominoplasty, which had eliminated the availability of sufficient abdominal donor tissue. Additionally, the patient presented with lax excess tissue on the back that allowed for a combined reconstructive and body-contouring procedure. A boomerang-shaped extended latissimus dorsi flap was harvested from the back, providing adequate volume and contour to match the contralateral breast as well as achieving both functional and aesthetic goals of the back.