几十年来，带蒂背阔肌（“LAT”）皮瓣一直是乳房重建的主力皮瓣。不对称的背部疤痕一直是投诉的主要来源。对于背部过度肥胖的患者，我们可以利用皮肤桨采集来改善背部轮廓。我们将美观的胸罩线后拉提原理与 LAT 皮瓣相结合，利用隐藏的疤痕同时改善后上躯干肥胖和皮肤多余的问题，这些问题一起形成“后卷”。建立一种新的手术技术结合胸罩线背部提升和背阔肌皮瓣（“BLBL-LAT 皮瓣”）进行乳房美观重建。这是一项 IRB 批准的回顾性单外科医生研究，在国家癌症中心进行。我们纳入了 2015 年至 2023 年间使用联合 BLBL-LAT 皮瓣进行乳房重建的患者，并进行了至少 6 个月的随访。106 名女性患者接受了 110 例使用 BLBL-LAT 皮瓣的乳房重建。 75% 的患者进行了假体植入，25% 的患者进行了 100% 自体假体植入。并发症发生率较低：4/106 名患者 (3.8%) 出现血清肿，需要手术。在 78 例种植体重建中，3 例（3.8%）出现假体周围种植体感染。一名（<1%）患者皮瓣部分缺失，没有患者皮瓣完全缺失。 4 名患者进行了双侧 BLBL-LAT 皮瓣重建。两名单侧乳房再造患者回来后成功进行了对称胸罩线背部提拉术（无 LAT 皮瓣乳房再造）。BLBL-LAT 皮瓣利用可隐藏在胸罩中的疤痕，实现了乳房重建和同时改善背部轮廓。这种二合一手术对于高体重指数患者特别有益，因为他们经常出现不必要的过度肥胖和背部松弛。由于该患者群体进行游离组织移植的风险较高，因此我们建议 BLBL-LAT 皮瓣应被视为高 BMI 患者自体乳房重建的一线方法。© 作者 2024。由牛津大学出版社出版代表美学协会。版权所有。如需商业重复使用，请联系 reprints@oup.com 获取转载和转载的翻译权。所有其他权限都可以通过我们网站文章页面上的权限链接通过我们的 RightsLink 服务获得 - 如需更多信息，请联系journals.permissions@oup.com。

The latissimus dorsi pedicled ('LAT') flap has been a workhorse flap for breast reconstruction for many decades. The asymmetric back scar has been a major source of complaint. In patients with excess back adiposity, we can utilize the skin paddle harvest to improve back contour. We combined the principles of the esthetic bra-line back-lift with the LAT flap to provide simultaneous improvement of both posterior upper trunk adiposity and skin excess, which together form 'back rolls', using a concealed scar.To establish a new surgical technique of combined bra-line back lift with latissimus dorsi flap ('BLBL-LAT flap') for esthetic breast reconstruction.This was an IRB-approved retrospective single-surgeon study performed in a national cancer center. We included patients undergoing breast reconstruction using combined BLBL-LAT flap between 2015 and 2023, with a minimum of 6 months follow up.106 female patients underwent 110 breast reconstructions using BLBL-LAT flap. 75% of patients had prosthesis placement and 25% of patients were 100% autologous. Complication rates were low: 4/106 patients (3.8%) had seroma, needing surgery. Of the 78 reconstructions with implants, 3 (3.8%) had periprosthetic implant infection. One (<1%) patient had partial flap loss and no patients had complete flap loss. Four patients had bilateral BLBL-LAT flap reconstruction. Two unilateral breast reconstruction patients came back for successful symmetrizing bra-line back-lift (without LAT flap breast reconstruction).The BLBL-LAT flap allows breast reconstruction and simultaneous improvement in back contour, using a scar that can be concealed in a bra. This two-for-one procedure is of particular benefit for patients with high BMI who often have unwanted excess adiposity and laxity of the back. Since this patient population are high risk for free tissue transfer, we propose that the BLBL-LAT flap should be considered the first-line method of autologous breast reconstruction in higher BMI patients.© The Author(s) 2024. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.