Wednesday, 15 September 2010

Meat: The latissimus dorsi, up close and personal

A couple of months ago, Mr A took a video into the operating theatre, and with the patient's permission, recorded key moments in the midst of LD flap reconstruction. I tried to upload 30 seconds of the four-hour surgery into blogger, but back in July it didn't work. I tried again today and — wowser! — it worked. And a good thing too; as I prepare my workshop for the pros, I need to remind myself of some of the surgery's spectacular details so that I don't end up looking like a thicko at the conference.


If you don't look too hard, the image in the video's initial frame looks like someone's having a Cornish pasty while they work. But what you're seeing is in fact an ellipse-shaped piece of skin, attached to the LD muscle, which has been harvested — separated from the body — with the exception of a large blood vessel which, like an umbilical cord, keeps the muscle alive. The surgeons are holding the muscle out like a picnic blanket. Or if you're Lady Gaga, like a skirt steak (check out her meat wardrobe here. Tasteful).

The muscle and skin are bundled into the body and tucked safely under the arm for safekeeping while the back is sewn up. That's where this video ends. Then the patient is turned over so that the surgeons can tunnel the muscle under the armpit and through to the front of the body, where they begin the second half of the reconstruction: shaping the breast and creating the areola with the ellipse of skin. I'm not sure if Mr A captured the second part of the surgery for me. I need to chase that up. Meanwhile, without further ado: Meet the LD.

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