# Evaluation of Shoulder Mobility After Breast Reconstruction With a Lipofilled Latissimus Dorsi Mini‐Flap: A Prospective Cohort Study

## TL;DR

This study evaluates shoulder mobility after a specific breast reconstruction method and finds minimal functional impact.

## Contribution

The study provides empirical evidence on the functional safety of the lipofilled latissimus dorsi mini-flap for breast reconstruction.

## Key findings

- 85% of patients showed no change in shoulder strength after the procedure.
- Active flexion and abduction decreased significantly, but rotations remained unaffected.
- QuickDASH scores increased slightly, but 80% of patients remained in minimal/mild disability range.

## Abstract

The lipofilled latissimus dorsi mini‐flap (LDMF‐L) broadens autologous breast‐reconstruction options, yet its functional impact on the shoulder remains uncertain.

To evaluate shoulder strength, range of motion (ROM) and patient‐reported upper‐limb function QuickDash 90 days after breast reconstruction with the LDMF‐L.

Prospective cohort of 20 patients operated on between November 2022 and November 2024. Inclusion: Breast cancer requiring immediate or delayed reconstruction with LDMF‐L; exclusion: Implant use or major pre‐existing limitation. Strength (Oxford scale), ROM (goniometry) and QuickDASH score were assessed preoperatively and at 90 days. Wilcoxon, Student′s t‐test, Mann–Whitney and McNemar tests were used appropriately (α = 0.05).

Mean age 54 ± 11.8 years; immediate/delayed reconstruction = 50/50%. Strength remained unchanged in 85% (p = 1.000). Active flexion and abduction showed significant reductions (p = 0.016 and 0.045), with no difference in rotations. QuickDASH increased from 8 ± 16 to 19 ± 24 (p = 0.008); nevertheless, 80% stayed within minimal/mild disability.

The LDMF‐L preserves strength and produces only mild early ROM decreases with limited functional impact, supporting its functional safety as an implant‐free autologous option.