The latissimus dorsi is the broadest muscle in the back and one of the most dependable tools in reconstructive surgery. Its blood supply is predictable, its bulk is generous, and surgeons plan whole operations around the assumption that it is where the textbooks say it is.
For a 69-year-old woman in Switzerland, it was not. Surgeons at Luzerner Kantonsspital in Lucerne had opened her back to raise a pedicled latissimus flap for delayed breast reconstruction, a year after radical mastectomy and axillary lymph node removal. On the left side there was no muscle belly and no tendon. The muscle was completely absent.
