The latissimus dorsi flap method of breast reconstruction has been in use for more than 30 years. Like the TRAM flap, the latissimus flap uses tissue from your body to reconstruct the breast. This method, commonly combined with a tissue expander and breast implant, offers additional options with regard to the appearance of the reconstructed breast. Very thin patients with small breasts can sometimes achieve their desired result using the latissimus flap alone, with no implants necessary.