Breast reconstruction using the latissimus dorsi (LD) myocutaneous flap is a type of breast reconstruction. This procedure uses the muscle, fat, and skin of the upper back, which is pulled and moved from under the skin to the breast. The scar on the back can be placed as close as possible to the bra-covered area so that it is not easily visible. Sometimes the surgeon will place breast implants during the same procedure to make the breasts larger.