Recently in Korea the number of breast cancer patients has been increasing, and at the same time early diagnose has been promoted with the development of diagnostic methods. As a result of the all, the number of breast reconstruction target is increasing. In the mean time, there are two breast reconstruction methods; one is autogenous tissue breast reconstruction and the other is prosthesis breast reconstruction, and today the former one is getting more popular. Now we are introducing the breast reconstruction by use of latissimus dorsi flap with implant and tissue expansion.
 The research had been conducted from May. 1998 to May. 1999 against 2 patients who are 31~37 years old. One among the two patients who got unilateral mastectomy had tissue expansion during the operation and the breast got reconstructed through latissimus dorsi flap and saline-filled implant, whereas the other patient got the tissue expansion first and then had the latissimus dorsi flap and saline-filled implant. The endoscopy was used for the all patients in harvesting latissimus dorsi muscle. The term between breast mastectomy and reconstruction was 15 months. The additional transection of tendinous humeral insertion of the latissimus dorsi muscle improves aesthetic results and avoids a displeasing bulge in the axilla and about a half of the tendon was left in order to protect vascular pedicle from excessive streching and to make the latissimus flap move more easily. Meanwhile, the augmentation mammoplasty was conduted simultaneously for the 2 patients who used to have small breast and wanted to get mammoplasty. Since drain was used and maintained for 10~14 days, complications such as hematoma or seroma didn't happen after surgery. The follow-up observation term was 19 months, 7 months, and there wasn't much problem except one patient who got grade II capsular contracture, though she didn't feel uneasy even without any special treatment. All patients could get symmetrical and voluminous breast, and they got only a 4cm scar on axilla and a very short scar which is extended from the previous operative scar by 3.4cm, which means they didn't get another new  scar on the donor site. All patients were satisfied with the result of surgery, and particulary the patients, who had the symmetricality of their breasts improved by a supplimentary operation on the normal breast, got satisfied more. 
 Below is the conclusion of the deferred reconstruction against the relatively skinny young patients by means of latissimus dorsi flap, tissue expansion, implant, and endoscopy technic. First, as well as getting latissimus dorsi flap, we can minimize operative scar by incising right on the previous operative scar and extend the scar just little bit. Second, it is the proper method for relatively young and skinny patients, because it enables to from natural anterior axillay fold and also make smooth and volumious breast - because it covers the implant material with latissimus dorsi muscle.
 For the young and skinny patients, it will be the most ideal way to combine the several methods such as latissimus dorsi flap which enables to get enough volume and smooth texture of breast without another new operative scar by extending the previous mastectomy scar, and tissue expansion & breast implant to give a change on the size of breast.