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Donor site seroma was found in 9 patients, and no flap or fat necrosis was found. CONCLUSIONS Our technique of extended LD muscle flap with lipofilling reproduced breasts with constant dimensions and appropriate width, height, and projection. Shaping the LD muscle flap is not difficult or unpredictable. This is a simple and easy technique to shape the LD flap and will provide surgeons with an additional autologous option for breast reconstruction.BACKGROUND Birth defects affect 3% of all babies born in the United States each year. Unlike