A, Latissimus dorsi musculocutaneous flap design (dashed oval). Note skin flap along anterior inferior portion of muscle. B, Latissimus dorsi muscle flap incision is parallel and 3 cm posterior to anterior edge of muscle. C, Latissimus dorsi flap isolation. Distal and posteromedial portions have been released to allow for cephalad dissection of vascular pedicle. Anterior arterial branch to underlying serratus anterior is divided. D, Division of circumflex scapular artery allows dissection up to subscapular artery origin of axillary artery. SEE TECHNIQUE 63.13.