A method of breast reconstruction using the whole of the latissimus dorsi muscle is described in which the usual skin flap is extended to include a large de-epithelialised flap of dermis and subcutaneous tissue from the loin to provide the necessary augmentation with living tissue rather than with a prosthesis. The method can be used as a reliable one-stage reconstruction, without a prosthesis, either secondarily or as a synchronous combined procedure at the time of the mastectomy.