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Topic: Latissimus Dorsi Flap Problems?

Forum: Breast Reconstruction — Is it right for you? Discuss timing and various procedures and techniques.

Posted on: Sep 10, 2008 10:12AM

aike wrote:

Please let me know if you had or did not have problems after the LD flap procedure.  I am contemplating this with an implant and prophilactic R breast surgery.  THANKS

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Posts 1 - 23 (23 total)

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Sep 10, 2008 10:45AM cocoathunder wrote:

That's exactly what I did in 2000.  Left side was radiated as part of cancer.  I bumped my story to the top of the breast cancer forum entitled "Home from NOLA".

I also posted pictures of before (with encapsulated implants) on the photo forum managed by "TIMTAM" if you'd like to see results.

I know many have great results with implants and was very glad that option was available to me back in 2000, but in the long run, my body didn't handle them.

Best wishes on your journey,

Karen 

Dx 1999, IDC, 5cm, Stage IIb, Grade 3, 3/9 nodes, ER+/PR+, HER2-
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Sep 10, 2008 01:02PM JustTurnedForty wrote:

I had BM with lat flaps a year ago June.  The cosmetic results are awesome.  I have not had any problems, per se, but I don't think I was informed of the continual discomfort that I still have over a year later, and so assume will never go away.  It always feels like I have a bra on that is too tight, or that a boa constrictor is wrapped around me.  My stomach also sticks out way more than it used to, like my midsection is a balloon, and since it is so tight around my chest, my stomach is pushed out.  Also, I tried to rake some wood chips this weekend and with every stroke of the rake, my boobs clenched.  Essentially, whenever the lat flap muscle would be used (to carry things, rake, row, etc.), the muscle still tightens as it would if it were still on your back.  Like I said, the cosmetic results are great, so how can I complain, right?!  But, when I think of living with this discomfort for the rest of my life, I wonder if it is worth it.

Janine, who is now 43

Dx 1/15/2007, DCIS, Stage 0, 0/3 nodes, ER+/PR+
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Sep 10, 2008 04:05PM Annabella58 wrote:

Hi Janine:

I had a lat flap in Dec. 07 and I do pt therapy religiously, 3x daily...I do also still at times have the too tight bra strap feeling.  If I consciously try to relax it (try it, try to isloate it) it does go away.  I still have the impant in, and expect to feel better after.  I'm told many of us lat flap ladies have this issue, it generally resolves somewhat about year two.  Here's hoping!!!

Did you get some exercises from your physical therapist?  If not, PM me and I can walk you thru them or try to.

Altho, Janine, at time I share the feeling....wondering if it was worth it (I think it is, even mastectomy patients w/out recon have to stretch the rest of their lives or live in pain.)  so let's try to look at this way for us....we may have to stretch continually, but that can only be beneficial as we get older.  and we have a great cosmetic result.  My boob even had a necrotic breakdown and my miraculous ps managed to patch it with skin from my c section (which he also made look so much better)

I have the jumping boob thing also, outside of trying it out for my hubby as a new party trick, it's a bit of a  pain in the (boob).  I believe there is a procedure where the PS disconnects a nerve or something,,I'm going to ask mine about it when I go for the pre final impant consult to see if I can find anything out.  I'll post if I do.

PM me anytime!  We lat flap ladies must stick together.

Luck to you!

Annie

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Sep 10, 2008 04:58PM aike wrote:

Karen (Cocathunder)

I too had radiation which is why the PS is recommending the LD flap.  I just wonder in the long haul, if it will really work, or give me so many headaches that I wished I never had it done.  Are you now wearing prosthesis?

Dx 7/11/2007, ILC, 3cm, Stage IIb, Grade 2, 0/4 nodes, ER+/PR+, HER2-
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Sep 10, 2008 05:17PM cocoathunder wrote:

I had the LD flap and implants removed 4 weeks ago and replaced by hip/GAP flaps.  Look for my story called "Home from NOLA" on the first or second page of the  reconstruction forum.  And you can private message TIMTAM to get access to the photo site where I posted before picture with the bad implants and my new GAP breasts.

Karen (cocoathunder) 

Dx 1999, IDC, 5cm, Stage IIb, Grade 3, 3/9 nodes, ER+/PR+, HER2-
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Sep 10, 2008 07:27PM ehall wrote:

Hi there--I am approaching my year anniversary with lat dorsi and reconstruction.  I'm very pleased with the results.  I agree with the above that PT is a must.  I seeing my pt 1-2 times a week and now only go every 2 weeks.  Stretching, stretching, and more stretching is a must.  Good luck and well wishes...Erin

Dx 7/6/2007, DCIS, 4cm, Stage 0, Grade 3, 0/6 nodes, ER+/PR+
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Sep 11, 2008 09:33AM JustTurnedForty wrote:

Anniebelle,

I have not gone to a physical therapist.  Could you describe the exercises to me?  When I do pilates or yoga, the tightness feels even worse.  I tried to send a PM, but I couldn't figure it out.  Could you send me one--I know I can answer one.  Thanks!!

Janine, who is now 43

Dx 1/15/2007, DCIS, Stage 0, 0/3 nodes, ER+/PR+
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Sep 11, 2008 11:47AM, edited Sep 11, 2008 11:48AM by Erica

Anniebelle,

I'm sorry you're still having a tight feeling (you too, JustTurnedForty) and hope it resolves eventually. I did want to correct something you said, though--that even those who have mastectomies without reconstruction have to stretch for the rest of their lives or live in pain. NOT TRUE, at least not for me. And most of the women I've met on the non-recon board don't complain of pain.

I do like to stretch, but that's more for arm range of motion. I have no chest tightness anymore. I had my bilateral mastectomy in October 2006 and within three months the tightness left and I was feeling completely normal (though breast-free Laughing). I had considered lat flap reconstruction, but concern about the boa constrictor effect was one of the reasons I decided against it. I would have been horrified if I'd had that problem even without reconstruction.

Barbara

BreastFree.org

BreastFree.org (breastfree.org); BreastFree Blog (breastfree.blogspot.com); Twitter @BreastFree

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Sep 11, 2008 11:56AM lvtwoqlt wrote:

Janine, I just sent you a pm detailing how to send a pm. Hope it helps.

Sheila

Women are like tea bags, we don't know how strong we are until we were thrown into hot water. Eleanore Roosevelt Diagnosed ADH Feb 2005, ADH Sept 2006

Dx 4/27/2007, DCIS, Stage 0, Grade 1, 0/7 nodesSurgery 02/12/2005 Lumpectomy (Left)Surgery 09/10/2006 Lumpectomy (Right)Hormonal Therapy 10/12/2006 TamoxifenSurgery 06/01/2007 Mastectomy (Both)
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Sep 11, 2008 01:32PM JustTurnedForty wrote:

Annibelle,

As for the jumping boob trick, my PS said he did disconnect the nerve (his nurse even looked it up in my surgery notes to confirm that he did), but it still works!

Janine, who is now 43

Dx 1/15/2007, DCIS, Stage 0, 0/3 nodes, ER+/PR+
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Sep 11, 2008 08:20PM Annabella58 wrote:

Hi Janine:

I will try to pm you and desribe the exercises to you!  I'd mention to your PS that you still have boob jump and see what he says...it may be a price we pay, but I'll take the pretty boobs anyday!

I also take klonopin in a mini dose 1/4 of a .50 tab three times daily.  It reallllly helps with muscle spasms.. most of all, I am looking forward to exchange and talk with ps about how to get around this boa tight bra bit.  But for me, I went and bought a 9.00 exercise ball at Walmart and it was the best thing to exercise with.  Saw a huge difference after that.  Most of the time I don't even notice it anymore, unless I overuse it, then I do. 

Ok I'll give the PM a shot....am computer impaired,so bear with me.  You are all done with implants and have no restrictions, correct?  If not, pls check w your surgeon first before doing!

Good luck!

annie

oh p.s. to cocoa thunder, no prothesis needed!  Even with an expander, the "stuffing" is all me and it's very pretty.  Just smaller than the "mothership" on the other side, hence the need for a lil' more stuffing with an implant.  One of the reasons I went with this.  After radiation, my skin was too fragile to support an implant so the lattisimus give the best cosmetic result with a "robust" stength.  My PS said if I was not active so much, go with the diep, or otherwise, but I wanted a good, strong new boob.  With the expander, I wear a flat ABD pad for comfort (it's kind of blocky in a bra).

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Sep 11, 2008 08:33PM, edited Sep 11, 2008 08:34PM by jt0703

I am 5 years out with my lat flap.  I have the jumping boob thing also, I think.  It is just when I flex, the breast kind of flattens out and moves.  No pain though.  I was a little discouraged for a year or two but now I don't pay much attention to it at all.  Stretching really is an important part.  Being 5 yrs out I honestly don't do it like I used to and I should.  Overall, I am pleased and have shown my breast to many others who are contemplating the procedure and they are amazed at how good it looks.

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Sep 11, 2008 08:49PM Annabella58 wrote:

Hi jt0703

Do you also have the tight bra strap feeling we have as well?  If you did, what helped it the most, PT or time or both?

they do make pretty boobies I'll say that for sure!  Just don't like this too tight bra when I am sleeping sometimes still.  Depends on how much I stretch I notice. 

Another question, if you'll forgive me:  did it get a whole lot better after the exchange?

Janine:

I just PMd someone named Ellie, with explicit instructions for exercise, thinking that was you,,,,oh well, will try again tomorrow.  I'm not too great at PMs!

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Sep 12, 2008 07:44AM Linda54 wrote:

anniebelle

I also have the tight bra feeling.  I was hoping it would go away after the exchange (which I am waiting for a surgery date) but it sounds as though it continues.  It just feels like I have a bra on all the time.  I also have the jumping boob syndrome.  I go to see my PS on next week and will ask him about the nerve cutting.  Sometimes when I am writing my boob jumps.  Weird feeling.  If its not too much trouble would you PM me those exercises.  I will let you all know what my PS says about the tight bra and the jumping boob.  Thanks and have a great weekend.....

Linda

I hate Cancer...

Dx 3/7/2008, DCIS, Stage 0, Grade 1, 0/0 nodes, ER+/PR+, HER2-
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Sep 12, 2008 09:10AM Annabella58 wrote:

Hi Linda, I will try to send you them, I don't know who the Ellie is I sent them to:

But I would like to make it VERY VERY clear that if I do manage to succeed in sending them to you, that you should first absolutedly and positively, run them by your PS first and see if they can help or hurt.  I would caution anyone withimplant to do that.

I have read from other ladies who have had lat flap that this tight bra bit goes away after a year or so.  But you utterly must go to a physical therapist and get the OK from your PS for the exercises which do help soooo much. 

I apologist for any misinformation I may have gotten from many friends who had mastectomies and yes, they are still in pain, and yes, have complications just like this one.  I am glad, Erica that you personally did not experience that.  I must say, tho it is not helpful to post how "horrified" you would be by our experience for yourself.  We are not judging your decision to stay boob free.

annie

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Sep 12, 2008 09:22AM Annabella58 wrote:

p.s. ooops ladies, I meant two years, the first year apparently it lingers.  Sorry!

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Sep 12, 2008 10:21AM, edited Sep 12, 2008 10:24AM by Erica

Anniebelle,

I in NO way meant to make you feel bad and am sorry if my comment had that effect.   What I intended to convey is that I would be horrified if, having chosen non-reconstruction partly to avoid painful tightness, that had still happened to me. If I had gone with the lat flaps, I knew tightness was a risk and would have accepted that risk as the tradeoff for getting new boobs. It sounds as if you're finding some good ways to relieve the tightness and hopefully it will eventually resolve. I should also add that I went to a physical therapist very shortly after my surgery and I feel that made a tremendous difference for me. 

As you may know, I created a website for women who are considering or have chosen non-reconstruction (BreastFree.org). As I do on my website, let me say here that I realize non-recon definitely isn't for everyone. Although I've been happy with my decision, I would NEVER judge anyone for chosing reconstruction and in fact I still feel that I could change my mind down the road and have the lat flap surgery. That's one reason I was reading this thread! One of the things I emphasize on my site is that, for most women, the option for delayed reconstruction is always there.

Again, my apologies if I offended you. That was never my intention.

Barbara

BreastFree.org (breastfree.org); BreastFree Blog (breastfree.blogspot.com); Twitter @BreastFree

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Sep 12, 2008 10:32AM Annabella58 wrote:

Hey Erica:

No harm done, I get a little "mother hennish" and protective of my other friends on the board particularly those having troubles.  For myself, boob free just wasn't an option but I applaud your brave decision and I have always thought "to each her own"  ...hey, I am walking around like Igor right now, very lopsided with a DD and a small C recon.  With the very same thought, that "down the road if I wanted to, I could recon the other girl to be smaller".   It's the still more surgery thought that stops me at the moment.  But I know women that'd trade that option in a second to be downsized.  Again, to each her own foob or non foob.  Or free!

I did wonder why you were reading this thread if you were so happy with your decision, but given your helpful website, I do get it.  Kudos to you for your decision and stay well!!

annie

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Sep 25, 2008 08:21PM jt0703 wrote:

Sorry I haven't responded but I am working and going to school so I haven't been online lately.  In response to your question, yes it is better.  I still do stretches - in the a.m. before or during my shower and any time I feel tight.  For the most part I forget all about it.  In fact I was at an appt this week and was asked which side I had my mastectomy on - I said left, no, no I mean right!  I had to think about it a second.  Crazy?  Actually I am glad I don't think of it as often as I used to.  Are you doing well? 

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Oct 17, 2008 08:25AM Linda54 wrote:

Got a question for those who have already had exchange surgery and had LD flap!!!!!!!

My LD flaps are raised somewhat to where if I have on something clingy, then the outline of the flaps can be seen.  I would like to know if after you have exchange surgery does the LD flaps smooth out. 

Linda

I hate Cancer...

Dx 3/7/2008, DCIS, Stage 0, Grade 1, 0/0 nodes, ER+/PR+, HER2-
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Oct 17, 2008 12:29PM Annabella58 wrote:

 Hi Linda,

Can you clarify and I'll try to help?  My lat flaps are inside, do you mean the back incision or the part over the implant.

I think if it's the part over the implant, I noticed mine were quite raised while the expander was in there, but it took so long to get the implant (10 months due to chemo) that they kind of went back down.  I know it all suddenly smoothed out about 8 mos. out? 

If you mean the back incision, that smoothed out only a month or so ago.  It does take alot of time.

Sorry I hope this helps!

xo

annie

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Oct 17, 2008 01:42PM Linda54 wrote:

Hello Annie

Thanks for responding.  I do mean the flap that is across each breast.  So glad to hear that yours  went down.  Hoping mine will too.  It is more noticable on my rad side.

You did help, thanks

Linda

I hate Cancer...

Dx 3/7/2008, DCIS, Stage 0, Grade 1, 0/0 nodes, ER+/PR+, HER2-
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Oct 19, 2008 01:34PM Annabella58 wrote:

Hi Linda, I took another look and I can see a faint outline where I guess the skin is thinner?

My flaps were internal (kind of like a muscle bra?) so it's prob. not the same thing.  Hopefully someone who can give you info will chime in, but glad I could help you.

God bless

annie