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Latissimus Dorsi Breast Reconstruction

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Comments

  • Xinghong
    Xinghong Member Posts: 84

    Thanks Kathy and kifinnigan for your best wishes! I only stay in hospital for one night, hopefully. I don't think I can eat a lot after the surgery. The meal hospital provides should be enough. 

  • andi44
    andi44 Member Posts: 23

    Hello all,

    I joined this discussion board last July, however I don't think I've ever posted to any threads...I have used everyone's posts to help me get thru issues...Anyway, I need to make a decision as to which direction I want to go - doing the 'latissimus flap' procedure or taking out the expander and and just being done with all of it...I've read mixed reviews from you ladies on doing the flap procedure - In a nut shell, I'm scared that I'm going to have a loss of mobility afterwards.  I'm an active person and do not want any limitations - golf, kayaking or gardening to name a few...I too have radiation damage -sores on inscision lines that just aren't healing.  My PS thinks the lat flap is the way to go...I've had a lot of surgeries in my lifetime, but for some reason, this one scares the hell out of me...Please give me your thoughts on the mobility or lack thereof...

  • mfml
    mfml Member Posts: 14

    Andi- You will see on this board that people have a wide range of experiences with this surgery.  I had a similar situation to you - my incision from the TE replacement just would not heal because of the radiation.   I had the lat flap surgery on April 1 and I was terrified of this surgery too... even though I also have had plenty of surgeries in my life.  Well - it wasn't a trivial surgery.  But I am happy I did it and I am doing well.  I had already planned a trip to Disney World for April 18 - and I went!  In fact I just got back.  I wasn't 100% but I made it just fine.  Now at about 4 weeks out I just have a bit of soreness and tightness in my back - always feels like I have a really tight bra on.  I came so close to just giving up on the whole thing - and having my implant out.  My PS practically begged me not to give up yet... and I am glad I listened to her.  I know there are exceptions - but I think most people are able to resume and active life eventually. If you decide to do this surgery - you will want to give yourself plenty of time... you won't be golfing or kayaking right away.  I took more time off work for this than I did for mastectomy or hysterectomy - I go back to work Monday.  Had I not had this trip planned I likely would have gone back sooner.  For some reason I found this decision harder to make than any other decision in the BC journey....  I was kind of mentally "done" when it became apparent that this was my only choice left pretty much for reconstruction.  So - it was hard for me to go back to that place of more surgery and not feeling well, etc.  Plus - I know it may sound strange but it felt like a "vain" decision I was making.  But - in the end I realized there were many very good reasons for me to push forward with this - and I would rather regret having it than later on regret NOT doing it (that didn't make sense I think).  But - I don't regret it at this point.  Best of luck to you whatever you decide.  And I thank you all for all of the valuable information and support you have provided. 

  • andi44
    andi44 Member Posts: 23

    Thank you "mfml" for your post...No, I don't think it's vain at all to want our bodies to be as normal as can be...When I was having my mastectomy, my father told me that I shouldn't worry about having reconstruction - I turned to him and asked what he would think about losing his 'manhood'...he didn't have much to say after that - go figure...I'm a strong willed person - and I do have faith in my plastic surgeon, I just want to be told the truth about this procedure instead of the doctor painting this picture of everything going o.k....I'm a bit upset with my radiation oncologist not telling me everything that could go wrong with that treatment and the fact that I can't have radiaiton on that side if ever I would need too...I would've declined to have radiation...

    MFML, I'm glad you're doing well, and hope that continues for you...wishing you continued luck on your journey towards good health...

    Andi

  • KSteve
    KSteve Member Posts: 190

    mfml - So glad you had fun in Disney World.  I'm sure you enjoyed the change of scenery and I'm glad it all worked out.  Just be careful to not do to much now that you're back.  Take it slow and easy and allow your body to keep healing.  Yay!!! I'm glad you're on "the other side" of this surgery now.  I understand your hesitation.  I had it too.  I think we're all just done by the time we get to this point.  But now we can both say we're healing and close to being done again, for good this time :)

    andi44 - It's such a personal decision and I understand your concerns about mobility.  I wish there was a crystal ball to help make it easier.  I am definitely thrilled with my results and so glad I did it.  But you definitely need to plan enough time for your body to heal before you resume some of your physical activity.  Good luck with your decision!

    Kathy

  • 3DX1013
    3DX1013 Member Posts: 6

    Hi, I've been reading this site for some time but never posted. I had a L MX in 11/13, then infection with TE taken out 12/13, and my skin became so tight and puckered in one area of the large scar, that it causes so much pain. There is a good size scar underneath the large scar from the infection. I have a lot of scar tissue. I've had to have PT because of shoulder pain and mobility issues. This helped a lot, but things got tight again. My PS is recommending the Lat Flap as he seems to feel I fit in the category of women with the tight skin from radiation, even though I was lucky enough to not have had chemo and radiation, just tamoxifen. I've been agonizing for month about this decision. My biggest fear is further loss of function and mobility and arm issues which I have now from the shoulder pain. I've read about the iron bra feeling, and it scares me half to death, as I feel I will have this muscle wrapped around me where I already have pain from the scar tissue, etc. He seems to think it is a good fit for me, vs the longer recup and more time in surgery for something like the DIEP. I feel like all I've read is that the DIEP and a "natural" breast is the way to go, vs the uncomfortable implant. My PS wants to do the Lat Flap with implant. I know many people on this site did not have the option of the abdominal or DIEP so had to go with the LF. I'm wondering if you would still have the Lat Flap if you had the chance to have the DIEP instead? I never had any abdominal surgeries so I could be a candidate. He is a great Dr, and I think he would do a good job, and feel like I'm doing this b/c that's what he feels is best, and not sure I'm making the right choice for myself. My surgery is getting closer and closer. 3wks away, with pre op only 1 wk prior to talk before surgery and choose implant I guess. I'm so confused..... and scared. Does anyone have any thoughts or suggestions for me? Thanks!!!

  • rozem
    rozem Member Posts: 749

    I would have done diep if I was a candidate -  no muscle involved and more natural looking - if you have an option go for the diep, also as about fat grafting, sometimes this helps with the tightness and A LOT less invasive

  • KSteve
    KSteve Member Posts: 190

    3DX1013 - I did have the option of both procedures and chose the lat flap.  The thought of the much longer initial recovery kind of scared me away from the other options with the stomach.  I really trust and value my PS's opinion and he really felt this was the best fit for me.  I don't find the implants to be uncomfortable any more. The right side was very uncomfortable prior to this surgery due to radiation tightening the skin of the approximately 3 years.  Now I'm much better than prior to this surgery.  But everyone's experience is different.  And with this problems you've experienced, I understand why you are cautious.  Have you looked at pictures at your PS office of both procedures?  That may help you too.  Good luck!

    Kathy

  • Xinghong
    Xinghong Member Posts: 84

    I understand why mfml had that vain decision feeling. I had the same feeling too. That's why I am still so struggling with my decision even I will have my surgery in 4 days. For mastectomy, I felt I had no choice and just wanted to get rid of it, but for the reconstruction, especially my only choice is this latissimus Dorsi, I am really worried the recovery and afraid I will regret. I am very active now, going to gym 3-4 times a week, yoga, arriba, box fit are my favourite. I feel very confident with my body with clothes on.  I am so afraid that after the surgery I can't have the range of the body mobility and can't work out any more. But at the same time I believe  I have a good surgeon and she will do a good job on me. Also I saw so many women here had very good experience about this surgery and very fast recovery. I hope I also can tell my positive experience to you all after my surgery. I will keep you updated. 

  • mfml
    mfml Member Posts: 14

    Best of luck Xinghong - I know exactly what you mean about the mastectomy vs. reconstruction. Sounds like we have had very similar experiences with our reconstructions.   I just got back from follow-up appointment - I am good to go back to work on Monday - yay!  I don't want to pressure anyone in any way - there have been plenty of negative reports here - but I thanked my Dr. today for talking me into this.  Please feel free to PM me if you have any questions about my experience - I am happy to share with you.

    M

  • Xinghong
    Xinghong Member Posts: 84

    mfml, Wow 4 weeks after surgery, You are able to go back to work and you had a trip during the recovery already! What a successful story! I am so happy for you. I also asked 4 weeks off from work. I hope I can go back to after 4 weeks too. Definitely I will ask for your help if I have any question after my surgery. Thank you! Are you having expander in or direct to implant? I heard that expander can cause lots of problem. 

  • KSteve
    KSteve Member Posts: 190

    Xinghong - I just wanted you to know that I also had no issues returning to work (not physical, mostly desk job, some walking).  I was working from home in week 2 and went back to the office at week 3.  I also had the tissue expanders.  Having had them my first time around 3 years ago, I knew what to expect.  I had went into the PS office every other week to get it filled and got it exchanged to implant 10 weeks after the lat dorsi flap surgery.  That was an easy surgery to recovery from.  I was back in the office a week later and didn't need any pain pills at all by day 3.  That was 3 weeks ago and I feel great.  The incisions are healing nicely.  Keep those positive thoughts in your head.  Good luck!  I'll be thinking of you.

    Kathy

  • mfml
    mfml Member Posts: 14

    KSteve - so glad to hear you are doing so well!  I honestly could have gone back to work earlier (obviously since I went on vacation :)  But my Dr. was extra strict with me about time off this time because I already had this vacation planned (and paid for!!)  I was able to do some of my desk work from home pretty much the day after the surgery - which suprised all my co workers - they weren't expecting me to be back online so fast.  Xinghong - I probably didn't explain my situation so well.  So - in the beginning when I had my mastectomy - I got tissue expanders. I had all the fills and everything and then I had my radiation with those in. (I didn't go very large..  my radiation doctor said I needed to stay on the small side if I was going to do radiation with TE's still in.   When I had the replacement to permanets in Feb - the radiation side didn't heal and I ended up with huge open wound - that is brought me to this place of getting the LF.   Other side was fine.  So - when I had this lat flap early April - I did not have to get another TE in - I was essentially "expanded".  In my case - the radiation boost area was right in the middle - about a 3 inch x 2 inch oval.  They cut that really damaged area out, put the flap there, and then a permaent implant under it.  Now I just have to get nipples, though I am considering just tattoo - I am not eager for anyone to cut into that side again ever!   I know that is probably not the correct technical description of what they did - but that is the gest of it.  Best of luck let us know how you do. And as Kathy says keep the positive thoughts going!

    M

  • Xinghong
    Xinghong Member Posts: 84

    Thank you so much ladies for sending me the positive energy! Both of mfml and Kathy went through so much and I am so glad that you two finally have successful result. I had one side nipple sparing mastectomy. I remember that the surgeon said that they can split it to use on the other side. I know it's too early to think about it now. :) The 3D tattoo looks very realistic now. So I agree with you mfml not cutting into it again. Actually I am thinking to get a lotus tattoo on my port scar on the chest. Sometimes I think breast cancer educated me in so many fields which I would never knew if I didn't go through all this. Cold caps, toppers and wigs, tattoos and now implant. :)  

  • 3DX1013
    3DX1013 Member Posts: 6

    Thanks KSteve for your feedback. He had pictures of other surgeries, but not of the Lat Flap. I went for a 2nd opinion when I was having the MX, but never for this procedure. I have 3wks and keep wondering if I should go for a 2nd opinion, but I'm afraid I'll get more confused. Now I went to him today as I'm having more arm weakness, and he wants me to go to a nuerologist and see if anything is going on before proceeding with surgery. This sure continues to bring on the anxiety!

  • peacestrength
    peacestrength Member Posts: 236

    Ksteve - have you had any problems with LE after lat. dorsi?  


  • KSteve
    KSteve Member Posts: 190

    peacestrength - no LE problems at all.  And I was nervous about that. Feeling very blessed!

    Kathy

  • Xinghong
    Xinghong Member Posts: 84

    OMG! I can't believe I am having low fever right now. It didn't happen for a long time. This morning I couldn't get up and just wanted to sleep. My body temperature is 36.9c now. I was fine yesterday. I went to gym and did grocery shopping and also helped my friend to file her tax. Maybe too much? I will have my surgery on Tuesday morning.  I don't want my surgery cancelled! What should I do now? 

  • gabriellaM
    gabriellaM Member Posts: 25

    Xinghong, good luck tomorrow!  I have a feeling you will do great!  Since you have already had surgery you will at least have an idea of what to expect in terms of anesthesia, drains etc.  My LD surgery was the first time I ever had surgery and I think the unknown was a big part of my anxiety (also not knowing what my final pathology would be).  I am going to try to post some more photos to the photo website today including some photos of my back since I think there are not many of these on line to get a sense of how your back scars may look.  In terms of eating post-op I didn't get out of the OR/PACU until late at night (my surgery was 9 hours long) so didn't eat anything the first night.  I found I was hungry the next morning and hospital food was fine -- friends and family also brought me things.  When I got home my friends had arrange for people to bring me dinner for 4 weeks (on that Takethemameal website) which was amazing!  I really didn't need people cooking for me after about 2-3 weeks but everyone said they wanted to help out and my family certainly appreciated the variety (they never ate so well!).  Now I'm able to cook again.

    Tangles, I hope you are seeing some improvement and starting to feel better!

    I see my plastic surgeon again Friday which will be six weeks out!  Definitely feeling much better but still there are things that bother me (my arms feel weak and I still have the intermittent tight bra feeling -- it comes and goes).  I was able to go to Florida and really enjoyed it!  Sometimes sitting in the sun by the pool I completely forgot I had recently had major surgery! 

    Good luck to everyone out there still recovering!

  • gabriellaM
    gabriellaM Member Posts: 25

    Xinghong -- I just saw your post about not feeling well!  Technically most doctors don't consider a temp under 38 a fever but I would call your doctor and let her know you're not feeling 100%.  I felt like I was coming down with a cold in the few days prior to my surgery and I knew they would not do a 9 hour operation if I had even a mild cold so I was really nervous.  I kept thinking I felt a lot of post nasal drip and stuffiness building up and would cough occasionally but it turned out to be nothing.  I hope you are ok for surgery -- mentally I felt it would be really hard to have to reschedule.

  • andi44
    andi44 Member Posts: 23

    Xinghong - good luck with your procedure tomorrow - and, like Gabriella mentioned, I would definitely contact your doctors office to let them know of your low grade fever...

    Andi

  • kfinnigan
    kfinnigan Member Posts: 490

    Thinking of you Xinghong!!!!  

  • Xinghong
    Xinghong Member Posts: 84

    Thank you everyone for your suggestions! I actually feel better today. I even went to gym and had yoga class. Not feeling 100%, but better than yesterday. I think maybe too much stress and nervous can cause low grade fever? Definitely I don't want the surgery be rescheduled. 

    Gabriella, I kept checking your post on picture forum and looking forward your more pictures. 

    Hospital called me today and confirmed that I need to arrive at 7:35 and my surgery is 9:15. I feel I am ready! 

    I will update you as soon as I can!

  • Jeepster1
    Jeepster1 Member Posts: 46

    Xinghong , my prayers will be with you tomorrow as you have this surgery. 

  • 3DX1013
    3DX1013 Member Posts: 6

    Xinghong, I truly wish you well! Keep us posted!

  • CLYDAY
    CLYDAY Member Posts: 40

    Hi ladies....I am not sure if I posted about my upcoming surgery yet...I will have Lat Dorsi on my RADS side May 15th with a new expander put in and in 3 months switch both sides for squishys!!! I am a bundle of emotions...scared...nervous....ready to get it behind me.  I have already had bilateral mast and 6 1/2 weeks of RADS...I have been really trying hard to keep myself healthy and fit my running and doing yoga,  Am so worried as to how long before I can start building my strength again....did any of you do physical therapy....any tips...advice....and what questions to ask please share with me!!!

    Cherri

  • jwilco
    jwilco Member Posts: 209

    Xinghong Good luck!  It will all be behind you soon.

  • andi44
    andi44 Member Posts: 23

    Hello All,

    I met with another doctor to get a second opinion...And, after talking to him, I'm choosing this doctor to do my Lat Flap surgery...This means I have to 'fire' my other doctor.  But, I have more faith in the UW Clinic in Madison, WI...I wish I had gone there to begin with...He wants to get it scheduled asap as my lesions are draining and very ulcerated...After doing the Lat Flap surgery, he's wanting that to heal - go back in 6 weeks to put the expander in - let that heal up to 3 months and than start the 'filling' process all over again...ugh!!! 

    Thank you ladies for listening and your input - wishing you all good health and healing... :)

    Andi

  • tangles
    tangles Member Posts: 211

    Hello All I have a little update. I had two MRI's last week one for my shoulder in which I have VERY little range of motion to make sure I didn't get a tear during surgery. No tear! I saw an ortho and he said I have a very bad Frozen shoulder. I will do PT for 2 weeks and if no great improvement I will go into surgery. Scares me as I had 22 lymph nodes removed, but I have to take the chance if I want to be able to work and put a shirt over my head and comb the top of my hair ever again!! I also had an MRI on my back do to the extreme back pain I have had since this surgery. Dr wanted to rule out any other under lying condition including cancer metastasizing into the back. Thank god that was all clear. I will have an epidural pain block next week to see if that helps. Tomorrow will be 9 wks post op and I am still not back to work. I am hoping the PT for the shoulder works as if it does not and I need the surgery it will be another 6 wks off work with no pay:-( This surgery has been the worst decision of my life. I think the fact that my implant is encapsulated again makes it heartbreaking. All this pain and suffering for nothing. It is now hard and un movable. It has shrunk up and is now sitting higher then the other breast. Not to mention the inplants are way too wide for me. UGH so many regrets...............

  • kfinnigan
    kfinnigan Member Posts: 490

    Cherri, I'm with you girl...my surgery is June 25th.  

    Tangles, OMG!!!!!!! I am such a bundle of nerves reading what you're going through.  Praying the PT will do the trick.

    Andi, do you have your surgery date yet?

    Thinking of you Xinghong, hope all went well yesterday!!

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