Latissimus Dorsi Breast Reconstruction
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Clyday - i've 8 fills so far, 60cc/fill, & i found that after the 5th one (one per week), the soreness & tightness is less intense, more manageable & shorter duration. I have one more to go, then my PS said I need to wait 3 months for the transfer. She also said that the expanders will begin to soften over time, so not as hard or stiff. I use a wonderful all natural lotion that softens the skin & relieves any dryness.
Kfinnigan - glad you're home & surgery went well. Gets lots of rest - speedy recovery!
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kifinnigan, glad to hear the surgery was successful and you are at home already. Don't rush in doing things. It takes time. As others said: Don't do it even you can. Remind yourself the restrictions.
DPiggy, glad that you can feel easier for your fills after your 5th fill. I had my 3rd fill last Friday. I felt harder than previous one and I still have 2 more to go. I have 60cc every two weeks. I hope I can feel a little easier next time.
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this TE feels like the devil...lol! Pretty painful. I see my PS on Wednesday. Forgot how much I hate drains!
Piggy, my PS said the exchange can take place one month after last fill, then three months to phase 3, nipple and areola construction. What is your PS's timeframe?
Xinghong, how are you doing with your fills?
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kfinnigan - i have one more fill, then my PS will wait 3 months before transfer. I was able to do nipple sparing on both sides, so will not have addt'l surgery to reconstruct.
xinghong - hang in there, expansions do get easier. My PS does 60cc weekly, but the next one, which is my last, will be 70cc.
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kifinnigan, as I said I already had 3 fills and the TE is 240cc so far. I will need another 2 fills to get 350cc. Felt very tight and painful a few hours after the last fill and took 3 days to feel better. I took Tylenol and Advil for one day after the fill.
DPiggy, thanks! I feel TE is annoying, but it's not out of control. I am happy for you that you are almost done with the fills and you don't feel that hard. I started to get advice from Exchange thread. Hope to see you there soon!
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2 of the 4 drains were pulled today and the bandage on my back was taken off. PS says everything looks great, just as it should. Next appt is July 11.
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Happy for you kifinnigan. After all the drains are pulled out, you will feel much better. But still be careful and don't do much even you feel great.
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Kfinnigan - i second Xinghong's comment. Glad things are going well, but don't overdue.
Happy 4th to all!!
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thanks! Happy 4th and continued happy healing!
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hi, sorry i disappeared for a bit. I had to stay off computer due to back ....and so when I went to recoup at a friend's mountain home, I left computer behind.
hope you are all doing well. kfinnegan, just caught up with your mesgs ...glad to hear all went well. Be patient with on healing and really, really don't overdue. every time I over exerted, seems to be a 2 day set back, but maybe thats just me. I am 7 weeks out and that still happens. I think the first three weeks a blur and a lot of discomfort, from there a little better, then a slow climb each week.
Sounds like folks moved off meds earlier than I did - I have a philosophy to use your full arsenal if needed. (hence our trial) I tended to become exhausted if trying to tolerate more pain or discomfort.
For first few weeks, I could not stay in any one position for long. that gets better. I do agree to surround with soft pillows, using a fleece blankie to tuck in! As mentioned, by advice is also lot's of protein, vitamin C, water and fiber!!!! (granola good for fiber and energy)
As for me, PT is really helping my mobility, esp. my shoulder which has been a problem. My biggest frustration now is my back and incision line. So tight, will it ever get better?
Did anyone use or given any scar therapy? i don't mean for aesthetics, but for tension off load for the back recovery? my PS dismissed saying my quilted closure helps with that, but I am questioning. I will look to see if there is a thread on this, but this surgery in particular ?
I now also have a minor case of lymphadema occurring in affected arm, pit and side. PT will address that, but rather alarmed since in all my years with this crap, I have avoided that -- oy vey
have a good monday.
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Hi Ladies,
I cannot believe I am here. I am so upset. My TE to implant exchange surgery failed due to infection and today I learned that I will need the Latissimus Dorsi for my new expanders to be placed. I am worried about the cosmetic appearance and the loss of back muscle. I was happy with how my original implants appeared but I don't know what to expect now.
For those with LD & implants -
Are you happy with your final results? Are most women reasonably satisfied?
My PS said most women have regained back muscle strength within 6 months. Does this sound accurate to you?
Any advice?
I just wish this whole stupid cancer episode of my life was behind me.
Thank you.
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Warrior_Woman- How disappointing...that just stinks! Hopefully the ladies who have gone through that process will be helpful. Goodness, this Monday seems filled with drawbacks. Did they give you any sort of timeline? How long do you have to wait for the current infection to clear? Let us know how things are going and feel free to vent away...you certainly have reason to!
Hugs and prayers for getting back on track!!
Ally
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Thank you for the speedy reply, Ally. My infection is clear and my LD flap with TE placement is scheduled 10/3. I don't know how long I will have to wait before the implant exchange. PS said I will fill quickly (2 mos.) because the pockets are already there. I don't know if she means 2 months to fill me or 2 months to exchange. I had to wait one month between final fill and last exchange. I wish I had a timeline. I am having a terrible time planning my life.
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I'm 13 days out from lat flap with TE placement. Had the last 2 of my 4 drains pulled yesterday, earlier than expected. Also found out I was not supposed to be doing any longer walks, which I had done a few. On orders now to take it easy and limit use of arm and only walks around the house for 4 to 5 days, then it will be ok to walk further. Also, no ibuprofen til the drains are out, but I think I will also wait 4 to 5 days for that too, even though drains were pulled yesterday.
Lots of pain after drains were pulled, mostly in my back, but also one portion of breast, this darn TE, feels like a vice squeezing my boob in places, worse when laying down to sleep. Back hurts, well achy, from sleeping on it only, I'm a side sleeper, boy how I long for that! Having flashbacks from mastectomy days, which improves, just have to keep remembering that!
After drains were pulled, he wrapped me in ace wrap around torso, have to keep like this til I see him next Monday.
Hope all are doing well. Best to you Warrior!
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Hello all,
I guess I will be joining this forum also....
Had my PS 7 wk post DIEP appt today. My Righty Diep breast is doing extremely well, no evidence of any fat loss or swelling. It is soft, warm and supple.
Lefty report.(My left flap failed at surgery) I don't have enough skin to support any type of implant. The skin is very thin and the fear is of a tear if we attempt to stretch with a TE. I have a history of multiple infections and wound openings from prior surgeries. It will not be a one surgery fix.
Recommendation is the lat flap to create a sling and support and to hold the shape. I apparently don't have as much fat in my back as I thought. During this surgery a small TE will be placed to hold the shape of breast. If I come down in size, breast envelope can be filled with fat grafting instead of implant. That would mean a reduction of DIEP righty.
Still processing all of this.
Vivian
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This is the first friggin' time in my life that I'm not fat enough! I've been reading through the many posts on this thread as I cannot sleep or eat. I'm too upset. It seems most women either love their results or feel their lives have been ruined by pain and mobility impairment. It's all or nothing and there is no way for me to predict how well I will fair. I am so frightened. I made a list of questions for my PS and I'll review them with her in consult.
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Warrior_Woman- I am so sorry you are having to go through all of this. It is alot to not only process, but just frigging deal with. Sure wish I had some great words of wisdom or advice. It seems like you have taken a deep breath and are getting your questions together. That is probably a great first step. Try not to let the posts that deal with difficult issues get you down...women that have no issues rarely post here. I think anyone would be upset in your position and just know that if you need to vent, here we are! I don't remember who posted it, I think it was AZ or Blessings but they noted that there were not many things that couldn't be fixed. It may take awhile but you will get there!!
Hugs,
Ally
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I cannot count the number of times I've been emotionally rescued by the women on this site. And I am grateful to everyone who has taken the time to help. I try to pass it on.
Ally - "there were not many things that couldn't be fixed." Does this quote refer to not many things with the LD surgery or life in general?
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Warrior Woman - I'm 3 months post double mastecomies & LD flap on both sides, surgeries occurred w/in a day of each other. I can tell you that the first month was not easy for me, but slowly but surely, recovery took a turn for the better. I can only speak for myself - initially I was very discouraged & depressed & didn't think I would be able to get back to something normal. I've been fortunate that things have been going smoothly, & my last fill is next week. I then have to wait 3 months for the exchange - which can't come soon enough since I hate the TE's. All I can say is be sure you address all your concerns & fears w/ your PS. Mine is awesome, & so far has not steered me in the wrong direction. This isn't an easy surgery by any means, & I've come to the conclusion, that patience & acceptance of a new normal is the only way to cope w/ everything. Easier said than done, & I have to remind myself constantly, but this is a journey that takes time, more time than I had anticipated. Rely on your support system. Mine is phenomenal & couldn't have gotten thru this w/out them. This thread helped me tremendously - not only to be able to read other's experiences, but to be able to share & know that I wasn't the only one going thru this. Much luck!
Keryl - Glad to hear from you & that you are making progress. Both my surgeons recommended scar message therapy - if that's what you're referencing. My husband is a PT, so that's a plus. I have found that massaging & stretching the back incisions releases tension & tightness. I'm usually a little sore the day after, but it's a good sore. Also, a lot of light touching, both front & back, to reduce sensitivity & to identify & increase different sensations/feeling. It's also great for the scars since I don't want to be hypersensitive to the touch or clothing.
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Warrior women ask LOTS of questions!! Ask him how many of his patients had good and how many had bad experiences. Ask him how many have failed and how many have been a success. Ask him how many have had mobility issues. Ask how many had to have revisions and what kind of revisions. Ask him about Hyperbaric Oxygen treatments. For me I read through all the good and the bad. I thought too women that have bad experiences will post and women that have good wont. I took the bad experiences with a grain of salt and figured I wont be one of them. Well I was. DOES NOT mean you will be but I think you need to be prepared. I still have chronic back pain and can not move my arm up only about 50%. I was told 4 wks off and had to take off 9, still not back full time....... I am going to see another PT next week. Thinking about getting an epasuril shot for my back pain. I just had a revision surgery last week. More cutting. Now I can add another 5 inch scar to my already 50 inches of scaring. I had fat grafting and Lipo. Im sore but peanuts compared to the LD flap surgery I had in Feb. For me I would not do it again if I had to do it over. My radiated implant is encapsulated again and at this point there is nothing we can do about it. The flaps look great and my scars have healed so well you can hardly see them. The implant is as hard as a rock though so was not worth it for me. I wish I would have waited longer. I finished Rads in Spet and had the LD in Feb. Maybe I should have waited longer. Guess I will never know. Good luck to you. Im sure you wont have my problems but do your homework. I wish I would have done more!
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Warrior_Woman- It was in responses to other women and referencing specific works that women have undergone on this site. Sometimes it is the same PS but often another PS took over and made a difference for them. Wishing you the best and to getting back your mobility as soon as possible! Ally
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DPiggy - Thank you for your insights and story. I was told this surgery will be on par with my BMX but I do anticipate it will be worse. You had both back-to-back (no pun intended). The exchange surgery is a breeze by comparison and the TEs are not fun. With limited exception, everyone is happier after the exchange.
Tangles - I've been following your story and I cringe at the agony you have endured. I didn't think I'd be one of the 4% of people who develop infections with implants but I was. We're all part of that 12% that get BC and I find as a result, I am always now assuming the worst will happen. I absolutely plan to ask my PS about her patient outcome numbers. I don't want to hear the word "most". That gets old when you find yourself outside of the "most" category. Thank you for sharing your story. I am weighing my risks and benefits. You and other women have clearly driven home the seriousness of this procedure.
Ally - That is reassuring. I liked my old implants. I don't want to go through life hating my appearance and dreaming of what could have been.
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Warrior_Woman - I am one of the "lucky ones". I'm thrilled with my results. I only had the lat flap on one side (my radiated side), but now that I'm recovered, it was well worth the process for me. Having said that, it was a major surgery and was a bigger deal then I had prepared myself for. My PS kept telling me it was a big surgery, but I figured it couldn't be tougher then what I had been through. Turns out it was a big recovery. I was off work for two weeks, worked from home the 3rd week and was back in the office by the beginning of week 4. I have an office job, not physically demanding like Tangles job. I still do have tightening across my back incision, but I wouldn't describe it as pain. If I had to do it again, I definitely would. Please let me know if you have any specific questions. I know it's a scary process and I wish we all had crystal balls to help us make these huge decisions. If it makes you feel any better, I just got back from a vacation with a lot of bathing suit days, and my girls looks better now then they did before I had the procedure
Hugs,
Kathy
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Hi Warrior_Woman, I also wanted to chime in with my experience. Like KSteve I am also very happy with my results. I have followed some of the stories of women who did not have good experiences (to put it mildly) and it must be incredibly frustrating to be in pain and not really know why things didn't work out well. For me, I am now 3.5 months out (surgery was March 21) and feel great. I am back at work (I have a very active job, working with kids. They allowed me to take a full 2 months off which I'm glad I did), going to a pretty strenuous dance class 3 days a week and I just started swimming laps a few weeks ago. Swimming has been amazing (I haven't done laps in years but I heard it was good exercise post-lat flap and would highly recommend it for those who are able -- it is great for both stretching and strengthening).
I think my good outcome may be related to the fact that I needed neither radiation or chemo (I had DCIS but also found out I have a BRCA mutation). I was in pretty good shape physically prior to surgery but I've read about others who were fit and still struggled afterwords. I felt a lot of tightness (iron bra thing) for about 6 weeks then that started to ease and at this point is almost completely gone. I have almost no pain (I did develop some trapezius pain in my shoulders and neck a few weeks ago but worked on it in PT and I think swimming has helped too, so it's basically gone). I highly recommend PT when you're ready for it -- I think that helped a lot. I also found listening to a guided imagery CD prior to and after surgery really helpful (mine was by Martin Rossman but I think there are many out there that could be helpful). It just helped me maintain a positive attitude.
I had immediate implants (375cc gummie bear type) so didn't have tissue expanders. I'm done until I decide to get nipples which will be after my ovaries are removed for my BRCA mutation. I'm definitely happy with how my breasts look, but they do feel a little weird (very firm, and of course no sensation).
I agree with Tangles to ask a lot of questions and I think she's posted a great list of what to ask. My PS does almost exclusively lat flaps and that's why my BS sent me to him. I wanted a DIEP but not enough belly fat. I still look at photos of women who had DIEP and wonder if their breasts feel more natural and soft. I don't love that mine feel so firm but they do look great in a bathing suit!
Good luck to you!
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Gabriella - Thank you for sharing your experience. I won't move forward with this until I have reasonable confidence in my consult outcome with my PS. I appreciate your PT recommendations and plan to arrange to start as soon as possible. I am a former lifeguard and swim instructor and have a heated pool. I fear losing my ability to swim and your story gives me hope. I will have to have the expanders but should have the implants 2-3 months later.
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I am so glad I found this topic. My surgery is scheduled for Sept. 3 in NOLA. I have had a DIEP and an SGAP. The DIEP was removed due to infection; the SGAP had failure at the top of the flap where the radiated skin has created a few issues. This time more skin will be harvested to aid in better reconstruction. I am still a bit anxious, but ready to finish this part of my journey with cancer. Thanks to all for sharing your experiences.
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good updates and good to hear from all. Warrior, keep us posted, when do you see your PS?
Tedwilliams, what a drag that your other procedures failed. Are you getting lat flap on one side? Keep us posted as well, would love to follow your story.
Sine drains being pulled I have a bit of fluid buildup at end of back scar. My daughter who is a nurse took a peek yesterday and said it was fluid, but not red, or hot. Watching it now, didn't change overnight. Should I be worried?
Hugs ladies.
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kfinnigan - i had fluid accumulate in left breast after drains were removed, & my PS aspirated a few times & had me wrapped in an ace bandage for a couple of weeks for site compression. After the ace bandage, she had me wear a sports bra for about 2 weeks, & any remaining fluid (which was minimal) was aborbed by my body. I asked her if I should be concerned, & she said no. It was perfectly normal & no infection was present. She did say that she did not want to continuously aspirate, since this could present an opportunity for infection, & let my body & healing do the rest. When is you next PS appt? Or, maybe call your PS for peace of mind.
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thanks dpiggy, i see PS next Monday. I had daughter and hubby look again and they aren't worried and said to wait. I do have the ace bandages this week also, although I'm washing them right now, so taking a little break from them.
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Warrior, do ensure your PS has a PT referral for you to someone who has experience with reconstruction recovery. Not just any physical therapist. You can also source suggestions through your oncologist - that's actually where my best referral came from. Mine has made all the difference, though I am still pretty limited, but going in right direction. After my mastectomies with implants, swimming was a great recovery but not able to swim yet this time. I hope to begin gentle swim in next 2 weeks. I am 8 weeks out from left flap on radiated side and just now feeling less discomfort and greater range of motion. It feels like PT begins too soon, but it's good to get going as early as "approved". I do not have expander this time, but went straight to the implant, so don't have fills, but breast very tight. I too was very active and athletic but over the last 18 months with ongoing infection and trouble on radiated side, became more and more limited. Working out of that now. Still, I agree with the "new normal" and know that I may not get everything back that I once had. I have to prepare for that I guess, but I think I can get a great deal back with time and work.
Yes, KFinn, I was referring to the incision scar massage, I also was interested in product. (like Embrace) My PT does the massage and it is amazing in terms of helping alleviate the tightness and stress; it sounds scary, but it actually feels really good! I think most products are aimed at the scar appearance and I am not really concerned with that. My back line is pretty vertical and about 8 inches long.
KFinn, I had some fluid too, and it came and went a few times. I didn't have any removed, but it did absorb. I was on antibiotics at the time, which you probably are too. If not, they might want to give another round since fluid can lead there I've heard.
My PT said my minor edema she actually thinks might be from cording (axiillary web syndrome) caused by the many surgeries I've had and the scar tissue formation. It can impede movement and thus, circulation. She has me doing some exercises to soften but I am uncertain of prognosis there. It is tender in my arm pit -
On a good note, I am feeling better each day. My breasts and symmetry looks good and I was even able to wear a bra (light weight stretchy type) this week. I returned to work today but taking it slow. I am fortunate to take two months off, but justification was also due to my complications from prior surgery, thus slower recovery....all this zaps your energy. AND I am now sleeping through the night!!!! I can't really imagine going back to work as soon as many of you have and I would encourage a longer leave if you can swing it -
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