Latissimus Dorsi Breast Reconstruction
Comments
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kfinnigan - I see my PS in 2 weeks. I've had minor fluid build up in my left breast after my drain was pulled and my PS said she isn't concerned and my body will absorb it. I will absolutely report back the outcome of my PS consult.
tedwilliams - Interesting that NOLA does the LD flap. There have been postings on this thread about hospitals that stopped doing the LD. That concerned me. I am going to Penn and my PS is Dr. Wu. I do have confidence in her judgement but I will drill her.
Keryl - Yes, I am in full agreement about the PT asap. When I had my BMX, an agency came to my home, assessed me and arranged for a nurse, PT and OT. They each made a huge difference. I am requesting they return. The nurse has cared for me with multiple surgeries. She is wonderful. I went to PT for cording but the issue resolved itself after my implants were removed. I suspect it will rear its ugly head again.
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I ended up emailing my PS and sent him a photo. He said fluid buildup is common with this surgery, but wants to see me tomorrow to be safe.
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Warrior woman , welcome to this thread! I remember I saw you at Cold caps thread. Good to know that your hair is growing crazy. I had a hair cut with a new hair dresser another day and she said I am so lucky that I have so much hair.
Sorry to hear that you had infection and had to remove the implant. I can understand after all the TE process, how frustrated that you had to do another surgery and start over again. As you read here, many women recovered very fast and had very good result, but some are not.
I had my surgery at the end of April. I had difficult time during the first 3 weeks, feel harder than mastectomy. Especially the back incision made me feel uncomfortable to sleep at night. But I was recovered very well. By the 4th week, I felt great. The incisions were all healed well and shoulder and back movement and strength were all good. I went back to work 4 weeks post op. But only after 3 days back to work, I had high fever and felt very painful on the non flap side and then redness and swollen , end up stayed in hospital with IV antibiotics for 6 days. It was an infection, but caught early. I have an office job, so I don't think the infection was from the work. I was thinking maybe because the bra I was wearing to work was too tight and had irritation. Anyway after the infection so far so good. I have fills every two weeks and hopefully it will be done with 2-3 more fills. So generally I don't regret doing this surgery and the outcome is good. My incisions healed very well. Movement and strength are not a problem for me. Of course I still feel stiff on the back, especially in the morning, but no longer have the pulling when I walk. I don't feel I lost lots of strength on the LD flap side and I am only 2.5 month post op.
I know it's a hard decision to do this surgery. I was scared about removing my back muscle too. But feel it's not that scary after I went through this. I was amazed by the work my surgeon did and I hope and believe your surgeon will do the same amazing job. Good luck!
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Xinghong - Thank you for sharing your story. I recall reading your account of your infection on this thread. As far as I know, as long as the infection isn't touching a foreign body, it can be treated and yours was caught early. Mine was caught early but it got the implant. Surgery #4 was to clean me and replace he implant then 2 months of antibiotics after 10 days in the hospital and then the infection returned and surgery # 5 was to remove the implants. If I have the LD surgery it will be # 6 and the exchange will be # 7. I anticipate # 8 will be to correct imperfections and who knows after that. I wonder who on BCO holds the record for the most surgeries. Unbelievable!
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Warrior Woman: With 2 previous flap failures, not many options are left. The veins have been compromised that are usually used to attach flaps and my radiated skin creates difficulty. Much of that skin will be removed this time and be replaced with the skin from my back. I had very good surgeons for the other surgeries, just not good outcomes. Dr. D's comment to me: "You have taken a long route to get to us". This is not their first choice but is held in the toolbox for situations like mine.
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tedwilliams - I will really need to understand why my PS feels the LD route is best for me. It seems extreme given that I only had one infection and no radiation. I would be less concerned if she were planning to use fat. I think we all agree that muscle is a big deal.
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went to PS today. Wasn't fluid build up by my back scar, all normal stuff, a little wedge of skin when they stitched me up and that will go away. He also removed some stitches from my boob. Wrapped me up in a new ace bandage, but said I could either wrap in ace bandages or wear a camisole or tank top with a shelf bra, my choice for a week. I came home and put on a comfy tank top. I was cleared to take ibuprofen and go on long walks. Limit use of left arm still. He said everything looked good. I see him again in 10 days.
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That's good news. kfinnigan. Progress! I cannot imagine wearing a bra after this surgery. An ace bandage perhaps but not a bra.
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there's no way I could wear a bra right now, lol!
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Ladies, I am still wearing soft cami or soft tank. Tried a bra lite and I am at 8 weeks - still no way - it made everything tighten/constrict, rubbed etc. It may be awhile. A friend wanted me to sit by the pool today; she didn't understand that I can't even wear a suit yet !!! LOL LOL sounded awful. On ace bandage, make sure to use the extra wide ones if you can. The skinny ones move to much and aren't as comfy. When I was using, I sent my hubby to get another and he came back with the thin one.... not so good.
KFinn, I have that puff too - actually mine was the size of a mini loaf at first, then shrunk to muffin size, now about the size of small cookie. It is left over flesh from wear they suture everything tight and it all doesn't easily fit at the end of the incision. MD said that the body will equalize and the slack will absorb into the space where tissue was removed. If it doesn't all go away, he said I could address it later. (cut/remove somehow...) I will wait it out for now.
Warrior, I actually agree with you. My PS tried the implant route several times before finally pointing me to LD and I DID have radiation. Not knowing the MD point of view in this case, don't know, but I definitely would get a second opinion. So far I am glad I did this, but I really had no choice if I wanted to salvage a breast of any size, plus he needed to remove damaged radiated tissue. You are on the right track to ask all the questions.
Good news - I did go to the health club today! I just did the stationary bike and my PT exercises but it was nice to be there. Going to ask about getting in the pool next week. (will find something loose to wear!) I am having a little trouble on long stairs. I can feel it in my back and have to take breaks or elevator instead. I think it's just muscle fatigue or weakness, but I didn't have it to begin with. Maybe I did too much. (again)
I hope you are all doing well, hang in there.
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great to hear from you Keryl! You are making great progress and you provide great info! Good luck at the pool.
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Glad to hear everyone is doing well! Approaching 13 weeks post-surgeries & had my last fill today. WOOHOO! Going to celebrate. Now I see my PS monthly & sit tight until the 3rd month when I have the transfer. Going away for my daughter's softball tourney next week, which just happens to be in Gulf Shores, so we're staying on the beach. Quite the task finding bathing suits that are comfortable w/ no underwire & don't expose back incisions. Was very discouraged at first, but found a few that work. Kudos to my husband who was very patient & encouraging.
Hugs to all!
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DPiggy- Congrats on that final fill! I was skipping out of the doc office!! Enjoy the softball tourney. We just finished my daughter's lacrosse tourney and it was hot, hot, hot!! Gld your shopping excursion was successful and kudos to our partners who hang in there on the small but important tasks!! Good luck to your daughter and her team!
Ally
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wonderful news! I'm still awaiting my first fill and wondering what tops I can find to wear to work while one boob gets inflated and the other real one stays small, lol!
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kfinnigan - I haven't uniboobed it so I don't know if this will help. After my BMX I got a "coobie" bra at the Faith & Hope shop. The bra comes with pads of different sizes. When my expanders were in, I was able to reduce the padding a little after each fill. Perhaps you can do this on one side.
I am delighted to hear of everyone's festive plans and progress. It gives me hope seeing you each come through this well. Although scaring is not something I look forward too, it isn't a big deal. Scars fade. Chronic pain and immobility are another story all together.
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Here is the link for my coobie bra. It is very comfortable. I sometimes wear it now when I go out because I am completely flat. Frankly, I like how I look flat. My husband doesn't though. :P
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how much does the actual site hurt? i am not particularly interested in something that's going to hurt..well, much at all. i was hoping for someone to try a TE even with irradiated tissue, but the only PS i've spoken to was adamant. i have a persistent and intrusive seroma and i am told the only "sure cure" was recon. can anyone give me an idea about pain at the graft site?
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I did not & do not have any pain from the lat flaps. There was definitely some discomfort right after surgery, but I have no lingering pain whatsoever.
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I am one of the UN LUCKY ones who have had a terrible time with this surgery. PLEASE do not think this will be you, but at the same time you have to take into account it "could" happen. I had Double Lat flap with immediate reconstruction. It was the worst pain I have ever went through in my life. There is no way I could have possibly gone back to work for at least 6 wks. I ended up taking 9 wks because I could not raise my arm up and I am a hair stylist. I now can get my arm up high enough to work, about half way, but still can not raise it all the way up. I also have chronic back pain. I guess my other back muscles are not wanted to step it up and take over for the Lats that have been removed. My results were also not good. The radiated side is once again encapsulated and this was the whole reason we did the surgery. My PS now says my only hope is to go to Mayo and have this done again using fat from my but. I say NO THANKS I am DONE. I had a small revision 2 wks ago. Some fat grafting and Dog ear removed. I would NEVER go back and do this surgery again knowing what I know now. Tnis is just my story others have had no issues at all. I read a few of these stories of women who had bad experiances and I thought this wont happen to me, but it did :-(0 -
I am 13 weeks out from BMX & double LAT flaps, & I still have discomfort & tightness in my back. The first few weeks were very uncomfortable, painful for sure, but over time, has improved.
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thanks for the coobie bra advice! I am three weeks and one day out from surgery. I lifted something with good side on. Monday and it shot a pain into the lat flap side, this darn TE is killing me at times, the ribs are what is hurting me so bad, different areas where the TE lies,MIT just presses on my ribs and it's painful, and it's hard to breathe deeply. My PS said that will get better, I sure hope so! I have one more full week off of work. My back and shoulder are tight but not painful.
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I am 9 weeks out. Finished my first week back at work. Saw PS yesterday and he my breast is doing great, better than expected and softer than anticipated. Thinks the blood supply is very good now. The back he said is tighter than he'd like to see and may take me months to get comfortable.
BUT I do have approval to get in the pool. he said yes....go TODAY! Very good for movement and for shoulder flexibility.KFinn, I had the breathing tightness and I couldn't talk very loud. That all went away. What you describe about lifting with the good side and feeling in the lat flap side occurred to me a lot. To the point that it hurt just as much on that side, so I gave it a break for awhile and that was discouraging, but its much better now. The other "watch out" is for stairs. I was doing fine on stairs and one day I went up and down all afternoon doing light chores and then next day, wham. Now every time I do stairs more than one flight, I feel my lower back muscles tighten and pull. Then doing stretches helps; all part of stressed back muscles I guess.
The most pain I have now is after email all day at work, ugh. Awful. Need to take lots of breaks. I do stretches there too, where I can. The other bad guy is my pec muscle on lat side - if I lift too much it spasms and gets hard as a rock. He said light swim, but no resistance will help with that too.
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I had my first fill today! PS said everything looks great. He filled 50 cc's. Had 30 cc's at surgery. The minute he filled me that awful rib pain stopped!! I could barely stand it on my way from the parking lot to his office but it went away! He said everything would settle down, but that was a sigh of relief to me. He will fill me again next Monday then the nurses will take over. I asked about range of motion exercises and he said do what feels ok, don't push it. I go back to work next Monday, will ease back in part time for a week or so first.
Oh... I found a comfy Jockey seamless bra at Macy's today. I wanted to try some on and found one that will work perfectly! It's a Jockey crop top microfiber seamless bra.
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kfinnigan- Congrats on the first fill!! Others have had pain and then as the expander is filled, it moves off the nerve or whatever was causing the problem. So glad your fill helped your expander feel better. I would ask your doc for a prescription for PT. It isn't only the exercises, it is also how they massage certain areas and make sure you are healing correctly. I highly recommend PT!! Keep us posted as to your fills and "low and slow" is good advice. Take care!
Ally
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Hello all
Went to PS today on a belly button issue and met a patient who was 2 weeks post lat flaps. I spoke to her at length and got to see incisions and flap , breast shape..
I felt do much calmer after seeing it in person. I'm ready for 8/6. I want my lefty.
Take care
V
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Hi Ladies -
I met with my PS re: her recommendation of Bilateral LD Flaps. She said that there are PSs who would do the expanders and implants again but she said I am too high risk for complications. Essentially, she explained that because the LD Flap remains attached to my body it is the safest alternative for me after my many surgeries and infection. She claim that she has never received a complaint from a patient re: mobility, ROM or pain problems. She said she expects I will recover from this the same as I did with my other surgeries. BTW, even after having the implants removed, and before the LD Flaps, I still feel the elastic band around my chest. However, her expertise is DIEP flaps and so I have a consult with a PS at Jefferson Hospital in Phila. who is the area Lat Flap specialist. He does many lat flaps a week. My PS said that she has seen women who had complications but they were not her patients.
Please keep the good stories rolling in. I want to have hope.
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thanks Ally!
Best wishes to both Vivian/Naiviv and warrior!! My PS had also told me all his lat flap patients have done well and he's very encouraging. I'm 4 weeks and one day out from surgery. It's amazing what a long way I've come! Walking twice a day now and walking normal again. My first walks were very careful I felt like I was ice skating at times, lol! I'm now start in to stretch my arm in different ways and hold. Boy, I will get there but it's all tight. I will ask my PS about PT, see what he says. Were any of you told how long before you can try sleeping on your lat flap side?
I've gotten back those darn electric shock pains (random times) at the bottom of my TE, don't know if it's nerve pain on my rib or not but laying down on the floor on my back alleviates it instantly. Not as bad as before the fill, so random and wierd. If I never got those darn pains I'd be a happy camper!
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Hi ladies,
Have any of you had your entire lat muscle used for this surgery, or has the PS only used a piece of it? in either case, I'd like to know if having this surgery has impaired your movement in any way and if you have any residual back issues as a result of this surgery.
I have very limited options for reconstruction at this point, given that I am thin and have had radiation to one side. Lat flap recon is my PS' preferred option now that my tissue expander (placed at the same time as my mastectomy) has constricted due to radiation, but he is willing to do a straight swap for a new expander with the addition of alloderm for support if I insist on going that route. He says there is a high risk of complication with this option, though. I'm SO nervous about the flap reconstruction! it seems like such a huge surgery. What is the recovery time? have you ever completely regained your strength and ability to do the things you used to do? how bad is the back scar?
What do you think I should do? Help!!
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I have bilateral lat flaps. My PS used the whole muscle for each one. My back scars are pretty well hidden in my bra line. About the only thing I have trouble with is lifting something with my arm outstretched. I can lift things close to my body, but I don't have as much control lifting away if that make sense. Otherwise I have regained full strength. I had mine done separately about 3 months apart & was able to return to work within 2 weeks each time. I have no back issues.
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thanks DLL66, that's reassuring!
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