Latissimus Dorsi Breast Reconstruction
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Keryl - welcome back! So happy to hear you had a great trip! Well deserved for sure.
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Andrea623, yes, won't we all be happy to close the book on recon.
I'd love a vacation, but I'm afraid surgery is going to have to be my vacation. I'm out of sick leave so will be using vacation time for it. I hope to save some. We'll see.
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Andrea, thanks for responding. My motions seems fine, and definitely sleeping better. Needed a pain pill again today, had to do a bunch of errands. Wearing the sports bra with wide side, (Champion is a good fit) I like the way it holds the "loaf". Still hard to manuever right to left when trying to pick something up from floor.Also a little slow in motion.
I would love to close the reconstruction chapter and am just scared that my scar problems will be visiting soon. Praying no.
2Tabbies, you might be right with the back, really nothing has to be done with the stitches back there.
I see on our avatars the we are all "cat and dog people", so we have much more in common that being bc sistas. So nice to know this.
I believe "venting" is good for all of us. Thank God for these boards. I also called the comprehensive rehab center at my hospital if they will offer me the massage they do or PT for breast reconstruction patients. Being that I will be cancer free this Oct. 30, I am hoping that they will accept me.
Hugs, Ronna
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hi merrellgirl. .I was just looking at the blog and came across yours asking why I chose LD flap. I can't remember if I already replied to you and can't seem to maneuver around this site to find out so I apologize for repeating if I did. My p's wanted to do this LD flap after prophylactic double mx but I thought I could just double TE and implants. That didn't work cause my skin was too thin & stretched from prior lift & augmentation. You could almost see the implant thru my skin and it was cold and numb and very weird looking..too round. I then did the LD flap & wish I had done it first. .my underarms are soft and not indented as before. Chest is warm and pink and I have sensation...I can feel the needle pick with fills now but don't mind as I am thrilled to have feeling again. I cannot feel anything on my back when I touch my chest.i don't notice any difference in strength. I am 7 weeks out now and walk & stretch alot. I needed blood supply to chest which is good with the flap being left attached with artery. I still have TE in with 360cc's and am going weekly with 60cc done. Not uncomfortable as before. Prior breast surg compromised blood flow for me even though it was augmentation cosmetic. Anyway wish you luck with your decision but I very pleased with this surg. Good luck in Nov. I will be interested to hear how you are doing
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gosh 2tabbies..you're up late with post at 1:30am. I get up early but wake up sweating all nite. It's funny that my hand surg hurt much worse..When they took off my surgical cast I started to sweat & felt nauseous. Couldn't move hand & had 3 mos of casts etc. You're right about feeling deformed..I felt same esp after TE and implants only. P'S thought my rt implant would work it's way thru thin skin and seeing how much better I look with double LD I am happy. I think u will be too. I notice that alot of women only do one side which is good for them but I want both sides to match..front and back. A little OCD I guess. Honestly I don't notice any difference in strength and I am very active.i have a pedometer and walk/jog about 8 miles throughout day & evening with one year old German shepherd. He brings much peace and it helps with anxiety. He really loves me too. I was planning on doing search & rescue tng with him then had to do all these surgeries. Hopefully I can after all is done. He is extremely bright..I have a fill today to 420cc. These fills do not bother like before. The LD flap with attached blood vessels and extra muscle fat & skin really has made a world of difference for me. I had no seroma or problems like I had before (ruptured blood vessels on rt with emergency surgery on rt. Had TE removed & another one else put in as skin too thin to work). Oh well..I do have peace of mind though due to "proliferative hyperplasia" throughout both breasts as final mx pathology. Very high risk. That's why I find u to be remarkable and strong and very insightful for others here. It helps me not to feel sorry for myself and doubt my decision to do double mx rather than "watch & see" as I had done for years. Anyway. .I am impatient too and would hate to wait for surg but I think you will be happier with result. I look forward to hearing how u do. It seems that the good blood supply from attached flap is what works well..it did for me at least. I had abd surg too and could not do diep flap either. Good luck
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Has anyone had the surgery with direct to implants instead of going the TE route?
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sistagirl, yes, I do tend to stay up late on the weekends. I'm a night person.
Andrea623, I'd love to go straight to implants, but doubt my PS would buy it. I hope you can do that if it's what you want. The expansion process doesn't sound like much fun
Speaking of my PS (PS#2 if you've been following my posts), he finally answered my email yesterday. He does not like the idea of doing a bilateral LD flap just for better symmetry because whenever you do surgery, there's a risk of complications. The less cutting you have to do, the better. So he sticks with the more conservative route and does just an implant on the non-irradiated side. PS#3 had some tempting ideas for better cosmetic results, but the more I think about it, the less I'm willing to sacrifice the latissimus on my good side if it's not absolutely necessary. Should the implant fail for some reason, I could get a lat flap on that side later. I can live with some asymmetry. I hope I can anyway, and I hope it's minimal. Everybody seems to have high opinions of this surgeon's work. Fingers crossed.
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2Tabbies, I think I would go with PS #2. I think he's right, the less cutting, the fewer complications. I'm glad he finally got back with you. Is he the surgeon who's already scheduled to do your flap?
I'm hoping that when it's my time for the surgery next year, my PS will be able to skip the TE, since I already have an implant on that side. I hated the TE process, and don't really want to do it again!
I hope no one minds me participating on this thread when I'm not even scheduled for surgery, and probably won't do it till sometime next year. I'm just very interested in everyone's experiences and I like to know what I can expect.
Thanks to all who contribute!
Ronna, how are you doing today?
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Andrea623, yes, PS #2 is the one who's already scheduled to do my surgery in November.
I hope you can skip the expansion process too.It seems like you might be able to unless the lat needs to be stretched.
Keep on posting! I, for one, consider this thread open to anyone who's interested.
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Ladies...it has been a few years since I have been on here. I had the Lat Flap back in 2009. I did eventually have physical therapy to help stretch things a little. NO more zingers of shooting pain. I still have some muscle weakness. I can't do half of what I used to in the garden. When I do put in a good day of working I pay for it that night and into the next day or so. It really makes perfect since. If I use that muscle in my back to shovel or plant in the garden it will become tight just like any other muscle. So it pulls from the back up into the front. I have never really been satisfied with my outcome/appearance. But having 11 surgeries in 9 months I was ready to be done. My breasts like to hang out towards the side of my body rather than in the front...I am sure this has to do with the lat muscle pulling back. I know at some point I will have to have my implants replaced and hopefully by then they will have something new that can fix all this. I am not sure I had the best plastic surgeon or if it was just that I hadn't finished..but the scars I have are pretty extensive. I would think a plastic surgeon could make nice thin scars but mine are quite wide up to an inch in some spots. I can't believe she had planned to re-do those scars as that would have her recutting the long suture lines across my back...who knows. I do know that I am going to someone else next time. Perhaps even sooner than later. Since I didn't finish I am not sure what my insurance will cover to have them fixed. Hope this helps...and I did post my pictures...all of them from the next day after my bilateral with expanders in place...quite graphic..but since no one else had posted anything like that I was very distraught when I saw myself. So hoping my reality photos have helped some of you prepare for what to expect.
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Hi, Bellz. I'm sorry you're not happy with your results, and I have to admit it's disturbing to hear about the amount of weakness you still have. Did you post your pictures over on the picture forum? Did you use the same screen name over there, and do you remember what the name of the thread was? Thanks.
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Keryl, welcome back and sounds like you had a good vacation!
Hope everyone else is doing well and recovering and those of you waiting...I hope you aren't too anxious, the waiting is tough! I accomplished an hour long yoga routine after work yesterday. First time I've tried and I did it!! I was away for the weekend and my back wasn't too happy about it, so the yoga really helped with that. My back is pretty sore underneath my scar toward my side, I will have to ask my PS tomorrow when I see him if this is normal.
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kfinnigan, congrats on getting through an hour of yoga. I hope your soreness is normal and not indicating a problem. I would think rearranging a muscle would make you sore for quite a while. You're right that waiting is tough. I'm not so much anxious about going through the surgery as wanting to see what I'll end up looking like. That's going to be a long wait.
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I hear ya 2Tabbies!
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Ladies, has anyone experienced this. I have been wearing my night bra when I sleep, somehow I loosened it and when I woke up the muscle and implant were on my side. I panicked but pushed it back. I know implants can feel like they travel, have been through this before, but the muscle had to be pushed back. Still in pain and hope to last until the 14th when I see PS. I can call him at any time, but I am being patient and hope that this episode will pass as well as the pain. I have started my third week and just wondering will the feeling subside. 2Tabbies I read you post and can say I do not have alot of weakness as expeced. One good thing. Just the tight feeling.
Belz, sorry about your experience with your experiences.
love to all, hugs,
Ronna
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Ronna - That would scare me but it may not be a big deal. I call my docs anytime I'm concerned. For the money they make I expect my concerns to be addressed especially when it is something I am worrying about. I am following all the posts here and it does seem like the 6 week mark is a time of real turn around. That what both my PSs said too.
kfinnigan - It must feel really good to gradually return to the things you've done before. Personally, I'm pretty pathetic with yoga even before the surgery.
Bellz - I appreciate your story. This surgery produces such mixed results. From my research I am finding several factors that seem to make a difference in the outcomes. The quality of the surgeon and physical surgery almost starting immediately following and sometime even before the LD. In preparation for the surgery, my PT has me doing planks, upper body band exercises and massage. At the gym, I am supposed to do my normal exercises minus anything involving the LD muscle. I absolutely get the wanting to be finished with this. I'm going on surgery # 6. It's getting old and scar tissue is adding up. At the same time, no one should have to look at themselves and feel badly or be in discomfort. It's not clear if the pain after gardening is from your surgery or that the muscles don't get used much. Do you know? We all experience muscle pain when we work muscles that don't get used as much.
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Warrior, why are you not supposed to exercise the lat? I had assumed that strengthening it would also strengthen the muscles that compensate for it when it's gone so might give me a head start in that regard. Are you doing planks on your hands or down on your elbows? I'm just doing a routine that a personal trainer gave me, but she doesn't have any experience with the lat flap. I'd be interested in a full list of the strengthening exercises you're doing. What kind of massage are you getting?
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2Tabbies - Apparently this is standard operating procedure with my new PS. Everyone goes for PT before and after. I was told to let the lat relax as it should be subtle and soft and it will eventually stop working as a muscle. I am also supposed to strengthen my core with the planks. I do them on my elbows. And I forgot to mention a lot of stretching that stretches out my chest. Some of it I do at the gym and some of it they do by manipulating my arms and chest. The massage is to loosen the skin and make it stretchy. The PT practice specializes in breast cancer. I have to travel for it as I cannot find anyone near me who has any clue. Immediately following my surgery they will give the orders to a local PT as the commuting won't be realistic right away. Here is the website: Dynamic Rehabilitation Maybe they can make some recommendations for you.
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Thanks, Warrior. Nobody has mentioned anything like that to me.
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My doctor never mentioned any excercise to do either. Just massage the area after surgery.
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I have to go through this tomorrow- I am scared..... I had my original Tram flap done about 2 years ago-it went fine.... I recovered and then did rads ... then radiation really shrunk up the one side - The big hard dent.... So tomorrow we hopefully get rid of all that- I'm wondering how many had something similar happen where TEs are not being used and the LD is used to correct the radiation hot mess side stuck to my chest. The fat grafting did not work ..... I'm so scared. My PS is one of the best of the best so I love him, and he says he's seen worse than me so it made me feel a little bit better. lol. Anyone have the same type of story?
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Emergency run to my PS. Last night with the muscle and implant flapping under arm leaving breast empty three times, he saw me this a.m. said my pocket (I really don't remember due to hysterics) has not closed. He taped me up with some big tape and have to wear bra 24/7. He is waiting for me to close up naturally worse scenerio he will have to tighten the pocket. As usual complications with me. Since Day 1. I also had excess fluid from where the drain was so he took the fluid out. I go back in 2 weeks hoping not another surgery.
Saga of my bc life.
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Oh Ronna, I would have been freaking out too. I'm so sorry this happened. Hugs.
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MandalaB:
After the removal of my DEIP flap the skin was allowed to rest on my chest wall. With the GAP the surgeon loosened the skin from the chest wall and this worked except on the very top of my breast. That area remained stuck and appeared to be very damaged from the previous surgeries and radiation. With this last surgery, Dr. D spent time with a laser and cut what he described as little white ligaments that were keeping the skin stuck to my chest wall. Initially he thought there would be the need to remove the radiated skin. After he cut all the "ligaments" the skin fell into place and the flap was inserted. After 4 years of the Grand Canyon at the top of my breast, it looks and feels normal. I did not have TEs or an implant. Nor will I need one. I had fat grafting as well and wore the BRAVA. This surgery by far has been the easiest and the outcome looks great. Not perfect, but I can finally wear a tank top or scoop neck.
I too was nervous after all the other efforts. I am very pleased and glad I decided to try one more time.
Jana
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Wow Jana- That's exactly it! This definitely helped me a lot in feeling better about tomorrow morning too.
Thank you so much for your story! I also watched the video at the beginning of this thread which kinda put me at ease too.
Thank you thank you ---
And I'm sorry Ronqt1 ...
I hope things get cleared up for you real soon. 
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Ronna - Pocket work is not unusual from what I understand but I've also read that it is initially uncomfortable. If you wanted to, you could see my PT for a few consults and request PT instructions be sent to a local PT of your choice. The offices are in center city Phila. and Elkins Park, PA.
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Back from PS and today was my final fill! He overfills as the TE will be projected out more than the implant when we exchange. I am really uneven again and have to find another piece to stuff in the right side of the bra I've been wearing. He said 6 weeks is the minimum time to wait for exchange for me, he said radiated skin likes to recoil and shrink. It had softened up quite a bit in the 3 weeks since I last saw him and is once again tight and painful on the side. He looked at my back scar too, I told him I've been sore and he said I have no fat back there so when I lean on anything I'm feeling my ribs. He will fix a couple of areas at exchange - one area on back that left a little flap of skin at the end of the scar and my flap is raised up on one side of the boob, he will fix all that and I will get a small implant on my good right side to give me symmetry. We're trying to figure out when to do it now...looking at the calendar. Moving along!
Ronna, I'm so sorry for your troubles, I am so glad you went to see your PS!!
Warrior, how cool is your center? nice!
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Hi everyone, I'm in the UK :-). Having an single left side LD Flap (no implant) & right side uplift for symmetry on Monday after having had a Mx last May & TE since then.
Excited and also nervous, not a lot of personal experience on the UK sister site to this so just thought you lovely lot could share some words of wisdom..!!.
Basically how do you feel straight after op & in the first few days?. Do you immediately have a cleavage?. How long are you restricted, ie not baths/showers & little physical movement.
Would really appreciate any advice or tips.
Thanking you in advance.
:-) xx
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Thank you all for these posts..scheduled. for lat surgery in Jan. Had chemotherapy and radiation 23 years ago ...mastectomy ..... had a choice for free tram or lat ....doc wants expander....lat with implant....has anyone had a problem .I will need a reduction and lift on left..I'm concerned about semetry.. Thank you ladies
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We thought we'd remind you ladies thatbthere are many articles on the Breastcancer.org main site to search for, that may be of interest. An example would be Latissimus Dorsi Flap Reconstruction: What to Expect.
Hope this is of interest to those newbies like Artemis17, welcome to BCO.
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