Latissimus Dorsi Breast Reconstruction
Comments
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Honeybadger, I'm so sorry you also lost your mom recently. Nobody needs grief piled upon grief. I hope you have lots of support from other family and friends. You and I are both "stuck" in our own ways. You're afraid to move forward with surgery, and I'm stuck in a quagmire of depression and anger at my body. I'm afraid I'm never going to get to where I want to be because there's no way to make the transplanted patch of back skin disappear so I don't have to see it every day. I'd gladly endure more surgery if it would accomplish that. I just need to suck it up and get over it. Most days I can do that, but not when I hit a black hole of depression which happens now and then. I hope you can summon the courage to make whatever decision is right for you and it turns out great.
kfinnigan, I'm glad your new nipple and skin grafting look good!
Myleftboob, thanks for the encouragement. Oddly enough, I don't feel like I've overcome any fears. Even when I got my diagnosis, I felt more anger than fear. I was never really afraid I'd die or afraid of dealing with chemo, etc. I knew I had little choice so I just did it. The worst anxiety I felt was in making decisions about recon because that really was my choice. I didn't want to get it wrong because I knew I'd live with the consequences of that decision the rest of my life.
Warrior, I've heard of the post-treatment depression and definitely had that when I finished with active treatment. There's a thread called "Why was I stronger during treatment than I am now?" I don't think I'm dealing with that in regard to recon yet. I still have exchange, nipple building and tattoos to go. What I'm going through now feels more like the mood swings I've had since losing all my estrogen and starting Tamoxifen. Thanks for the tip on Mederma. I'll try some. I wish there was something that would fade the discoloration in the rad damaged skin so it wouldn't contrast so badly with the flap. As far as I know, there's nothing.
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2Tabbies. I hope you don't think I was minimizing anything for you. The inspirational post rang true for me because the fears were plenty since I've been DX that were over and above the whole DX and fear of dying, fear of treatment/ I, a feared that my "DH" would have a hard time dealing with my BC and not find my attractive any longer. He did, I left. Fear faced and checked. Fear that my income would be so eroded during active TX that I might have a hard time financially and need to sell my house. It was hard as I was totally commission based sales person. I sold the house, check. Fear that I wouldn't find a decent job at my age and make living alone. I did! Check. Fear of living alone for the first time in 30 years. I do, and love it! Check. It took alot of praying mind you! Now I just need to get over the recon process and still afraid but hopeful.
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Myleftboob, not at all! I knew you weren't making light. I'm sorry if I sounded snarky. I didn't mean to. Good heavens, woman, you've been through way more than I have. I never had to worry about my husband leaving me or losing my house or job. You are tough! My worst anxiety was over how bad the long term side effects of treatment would be and whether recon would come out ok. Maybe I should have worried about some other things, but sometimes I'm oblivious. I'm confident that you'll conquer your recon fears. For me, facing life issues like you have is way worse than facing surgery.
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2tabbies,
Don't feel bad for feeling gloomy. I have definitely been there too and you will come out on the other side!! Hopefully sooner than later! I have said this journey is such a roller coaster ride and it is sooo true!! You have been through a lot both emotiomally and physically. Maybe you can talk to your Dr about an anti depressant?
Just know you are in my prayers and I will be thinking of you with happy thoughts to help lift your spirits!
Best wishes,
Kathy
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Kathy, I'm already taking both an antidepressant and gabapentin which is supposed to help the mood swings caused by Tamoxifen. They help, but aren't a miracle. I guess all of us would like a miracle of one sort or another. I just wish I didn't feel like I was lied to, misled, and/or just not given all the facts when I was making decisions. My fault for not getting a second opinion on recon before my mastectomy.
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2Tabbies. I kind of did the same thing re surgery and recon. My doctor referred me to the surgeon 1 week and I was having a MX the 2nd! Although I have to say I didn't know a bloody thing about reconstruction at all. I only found BCO the night I got in from the hospital. Mind you in Canada they seem to err on the side of MX or LX vs skin sparing or immediate recon. Yeah been through alot but thankfully I have a positive disposition for the most part. Trust me I've had my moments. Re the DH, good riddance I say. As far as material things, I don't have anyone to leave anything too so rather than saddle myself with a big mortgage, I''m renting a nice space and going to do alot more travelling and enjoy. Booked for the Mayan in January! Next will be Ireland in summer 2016. God only knows what the future holds so I'm dedicating my life to having a great time (within sensible reason of course)
BTW you weren't crabby. I was afraid I insulted you!
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Myleft, you definitely did not insult me. I had the mx about 3 weeks after getting diagnosed. I don't know if they do a lot of nipple and skin sparing MXs around here. I did have skin sparing to some extent, but nobody mentioned sparing nipples even on the prophylactic side. Radiation shrunk the skin on the bad side so there wasn't much "extra" left by the time I got to recon. The PS I consulted before the surgery said that starting immediate recon might make radiation treatment difficult. My RO agreed with that, but I later found out that's not really true. It's just the traditional viewpoint. An RO from MD Anderson told my current PS that it's perfectly feasible to start recon then do rads. I had the misfortune of needing my surgery when the PSs and ROs around here were still arguing about this from what I heard.
I agree about your ex. Good riddance. What a jerk. I'd like to do some traveling too. I need to save up some vacation time first though. All of my leave time has been used up with other stuff lately. I also agree with you on material things. We purposely bought a cheaper house than what the mortgage companies said we qualified for because I wanted to be able to pay it off early. It's not a palace and not in the swankiest neighborhood, but it's good enough.
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Tabbies - BioOil is also supposed to be good. A lot of women on BCO speak highly of it.
MyLeftBoob - Amazing how our perspective changes and we begin to live our lives as we always should have. I just returned from Belize and we booked a trip to Hong Kong, Thailand, Laos and Burma. I traveled extensively before cancer but did it on a budget. My priorities have shifted.
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Warrior-Good for you!!!! My priorities have shifted too. I think most of ours have. Before BC-I was saving always for retirement. Now-I want to do things now. Not just big things but even small things-experience a restaurant I have never been to, I have a weekend trip planned for memeorial weekend to a place I that i have never been to.....i do monthly pedis now-I just plain really dont care about money anymore. I have nobody to leave it to anyways-and as I tell hubby-"I will be damned if I get ripped off after working my butt off to get here." I am in the throes of starting a 30K kitchen remodel too. I just want to live, feel and experience at this point......
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vettegirl - Here's hoping we both live to 100 and have to figure out how to manage when we're flat broke!
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Priority shift exactly. Case in point. My ex FIL who's quite wealthy and was always a bit tight fisted with his money was DX with stage 4 brain cancer just this March. He has not responded well at all to TX and the MO says 3 months max. Very sad but the lesson is you can't take it with you
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Myleftboob-You got that right
Warrior-I say lets do things while we are healthy enough-I will sit around when I am old if I get broke by then. This life has no guarantees for sure. My dad-never sick in his life-got prostate cancer at 59-dead at 64. All he talked about was retiring at 65 and traveling-he never got there. I always say if I learned nothing else from his death-it was that-grab life by the horns and make every single day count. I am a work hard, play hard kind of girl for sure.
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AMEN girls!!! Live life to the fullest and treasure every day with your family and friends!!
Kathy
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vettegirl , yes, let's do things while we're healthy enough. That's why I plan on at least going to part-time, if not quitting my job, as soon as recon is done and paid for. I may not have enough money for major travels, but I can do a lot of things that are fun and don't cost much. And I can do some things that are more meaningful than my job.
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2Tabbies:
What you wrote about being patched together resembles me. I don't have the beautiful success story that many do. The LD was my 3rd flap. There are lots of scars and mismatched skin. Each time I look in the mirror I too wonder what I could have/should have done differently. And the answer is not much. I went to the best doctors in the field of reconstruction. The damage from other surgeries and radiation made my journey much more difficult. It takes time to mourn the loss of what was and the unfairness of being in the minority of perfection in this world of reconstruction.
And I do occasionally think, do I risk one more surgery? Do I attempt to make this just a little bit better? I am not certain I can go thru another procedure or put my husband thru another procedure.
Just wanted you to know, I do understand. And at times it just plain sucks.
Jana
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Hello everyone, I recently had LDR (not sure what the abbreviation is) on Monday and would like your experiences with recovery. As a background, I had BMX on 3/13/14 with tissue expanders. Chemo, radiation and expander exchange followed. Due to the radiation, my left breast became infected and rejected the impant less than a month after the exchange-that was November. My PS typically does a scarless LDR (he does not cut the back), but I was not so lucky; because of the extensive ratdiation damage, he had to use quite a bit of skin from my back, and inserted an expander rather than an implant. He will fill the expander much slower than the first ones because he is concerned about tearing the skin. He also said it would be a challenge to keep the implant from riding up, again due t the radiation. I had the same problem with the origianl expanders, but was not cooncerned then because i knew it culd be fixed during he exchange. Now Im freaking out a bit-my silver lining in all of this mess, was never having to wear a bra again and having perky boobs until I'm 89. Now I'm not so sure that will happen.
Did most of you get implants or TEs when the surgery was initally done? How was the fill process?If you've healed, do you feel both sides are symetrical enough that you don't need a bra to even them out? My PS also said he may do fat grafting at some point to smooth the edges, has anyone had that done?
So far my recovery has been quite eventless, much less pain than I would have expected. Anything I should know in the coming weeks-I'm thinking there may still be anasthesia in my body helping with the pain. Could there be muscle spasms or any other discomfort, or am I over the worst?
Sorry for so many questions, but I am so nervous about all this and would love and appreciate any responses I don't know of anyone who has gone thru this procedure and feel quite alone This forum is great and will be a sanity saver!
Thanks everyone!
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2Tabbies I'm with you on that one. My job has consumed me for the past 5 years, to the point that I can't wait to quit! It changed our lives financially, but it left holes that I can't repair. Going through this made me realize that I need to go to Ft Myers more and visit my sister n law and brother n law, travel with my now adult kids, spend more time with my husband.
Then, just 8 days ago my son's ex girlfriend, who lived with us for 5 months, was killed in a hit and run accident. She moved to Tampa 8 months ago but they dated for over a year and broke up just a couple months after she left. They were talking again and she was moving back to Orlando to go to college. Sweet 20 year old girl that could very well have become part of our family. Now I need to be there for my son and this really drives home just how fragile life is and how you have to spend time where it is actually important.
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TedWilliams, my main complaint is no one told me that radiation would be a problem as far as just getting implants. In fact, I was specifically told I could have any reconstruction procedure at any time. Had I known the problems with recon after radiation, I would have gone for immediate recon at the time of my mastectomy with TES then implants. I didn't want a flap procedure. Immediate recon might still have failed, but at least I would have been making my decisions based on correct information and would have had a chance to avoid the flap. Thanks for understanding. I'm sorry you've had such an ordeal with a less than perfect outcome.
Calibea, I'm sorry to hear you'very had to deal with complications as well. I'll try to answer some of your questions. No need to apologize for having a lot of them. I'm always like that. I'm sure it drives my docs nuts. Anyway, I had TES placed at the time of my LA flap. I think that's more common than going straight to implants. I still have them, and will have my exchange next month. I didn't find the fills a big deal. They were a little uncomfortable but not painful. Some women do have pain and muscle spasms. Your PS can give you something for that if necessary. On the subject of pain, I think if you haven't had much from the surgery yet, you don't have to worry. My pain was at its worst right after the surgery. I'm not worried about needing a bra to even things out. My PS says I won't need a bra and should end up with reasonable symmetry. As you said, that's about the only silver lining in this whole mess. Good luck!
HomeMom, I'm so sorry about your son's ex-girlfriend. What a terrible tragedy. We never know what the day will bring when we get up in the morning. Let's hope we both get to start spending more time doing the things that really matter.
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I'd like to encourage everyone to consider work that you're passionate about rather than retiring. This does not mean staying with a job you hate that consumes your life. Done right, a lot of fulfillment can come from what we create. I transitioned from a successful counseling career in 2001 to become a college professor. I literally took a 50% pay cut. Frankly, I was tired of hearing people's problems. Most days I am excited to get up and go to work. There are days I'm tired and I'd like a break but most days are rewarding. I see students turn their lives around in such positive ways and I'd like to believe I have had something to do with it. I'm not sure where my brain would be post treatment without this stimulation. Yesterday I received Professor of the Year for a 2nd time. I attribute my good fortune to my passion for making a difference. And in my free time I tend to our farm, travel, run, sky dive...whatever. I am convinced that a lot of life's satisfaction comes from what we're actively choosing to be involved with and create. Don't drop out without a plan for living a fulfilling life.
To everyone who is disappointed by the cosmetics of reconstruction: Reconstructed breasts do not look like augmented breasts as we all know. They're far less than perfect. I am hoping my happy dance of my post exchange satisfaction has not left others feeling cheated. I have scars all over the place. The holes alone from all the drains (14 total) make me look like a dart board. But this time last year I had a freakin' pic line in my arm all summer with boobs at 2 different points on my chest as they tried unsuccessfully to kill the damn infection that ultimately caused my skin to adhere to my ribs. And then I was told they did not know if I could get past and A cup (and then why bother). And so, I choose to be happy. It's a choice. I choose to congratulate myself on my bravery for my BMX and loving my life more than my appearance. Good for me. I got through the worst damn experience of my life. My boobs look far from perfect. I simply choose to look in the mirror and see them as marvelous.
Calibea - Yes, I believe most of us do the expanders. I did find that taking my time with expansion allowed me to get to a C cup as my skin was very thin and damaged.
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Interesting the topics popping up in the posts. I had retired from 30 years of teaching a year before being diagnosed with cancer. Not working gave me the luxury of just being a slug during treatment. Great insurance, an English bulldog and a supportive husband made this journey easier. After treatment I moved to Texas and he moved to Scotland for the last two years before retiring. We are planting a vineyard. I worked in a winery for several years and with that experience we will never have a winery, just grow grapes. I found myself listening to the petty things people were concerned about and shaking my head. I drink the good bottle of wine on a regular night; I have become a food snob; I will debate topics I normally would't. My husband and I talk often about what is important and whether to expend the energy for a cause or for a friendship. This journey helps one to redefine normal and the passions of life. And sometimes people or things get left on the side of the tracks.
I did not have an expander or implant with the LD. The LD was used to supplement my SGAP flap. Only occasionally do I have a muscle spasm. My massage therapist has worked miracles on all the scars and tight muscles. I did have an expanded after my mastectomy. It was in place during my radiation. Six months after radiation I had my DIEP, which for a variety of issues failed. Looking in mirror I can easily trace my journey. My husband has laughed about using a sharpie to connect the dots of all the scars. I do not find fault with any of the three surgeons...it is what it is. I am disappointed that I don't look like the photos in the various galleries, but I am on the right side of the grass.
I do believe the various meds contribute to the ebb and flow of emotions. Five years of tamoxifen and now beginning five years of Arimdex have taken a toll as well as protecting. The meds from the various surgeries have brought back the fog of chemo brain. We each must mourn and celebrate this journey in life. Often in the throes of treatment we don't have the time to truly allow the emotions, whatever they may be, to be felt and dealt with. Once we stand still and truly look at the scars of our journey the emotions talk to us.
Thanks to all for asking questions and sharing thoughts. This is a time for realigning the stars and moving forward.
Jana
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Coming up on a year since my diagnosis of stage II BC. I had neoadjuvant chemo June - Nov, MX and lymph node removal in December with immediate reconstruction using LD and implant (and reduction on other side to match), and then radiation. All the medical professionals I have seen tell me how great my reconstruction looks. But ... well, apart from not being totally symmetrical especially after rads, I am really hating the feeling. I think it's the implant. I have the weirdest sensation when I flex my pectoral muscle, and at night I feel like I have a bowling ball on my chest. My PS said it could take up to a year for the brain to accept the implant as part of my body. Will this feeling really ever go away? Or will I just supposedly "get used to it" the way you get used to other unpleasant things in your life, like a long commute? :-(
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Thank you 2Tabbies for your response. My questions may have been too much since I haven't had any other replies and this forum is quite active. Hopefully more people will respond, I am desperate to see how people are recovering.
How long did you have your drains in? I see my PS tomorrow and that will be one week out. I'm hoping he'll take them out then, but I think that may be fruitless.
Take care 2Tabbies.
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Hi Izzy F, I love my implant and it feels natural to my body, however it could be related to my experience. I had the TEs for 7 months and totally hated them. I felt I had a very tight iron vest on my chest and they never felt as if they were part of my body. When I got the implants, I was so happy, unfortunately as described above, within one month, I had to have the left one removed. I was implantless on the left side for seven months and that was horrible as well. Point of my story really, is to say my right breast has had an iimplant since November, and for me, it feels like a part of my body. Could be because the TEs were so terrible and I am so chomping at the bit to finally get an implant. So much better than looking at a unrestructed breast-now that looks like a science experiment
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Warrior, first let me congratulate you on the professor of the year award. That's fabulous. It sounds like you've had the good fortune to find fulfilling work, and even though you took a pay cut, you're still making enough to be able to travel and enjoy your other hobbies. I have not been able to find that sweet spot, and believe me I've tried. I've had to reinvent myself every time my husband got transferred and a few times in between. I will be 58 tomorrow. I know some people start new careers at this age, but frankly I'm too damn tired. On top of that my husband retired 7 years ago. I can't tell you how hard it's been to watch him do whatever he wants every day while I go to work. So, yes, I'm going to retire as soon as I can. I don't look at it as dropping out. I have plans for some volunteer work that I hope to find fulfilling. I also hope to turn a hobby into a small business. Maybe none of it will work, but cancer has taught me that I can't keep doing what I'm doing even if I can't find a paying job that's fulfilling. I hope some of this makes sense. Again, congrats on finding a career you love and being chosen prof of the year.
As far as how I feel about my surgical scars, etc., I agree with TedWilliams that at least part of the blame belongs with Tamoxifen and the other meds. In my case, lack of estrogen also aggravates the depression that runs in my family. This first happened after I lost my ovaries to cancer. I tried to go without estrogen supplements because that study showing their dangers had just come out, but the mood swings were horrible. I'm amazed I didn't commit homicide or suicide. Of course, I had to give up my beloved estrogen patch when I got diagnosed with bc. Then came Tamoxifen and the mood swings git evrn worse. Antidepressants and other meds have helped some, but I still have periods of depression and anger. I do not choose to feel this way. It just happens. If I could make a choice to be happy and make it happen, of course I would do that. But the depression and anger are like an alien trying to burst out of my chest and can come on very suddenly sometimes with no apparent trigger. It's at these times that I detest what I see when I look in the mirror and literally want to rip it off my chest. Believe me, I hate feeling like this way more than I hate how I look in the mirror.
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Izzy, I'm sorry to hear you're uncomfortable. I still have TEs so I can't really answer your questions on how implants feel. I hope yours starts feeling better soon. Have you asked your surgeon about the discomfort?
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Calibea, I honestly, don't think you asked too many questions. Maybe people have just been too busy to check the forums. I had my drains for 2-3weeks. I know they're a pain, but it's really best not to take them out too soon and end up with a seroma. Hang in there. I think most people recover well, but it takes time. A lot of people seem to feel a lot better after about 5 weeks.
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I have asked my plastic surgeons and they keep saying it takes time to get used to the implant. However last time I saw one of the PS team members (3 of them operated on me and I see different ones), about a month ago, she also mentioned something about "just having to get used to it" and the oncologist whom I saw 2 weeks ago said something about how a small percentage of women never get used to it and end up having the implant removed. I do not want to be in that group!!
During the day if I'm just sitting at the computer it's not so bad. It's mostly that weird heavy sensation at night, and whenever I bend over or stretch my arm. I would really love to hear if this sensation goes away and WHEN!!! It would be nice to get a good night's sleep one of these days.
thanks for your answers 2Tabbies and Calibea.
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Hi All,
I am still so confused re what to do! I thought I was headed to fat grafting and small implant, but today my PS said lat flap is way to go. It would be one procedure vs 3, (2 fat grafts and then exchange) but I am so nervous about the lat flap.
Are you happy with your choice? I know that a few of you have had such a hard time, and that is adding to my fear of such a major procedure.
I am 63 years old, and small breasted. I am not sure I am ready for such an invasive procedure. =/
Thanks for your thoughts!
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AnotherNYCG - I've followed every LD flap post on BCO in an effort to predict my own outcome. I'm convinced the LD flap has complications at a lower rate than other flaps. It is a tough surgery. Some say worse than the BMX but I thought my BMX was worse. I just had my exchange surgery and I'm very glad I've done this. I was going to forego reconstruction because of my fears of some reports I've read on here. My advice - only have it done by a surgeon who does them all the time.
Calibea - I responded to your post although it's brief. I wasn't ignoring you.
Scroll up.Tabbies - You're plans don't involve dropping out. Volunteer work is very rewarding and you have interests that you really enjoy. I'm not a believer in continuing with things that aren't working in our lives but I do think it's important to find what does. I really hope your life leads you to greater comfort and peace.
Izzy - I'm trying to appreciate what your implants feel like. It sounds like they're bothering you. I'm aware mine are there when I think about them. No, they don't in any way feel like my old breasts did but rarely am I paying attention to them. What you're describing sounds different. Have you had PT? Stretching and massage have helped me a lot.
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Thanks WW for your response. I appreciate it!
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