Latissimus Dorsi Breast Reconstruction
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2T, may be a bra type of support?
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Anothernyc, no, not a bra. It's literally a band that wraps around the chest above the boobs and pretty much up in your armpits. He said it does tend to chafe a bit. Sounds, um, interesting to say the least. Like something they might have worn in Elizabethan times to keep their boobs from poppibg out of the top of those flat fronted bodices. I'll have that on plus one of the tube top binders when I wake up. I'm getting a collection of those binders all in a pastel pink floral print. Honestly, do the people who manufacture those things think women only like pink? I am not a pink person. And let's not forget the drains. I'll have a couple of those but smaller ones than after the first surgery. This will be another adventure. But I'll end up more comfortable with the implants than the TEs eventually, right? Please, she whimpered.
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2T, - I am sure the recoup time will be better than the LD flap procedure was. Having the band will keep you from moving wrong, - and having those TEs out will be SO worth it!!
Are you sure drains will be required? Maybe not?
I agree re pink pink pink ! Not my favorite color either! (although it is supposed to be a flattering color for all
Just keep thinking that the reconstruction is almost complete!!
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anotherNYC, yes, I'm sure about the drains. The PS specifically said 2 drains, but they're smaller than the ones I had for the LD flap sx and the mastectomy. He also said they should "only" be in a week. I'm not sure the band will stop me from moving wrong. It's more to stop the implants from moving. It holds them down in the pockets. I can deal with anything that's temporary. I was just surprised to hear about this band since no one else has mentioned one. Here's what the band looks like. I was hoping to be reasonably comfortable after the surgery since some of the tightness from the expanders will be gone, but this looks like it will generate at least as much discomfort as the TEs. Oh well. This too shall pass.
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2tabs, it will be easier...yours sounds a little more involved than mine but if it is even in the slightest bit like mine then I want you to know this was a piece of cake!! I had taken 7 days off work but by post op day 3 I only took a pain pill at bed time. I feel so much better than I anticipated!! With that said, I did not have drains but I had talked to my friends that have had "regular" boob jobs and all I heard was how painful it was. I think since we have expanders in and the skin is already stretched that the exchange is not as painful. I hope it is the same case for you!!! Plus, I can not believe how soft my boobs were instantly!! I was expecting more swelling and firmness but I didn't have any of that....as soon as my PS took off the ace bandage(post op day 2) they were soft!! I just kept feeling them saying "I can't believe how soft they are". So much more comfortable than the expanders!!!!
I love that saying 2tabs and you are right,
This too shall pass....
Kathy
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hi everyone! Surgery went great and I'm amazed how good it looks already!!! I'm so happy. The pain is more like discomfort and totally bearable. Most of the actual pain is where they created the new bottom of the boob. Must be a lot of stitching there. I've been taking nothing but Tylenol and tramadol. I have one drain and no dressings to change. I'm headed home to take a shower and can't wait!
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Hbb, - happy to read your update!!
2T, - I didnt have the band, - but I also dont have such good sized foobs! Mine are small mounds, - so I guess the band wasnt needed. I would have worn it for a while, if it meant i looked like the photo in your link!
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Kathy, thanks for the words of support. I'm not really worried about pain. I'm pretty tolerant of that and can always take a pain pill if I need it. I don't know why the thought of this band I have to wear is a bit distressing. Maybe because it was a surprise and nobody else seems to have experience with it. I don't like surprises. Maybe because it sounds like one of those sources of discomfort that you can't do anything about unlike pain. You can't take a pill to help with chafing and tightness. I suppose a couple of shots of Irish whiskey would make me not care!
Pain also tends to decrease as time goes on, but this band will be the same every day. I hope I'm remembering correctly that I only have to wear the band for 2 weeks because the thought of going back to work with it especially in the heat we're having is not a happy one. The least little thing gives me a rash. My PS said to wear a t-shirt under it if it chafes which will make dressing for work a bit of a challenge. I also have a trip planned a bit less than 4 weeks after my surgery. I want to be done with it by then what with dealing with flying and luggage, etc. I really was hoping to wake up feeling a bit better after this surgery except for the unavoidable incision pain. Oh well. Onward. No need to obsess even though I do!AnotherNYCG, I didn't have this band thing after my initial lat flap surgery either. This is something new with the exchange surgery. I'm not getting really big foobs either. They started out as small mounds. I think I'll end up somewhere around a B cup. I'm not really sure anymore, but I didn't want big ones. I was only somewhere between and A and a B originally. I'm not going to look like that gal in the bra band link either! I keep telling my PS I want him to quit using a scalpel and use a magic wand instead.
hbb, I'm so glad to hear your surgery went well. Being able to shower already is wonderful! I think you're right that the majority of the pain is from all the stitching they have to do under the foob.
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Hbb, so happy the surgery went well and you are on your way home!! The shower will feel so good! It's so good to hear you in such great spirits😃
Kathy
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Hi Jo. I've been wondering what you found out. I had 3 drains after my LD flap surgery - 2 on the left which was the flap side, and one on the right where I just had a tissue expander placed. It's annoying and inconvenient, but doable. I had a cotton camisole that the hospital gave me after my mastectomy that I wore. It has a kangaroo style pocket in the front that I stuffed the drains into. It was similar to this one. Shirts that button up the front are easiest. Regarding full use of your arm, I didn't have much trouble with this as far as simple daily activities. My surgeon didn't limit how high I could lift my arm like a lot of them do. He just said to do it slowly and stop if it hurt. I just couldn't push or pull anything that required effort, lift anything heavy, etc. For me, the main limitation was driving since my car steers really hard. It was a couple weeks before I could do that, and even then it was uncomfortable. However, I was fine with my husband's car after a couple weeks. It has power steering. Regarding pain, I think I only took the narcotics during the day for a couple days post-op. However, I did continue to take them at night just because if I repositioned myself in my sleep, it hurt enough to wake me up. So maybe it won't be too bad on just Tylenol and ibuprofen. I've heard of something called a "pain ball." I think it's a device that infuses local anesthetic into the surgical site. Maybe you can ask your surgeon about that if you aren't allergic to lidocaine or whatever they use in it. I didn't have a skin graft from my leg so I can't help you there. I imagine the healing would be about the same as the back incision. I didn't have a lot of discomfort or other issues with that incision. It's tight now. I don't know if that's because of the skin that was removed or scar tissue. I'm hoping massage might loosen it up. Good luck! I'm having my exchange surgery just a few days before you on the 25th so we're sort of surgery sisters.
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hi everyone, I had an OnQ pain ball and it is exactly what 2tab described. It worked successfully and I had no pain until it wore off. The majority of my pain and discomfort is in my drain site. It's awful, I absolutely hate it and am so done even though it's only been five days. I can use my arm but I'm weight restricted to under five pounds. I've still never taken anything except Tylenol and tramadol.
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hbb, sorry to hear your drain sites are so painful. I didn't have any trouble with them. They were uncomfortable if anything tugged on the tubing, but not painful in general. They don't look infected, do they?
Jo, I don't have LE on the flap side. After my mastectomy, I had some LE, on the prophylactic side, but it went away with therapy and blessedly hasn't returned. (I have LE in one leg, but that's another story.) I have read in a few places that the LD flap may actually help LE. Maybe that's what your surgeon was referring to. It sounds like that isn't true in his experience.
Thanks for the good wishes, Jo.
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Hbb, - As 2T said, my drains were uncomfortable, but not so much painful. If I found a good place to pin them so that they didnt pull, it helped. Check with you PS if you are having pain!
JO, - My back was marked right before surgery. I, too, needed the lat flap because of very thin and damaged radiated skin. I had IV pain meds while in the hospital, but was ok with tylenol at home, and valium to sleep.
2T, - so glad that you are almost at your exchange date!
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Jo, I forgot to mention the market. I was also marked in pre-op right before surgery as anotherNYC said.
AnotherNYCG, 12 more days and one memorial service to get through. No more work days until after surgery though so that helps. How are you getting along?
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I should clarify, mainly it's the discomfort I can't stand. He has both the back and the front draining into the same bulb. There is so much tubing internally that I can feel it rubbing against itself any time I change positions. It gives me the heebie jeebies!!! I see the PS tomorrow for my post op which is good. And like all the others my markings were done right before surgery.
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Question for everyone... What was your drain fluid like? I don't remember it being so bloody after my mastectomy.
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Hbb, the drains were the worst part for me too!!! I think I remember it being pretty bloody for the first couple days then it started to lighten up.
Kathy
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kthielen, glad to know yours was bloody too. today is day six but still looked bloody to me, glad I have a doc appointment in the am even though I know he's gonna make me keep it another week.😒
Jo, my back drains out my side. Sleep isn't easy but you make it work.👍
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Jo, like with hbb, the drain for my back incision exited on my side. It was no trouble taking care of it. The tubing is long enough so that the reservoir that collects the drainage can be easily emptied. I really didn't feel it when I laid on my back. I was just more comfortable propped up to sleep in general but it wasn't because my back hurt. It was more the fact that repositioning when I was completely horizontal was difficult and painful.
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Tabbies - My PT mentioned the band for women whose implants rise up on the chest. He told me that is more likely to happen if I break the 90 degree angle with my arms.
Jo - I'm catching up with posts now. It sounds like you're having the same surgery the rest of us had minus the expanders and implants. Individual opinions vary but I found the LD surgery much easier than the BMX.
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Warrior, my PS apparently uses this band as the standard protocol. He didn't say anything about how I move my arms. I guess he's making good and sure the implants don't move up. It bothers me a little that no one else has had this though. Makes me wonder if it's really essential.
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Jo, I think the majority of us had this procedure done on radiated skin. That's usually the point of it, to remove or add to the damaged area. I believe there is a very low flap failure rate as well. My PS was at 100%success rate for 30+years. You should ask yours his record. Good luck!
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Jo, ditto to what hdd said. The only reason I had this procedure was because of irradiated skin. I'D have definitely preferred just TEs and implants without the flap, but was told the failure rate was too high after radiation. I also know that there are people here who had this procedure after having infections and other complications. I'm not sure about necrosis specifically. In answer to your question about the weight of the TEs/implants causing the iron bra, I think that you might have have some tightness regardless. Initially after my surgery, the TES weren't filled so the extra weight was probably negligable. But there was still tightness. You certainly will avoid the extra tightness that comes with each fill. But I notice tightness anywhere I've had an incision. I wouldn't worry about it too much if I were you. Mine has eased up a lot even with the TEs. Like hdd, I was told the failure rate of the LD flap is very low.
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Jo, I'm the same way about wanting as much information as possible. So I completely understand.
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Hi Ladies - I've been checking in on the boards periodically, but haven't posted recently. Just wanted to stop by and give those of you who are in the process of getting ready for this procedure hope and encouragement. I had lat flap surgery back in October of 2014, so am 8 months out now. Had my final implants put in in February and feel pretty much whole again. I have no residual pain or loss of strength, and am pretty much back to normal. I do cardio, lift weights, and took my first yoga class last week. There was really only one move I couldn't do, but it involved literally putting your entire weight on your hands while laying on your side. As the instructor was telling the class to try this move I mumbled to myself, "not gonna happen", at least not with a missing lat muscle
So, just know that although you may initially have some discomfort and tighteness, over time most, if not all of it goes away. Things settle into place, and you start to forget you ever had the surgery.
Trust your doctors, and follow their advice. Healing takes time and patience, but it does happen and life begins to normalize.
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Hi--I have been reading along and wishing 2Tabbies and Jo-5 the best next week!!I met with the 3rd plastic surgeon for a consult yesterday and it was the most informative appointment I have had. She said that some ps have surgery that they specialize in and will try and push patients to that surgery only. When I told her the name of ps#2(the one that told me I was not a good candidate for the lat-flap) she said she was not surprised knowing him.
She said one of the things she has learned over the years is it isn't about her--it's about the patients, their desired outcome and their long term mental health. She went through the pros and cons of what she felt were my best options for recon with the radiation damage, and said I need to take the time to decide what I want out of it and find the surgery that best matches my desires.
Two things that she mentioned that I wonder if you ladies could help with. First, with the amount of radiation damage, she felt that even with a lift of my natural breast I will never achieve symmetry, it may be close be never the same, is anyone else a unilateral that my give me insight to what is "close"?
Secondly, she felt that with 54 lymph nodes removed and mild lymphedema, the odds were high that the lymphedema may get worse, anyone experience this?
Thanks so much for sharing your insight!!
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Hi Jo an Sam...I just developed a very mild case of lymphedema. I only have the wear the sleeve for 6 hours according to therapist, and 2 hours according to my breast surgeon. I was constantly complaining for the past year and a half about my right armpit feeling numb and huge, even though the appearance of it looked normal.
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Jo,
Never had LE before, and I hate the pillow feeling under my armpit. My BS and MO used to tell me that it was the nerves trying to regenerate. So after my final exchange surgery, I was still experiencing the pillow effect, but they ignored my "cries". If you look at my stats I only had 2 nodes removed. But since wearing the sleeve I am not experiencing that pillow feeling that much. Hope this helps.
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Jo-5 - FYI-I have no experience, just what the dr. offered as her observations. My oncologist was concerned with the risk of increased LE problems with reconstruction, his impression was that the implant could effect it. The PS said that in her experience, the movement of the muscle and blood vessels under the arm and to the front can cause LE problems, not all the time, but some times. However, she stressed with radiation damage that the blood vessels were crucial to the success of the LD flap.
PS also said with 54 nodes gone she was shocked that I didn't have huge problems with LE, so numbers/stats obviously aren't the most reliable.
With my mild LE, I find the manual massage to be a great help--ask your dr if you could see a physical therapist that specializes in LE, it has made the world of difference to me.
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Raelan, - Thank you for the encouraging post! Glad to read that you are doing so well!
I am almost 3 weeks out from LD procedure, with small implant put it. I do see daily improvement, - but still uncomfortable. Lots of soreness, but I am going to ps this afternoon, and will see what he has to say.
2T, the exchange procedure will be much easier, I am sure!!
Feel well everyone!!
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