Latissimus Dorsi Breast Reconstruction
Comments
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Sam2U, Ruth7733 & Tabbies - Whippetmom is not a fan of LD surgery. Know this before requesting a referral for a surgeon for this procedure.
Camille - I'm with Tabbies. Go see your surgeon. It does sound like seroma but your PS would need to diagnose. If it is, you'll be better off getting it drained sooner rather than later. Draining doesn't hurt if done properly. Usually it takes a few rounds for it to really subside.
Jo - I was thinking of you this week when I saw my PS. I'm well over a year out from my LD Flap surgery and it wasn't until he pointed it out that I noticed my loaves are completely gone. I recall after the surgery he told me it would take time and estimated a year. At that point I ignored them and forgot all about it until this week. I remember how it was shaving my underarms early on. They protruded and made shaving a breeze. I cannot see the loaves any longer and shaving is now normal. I cannot even tell that my LD muscle is tunneled under my arm unless I really press around. So that is good news and I'm expecting you will have the same experience. I know it was bothering you a few weeks back and I imagine that without reconstruction it become even more noticable.
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I don't like having to get the Flap either. But I have zero choices here if I want reconstruction. There are no other options for me.
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Leslie,
If you did not have LD flap surgery, it stands to reason that you wouldn't have the issues that a LD flap surgery can cause. So the whole point of having a nerve cut or not is completely nul in your case. And no, you don't have to do a lot of straining to get breast animation. I remember the first time I noticed it was when I pulled the window blinds up. My breast jumped towards my shoulder. That is not straining by no means. You don't have breast animation, and with the type of reconstruction you had, you don't know how that is and how it makes you feel, so you don't have all the information necessary to even figure out what one would have to consider when deciding to have a nerve cut or not.
If you would have read my post entirely, I had already replied I had emergency surgery 1 month after the first surgery.
I think it's a good idea to re-read what I wrote also when it comes to other conditions. True, I didn't write anywhere that I had a C-section as well as a miscarriage before and also a sclera transplant in the left eye (trust me, way more painful than even the miscarriage) and that also (I am quoting myself here because it seems you missed it): "Pulmonary apical fibrosis from Cytoxan (irreversible). Disappearing teeth from Taxotere (they just dissolved, practically). Peripheral neuropathy and fibromyalgia from any of the two above. Post mastectomy pain syndrome. Iron bra. Iron corset due to the bottom 2/3 of my back being scar tissue because the surgeon took the "we'll wait for them to reabsorb themselves" approach on my extensive back seromas. That is on him. The slipped vertebrae I mentioned in the previous post due to the lack of LD muscle to keep my torso up. Herniated muscles. Rapidly advancing osteoarthritis following AI treatment." I actually forgot to say costochondritis (chronic inflammation of the cartilage that connects the ribs to the sternum), right hip bursitis, left central meniscus tear, and to be more detailed on the osteoarthritis part, from C2 to C6 severe degenerative disk disease with annular bulging, ring osteophytes, severe narrowing of the foramens and deformity of the cord.
What do you think, do I know what REAL pain is compared to just a "simple BMX"?
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Jo -
You probably mentioned this but I don't recall. Have you been going for physical therapy? I mention it as I truly believe it contributed greatly to my good recovery. I went several times a week for months before the surgery and for 5 or 6 months after. If you haven't tried it you may want to ask if you're a good candidate.
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Joanne, my heart goes out to you. You have inflammation going on all over your body. Are there any integrative endocrine doctors in your area that you can see? My husband is seeing one and for the first time in years is seeing improvement with his multi-systemic issues. Diet and supplements are making a huge difference.
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My experience with PT was more routine. I was given exercises to strengthen the muscles around the LD and to get back full ROM and maintain good posture. Massage was to break up scar tissue to get rid of that iron bra sensation. Under normal circumstances I really think it is a good idea.
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Warrior, Whippetmom might not be a fan of the LD flap, but she was able to give me the names of a couple reputable PS's in my area regardless. She probably knows that some of us like Ruth7733 and I don't have any other options for recon. I'd have given a lot to have avoided any sort of flap. That said, I can't really complain about the results. I'm glad your loaf is gone. I never had a bad one, and it went away fairly quickly. I can't tell that the lat is tunneled under my arm either. Even when I palpate the area, I don't feel anything.
Jo, feel free to post if venting would help. We're not tired of hearing from you! You have been through a worse wringer than just about anyone else here, I think. What's the deal with the digestive issues you mentioned being caused by the lat? That's a new one on me. {{{Hugs}}}
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2Tabbies, Your story gives me much hope. I really want to say the same things to other women at some point in the near future. I desperately want this surgery to work for me. I saw my ps this afternoon and he is happy with how my skin now looks and has given the go ahead for my surgery in exactly 10 days. I asked him how many of these he has done and his answer of around 600 reassured me. He was very confident that this is what is needed for my issues. He truly believes that my radiated skin needs new, additional blood supply in order to 'keep' an expander (and of course eventually an implant). And as we know, that is exactly what this procedure does. I also asked about length of likely hospital stay and amount of drains. He replied that the answer to both is a hopeful two.
Jo, I pray for you.....I can't imagine
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Joanne - I've never had to deal with the loaf issue to the extent you're describing. Nordstrom has reps. who have training in fitting women post masectomy.
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Ruth - I am crossing everything for you--I hope this will be the answer for you with no complications!!
Jo--I never get tired of hearing from you, I am frustrated that we can't do more to help you heal quicker. When I see my LE specialist the massages are great--very light and nothing painful, wish you could find something that helped.
After my mastectomy for a long time all I wore was a bra like this:
They are available at Walmart and Walmart has a cheaper version if you want to try them. They have a pocket for a lightweight form and a wider area under the arms.
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I wore the coobie bras after my BMX and after my LD surgery I wore the Genie bras. They're like a stretchy sports style bra but they cover the back well and it provided compression for my back, front and sides. It did not cover the area where my loaf was.
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Jo, I'm afraid a lot of this is trial and error. I understand that feeling of being left on your own. That's how I felt when my active treatment finished. I hope your PS is wrong about how long it will take for your pain and swelling to resolve. I agree with Warrior Woman that PT might be helpful. Or maybe massage therapy. I'm thinking general massage therapy not LE massage. Another thought - maybe a different LE therapist would be a better fit for you. Hang in there.
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ok a question I forgot to ask the ps.....what will I wake up in? A bra? Some sort of compression garment? An ace wrap? What did all of you end up in when you had your lat flap? Also I know I've seen a lot of suggestions for the genie bra on here, but won't I need a bra that zips so that I don't have to lift my arms or struggle to get it on?
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Ruth, steristrips/bandages (really depends what your surgeon will use, some use surgical glue) and a surgical bra. That doesn't really look like a bra but is what you need. Depending on what your hospital uses, it might even have drains "pockets". The Ace bandages to push the implants down come much later after some healing has occurred otherwise the pressure from the implants being pushed down might open the sutures.
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Ruth - Ask your PS. I woke up with ace bandages and they were so uncomfortable I removed them in a day or two. I did use the Genie bra rather early into the game and I recall it was tricky to get it on and off over my head. Somehow my body has adapted but for quite a while my muscles were confused over how to lift it off over my head. I'd end up balled up like a pretzel. I don't know when I figured it out but it hasn't been a problem for quite some time. I purchased a bunch of cheap stretchy bras that would fit many sizes as I wasn't certain how big I would be. They're very comfortable and come with hooks in the back or front. You will need it larger around the midsection than what you normally take because of swelling. I recall thinking I was getting fat. The idea is to have support and compression. Check with your PS. This is another example of how they all do it differently.
So, get a load of this... Now that I'm finished with reconstruction and only have my tattoos left to finish, I scheduled myself for more cosmetic surgery. As I have a PS I am confident of and have become accustomed to the surgery routine, I'm scheduled in March for a nose job and upper and lower eye lifts. If all goes well, next year I'll have my entire face sucked up. Cancer has aged me a lot and I prefer to reverse it. One more FU to cancer. It's so bizarre that I'm doing this but after 9 surgeries the entire process has become so routine. What the heck. I even know where my favorite parking spots are in the city. The good news is that these procedures are a walk-in-the-park for my surgeon. If he can unglue my chest from my ribs and create attractive breasts, he can certainly straighten my crooked nose.
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Ruth, I had a ace bandage wrapped around me after the lat flap. Like Warrior woman said it was very uncomfortable and so tight! My follow up was 2 days after the surgery so he removed it then and my PS did not want me in a bra for a while, just a tight/slim fitting tank top is what I wore for a while! Good luck on your surgery!!
Warrior woman, good for you! You go for it:)). We deserve to live the life we want and do whatever we want after all that we have been through
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Ruth, I think every PS and hospital is different as far as what they wrap you up in after the LD flap. I woke up in a tube top with velcro down the front. I had the same thing after all my biopsies and my mastectomy. It literally is exactly like an elastic tube top. After my exchange, I had a breast band to hold the implants down. I haven't heard of anyone else having one of those. I can't remember if I had the tube top over the breast band.
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Yea I forgot to ask the ps when I saw him Monday. The next time I see him will be surgery day (next Thursday). So I was just curious about your experiences. I woke up in ace wrap for my last 2 surgeries (getting the expanders put in & then having one removed). They were so hot & itchy I could barely stand it. I have a feeling I will have them again though due to my size. I'm an extra large lady. (I have lost 20 lbs the last few months, yay me😄).
The velcro tube top sounds much more convenient & comfortable.
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Ruth, yay you is right! Good for you managing to lose 20 lbs. The tube top is definitely more convenient than an Ace wrap. I don't know about comfort, but at least it's easy to loosen up briefly when you need to.
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Ruth- I just had LD surgery 3 weeks + 2 days ago. I too didn't have any other choice if I wanted breast reconstruction. I was very concerned about this surgery and complications, etc. but decided in the end to put my energy and trust in my PS and the fact that the majority of women who choose this have little to no issues. I had 2 drains, both out my side so I could sleep on my side and back. I woke up wearing nothing but a hospital gown, no bra or wrap of any kind. I had gauze/ bandage on my back incision. I spent one night in hospital, going home late afternoon the second day after I could prove I could eat 2 meals and do a lap of the floor. The following day when I was at home I received an Amoena camesole that has adjustable Velcro drain pockets that I kept in the front and it was so handy! I had never had a catheter before but was thankful I did for that night in hospital (I didn't have one for my masectomy/first attempt at reconstruction)- it was nice just to wake and sleep as I needed without having to worry about getting out of bed to pee. I was able to stop all Valium and pain meds less than a week later and am thankful for that as they make me feel weird and the pain meds really give me constipation despite my best efforts otherwise. I got my drains out 1 week exactly after my surgery (it didn't hurt nearly as bad as last time)eventhough we probably should have left the back one in a little longer but it was nice to have it out for Thanksgiving.
I can't complain. Today was my first day back at work. I can still play my musical instrument from which I make a small part of my living. I go for my first fill of the tissue expander on Wednesday, exactly 1 month since the surgery- the time has flown by. (I'm totally curious how this "fill up" thing works!) I am thankful that so far everything has gone well. I know that not everyone has such a smooth ride. But I hope that some of my experience, even with its mundane details, can help you or someone else that might be worried or nervous about their upcoming procedure.
Have a great weekend!
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Tapanga, the fills are kind of interesting. The doc suspends a magnet on a chain about the expander, and the magnet points to where the port is. Then they just inject saline solution into the expander. Since my skin was still numb, still is for that matter, it didn't hurt. I guess some women have some pain due to the stretching. I never had anything significant maybe because my PS believes in going slow. I think that might be one reason I've had no complications at all. He's really conservative on timing and hasn't rushed any of this.
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oh a camisole would be great! Thanks Tapanga for describing your experience. I'm so glad you are healing nicely. How do you think it looks right now? Do you have a small mound even without the fills as of yet?
I can tell you that I've had fills in the past, currently my right side with just an expander is filled. And I had the same experience as 2Tabbies. I am completely numb & didn't really feel a thing except a tiny bit of tightness for a day. It wasn't even enough to warrant a dose of ibuprofen.
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Ruth, I got a Softee camisole after my mastectomy. It was very useful because it had pockets for the drains. The volunteer group at my hospital provided them which was great considering the price.
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For drains I wore a lanyard around my neck that I pinned the drains to. It meant that I did not have to pin and unpin every time I took a shower or changed clothes. I preferred it to anything with pockets and they're cheap.
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Hi All
I have been reading here, - but i am far behind on responding!
Jo, - I hope that you see steady improvement, even if slow in coming!
WW, - I can understand your plan to get back your younger look! I wish I could do the same! I feel like I've aged decades in less than 2 years.
However, I did start PT, and already see some improvement!
This week I have appts with my breast surgeon for check up, and with my PS to schedule fat grafting and a possible 'lift' to the expander on the LD side. I will ask about skipping the lift, - it's not THAT low! I am so afraid of adding to the risk of infection. I dont know what he does re nipples, but I am hoping it is something simple!!
All the talk about drains reminds me how much I disliked having them, - but it was really very do-able. I actually dont even remember what I came home from the hospital in! I am pretty sure it was a surgical bra, but it's as though my mind blocked some things from memory!
WIshing everyone here a happy and HEALTHY holiday season!
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AnotherNYCG, good to hear from you. I'd actually like a bit of a lift on both sides, but my PS says there's not enough loose skin available to do it. I'm going to ask him if slightly smaller implants would make the skin loose enough.
Warrior, if I had the money and available leave time from work, I'd sure like my jaw line tightened up a bit. I feel like I've aged 10 years in the last 2 like NYC said.
I hope none of the rest of you catch the virus that's going around here. I've been sick for 9 days. I've used all my sick leave so I have to go to work tomorrow. I'll have to use my vacation for my surgery in January.
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2Tabbies - thanks for the explanation on the fills. I was wondering how they knew where the port was, figured they wouldn't just stab at me hoping they would get lucky at some point.
Ruth - I do have a little mound. I used to wear a 34D, so I have a nice C on my left side and I'm looking forward to having my right side eventually catch up. The mound is probably an A cup but I'm terrible at tellin sizes. Right now I'm improvising with inserts, pads and whatever else works to fill out my right side a little while trying to give my left side a bit of support while wearing the camisole (it came with two inserts and pockets for them too). Some ideas are more successful than others depending too on the clothes I wear. I figure I went to the gym for a month totally flat on one side in the spring so I can bide my time now and slowly get filled as 2Tabbies mentions.
The craziest part is looking at the skin flap that used to be on my back and it's now on my front. Totally different color thanks to my pasty-white back and my radiated front. It half fascinates me and half gives me the creeps to think my skin and muscle is now residing elsewhere than from where it started.
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2T, - oh no! The flu? Take it EASY and feel better SOON!!
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Tapanga, I've got the pasty white back skin sewn onto my radiation darkened chest too. Don't ya just love the patchwork quilt look?
AnotherNYCG, it's apparently not the flu. Just some other really nasty virus. I've never had pressure in my ears so bad before. One of my eardrums actually sprung a leak. That hurt. I'm getting better. Slowly. Wish I was at home in bed instead of at work. Oh well.
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I had rads 14 years ago & the skin on my chest is still very dis colored. I do not sunbathe either. So I guess I will have the patchwork look as well. Fine by me. If everything goes well it will still look better than it does now.
If all turns out well AND I lose another 60 some pounds....I may just have a tummy tuck
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