Latissimus Dorsi Breast Reconstruction
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Just touching base. Anyone doing this surgery please discuss the risk. l had to have a repair surgery last week from the result of a very large mistake from this surgery. I had to travel to the Mayo Clinic to try and get this mess fixed. wont know if it even worked for 6 to8 weeks. This surgery was the lrgest regret of my life. please doyour homework and ask lots of questions!!!!!!!
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Hello ladies! I hope this finds you well. I haven't posted in a while but I do check in every so often. I just had my nipple reconstruction on Dec 23rd and so far I like it! Kind of hard to tell because I still have stitches but I think once I get the tattoos they will look great!
I have been having pain in my shoulder and can feel a cord that goes from my underarm down to the inside of my upper arm. Has anyone had this happen?? I called my MO but played phone tag all day:
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Did you have axillary lymph node dissection on that side or SNL? What you describe sounds like axillary web syndrome. Even radiation or just plain the mastectomy can cause that.
There is a thread on here about that, https://community.breastcancer.org/forum/64/topics/829271 - this one is newer but I know it was an older one as well. Normally you need to see a physical therapist who would break the scar tissue in the armpit releasing the lymph vessel cording. This happens exactly because of the scarring - imagine that you'd have a tourniquet applied on the lymph vessels going from under your armpit along the inside of the arm all to the base of the thumb. Breaking the scar is a tad painful but only lasts a couple seconds and you get instant relief. You really need to take care of it asap or it will get worse and will make your arm bend in a 90 degree angle and hurt like he@@.
Been there, done that. Takes about 2-3 weeks of daily scar breaking to get back to normal.
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Thank you! I did have lymph nodes removed but back in July 2014....this seems a little delayed but I really don't know much about it. I have an appt on Monday with my breast surgeon. Thanks for the link!
Kathy
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Kthielen, good to hear from you! Sorry you're having a cording issue though. I had a slight case of that a few months after my mastectomy. I was seeing an LE therapist at the time, and she took care of it in short order. Regarding the delay, LE showed up in my leg 9 years after my ovarian cancer surgery. So I don't think the risk ever goes away. In fact, my MO told me that as we age the lymph system, like everything else, gets less efficient so LE can show up. It sucks. I think a broken ankle might actually have triggered mine, but who knows.
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Thanks 2tabbies! We will see on Monday...I will keep you posted
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Hi, everyone. I just wanted to say hi. I'll be having this reconstruction over a year from now after chemo and radiation and healing time. I just wanted to get a feel for how everyone felt about their results and what recovery was like. As usual, lol, not easy and everyone's different! It's still a ways away and I have LOTS of other stuff to focus on first, but I wanted to poke my head in and send some hugs.
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Frill, definitely, explore your options. As Jo said, this is serious surgery. That said, I've had no complications, and am relatively satisfied with the results. I look fine in clothes. Not perfectly symmetrical if you look closely, but probably nobody else is looking that closely. I do get depressed about the scars and look of the flap of skin from my back. It's much lighter in color than my chest skin which was darkened by radiation. Some people are lucky enough that the skin matches better. I had no other options for recon, though. So it's not like I wish I'd have chosen something else. If I had had the option of just implants and no flap, that's what I would have done, but radiation ruled that out for me. Good luck with all your treatment and recon decisions.
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Frill, - as Jo and 2T said, this is quite a procedure, - but I, too, had no other option. Although my PS attempted reconstruction with TE and small implant, the previously radiated skin would not heal well. At that point, I needed this surgery with or without an implant.
The first few weeks were uncomfortable, but manageable. I got by with only tylenol, but I do have a retired husband who helped a lot with household chores! I am soon having fat grafting to fill in an area above the implant. These last couple of months I have been going to pt to regain strength and range of motion on that side, and it is helping.
Overall, it has been ok!
Good luck with your decision! Let us know how you are doing!
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Welcome Frill!! I have yet to go down this path, I am still working up the courage
so others can offer you experiences on recovery and difficulty of the surgery, but I will share some observations of mine.It is important to find a plastic surgeon that has extensive experience with this type of surgery, don't be afraid to take the time to feel comfortable or to ask questions regarding experience and results. The term LD Flap covers many types/variations of the surgery that involves the latissimus dorsi muscle to reconstruct the chest area, sometimes skin islands are used, sometimes expanders then implants, sometimes just the muscle is used. Again, don't be afraid to ask questions!
Good luck on your journey, sending you healing thoughts!
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I had the surgery to repair the herniated abdominal oblique as complication to the LD recon. Surgery was on the 6th of January and I can tell you I was not expecting it to be so painful. No colon or kidney involvement, thank goodness, but by my understanding it was more than just the abdominal oblique muscle. I did not talk to the PS afterwards as he was in the OR until well after I left the hospital, he sent his resident to talk to me and tell me he will explain everything at the post-op follow-up on the 12th. As i was under he also did some abdominal lipo to fix a dent I had in the right breast, removed a scar that didn't fade properly and re-tattooed my areolas.
Anyway, it is exceptionally painful - the herniated muscle repair that is. I have a drain, they've put in an artificial mesh. The first day the pain was as bad as a kidney stone pain. Right now I have issues because I'm very tired. The pain killers work for pretty much exactly 4 hours, and as I fall asleep and get past that time I wake up in excruciating pain. I've been trying today to set my alarm clock so I don't get past the 4 hours but it's "broken" sleep. Oh well, better than none or horrible pain. Otherwise I'm good, highest temperature was 98.1F, the drain output is 40-50 cc/24 hours and already changed from "hawaiian punch" to slightly clearer orange-ish.
I sure hope this is the last surgery I have to do with this blasted type of breast reconstruction.
Even if I'm repeating myself, ladies, think not twice, not thrice, but ten times before having this kind of reconstruction and if you have any other way, chose it not LD flap.
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Hi Ladies,
Its been a while! I am now 1 yr. post reconstructions with Lat Flap and doing well! I had complications in my shoulder.... traumatic injury that caused a torn rotator cuff and ligament tear. I had 4 pins in my shoulder and looking at 18 months of recovery. Really, the shoulder issue was way worse than any of the BC treatment combined! Glad most of that is behind me.
I do notice sometimes after laying on my left side all night, when I roll back I get quite the jabbing pain along the outer side of the implant. Probably from laying on it all night, but it will sure wake me up!
I am nipple-less and enjoying it really. I don't like to wear a bra now (THE silver lining in all this crap) and when I only have blanks, there is no need to cover any dark areolas! Have you noticed how thin all fabrics are these days??
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jbokland, good to hear from you. I was going to go without nipples because I don't want to wear a bra either. The PS said they'd be flat enough that I won't have too. Of course, there is the thin fabric you mentioned. I guess I'll make sure I get darker colors. I'm glad your shoulder is doing better.
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hi all
I am one of the doom and gloom posters who left the thread for awhile when I was also being accused of scaring women who were just looking for truthful information
well, I am not crazy or irrational or and alarmist - I am reasonable (not during cancer but who is), I do my research (I can tell you the dosage of chemo I had) and I looked for the absolute best doctor (top cancer center in the COUNTRY) asked a ton of questions, got second opinions and STILL ended up with long term issues with this surgery.
When I hear women say "just find a good surgeon who has done a lot of these" I cringe. I really do. The fact is, technically my PS did nothing wrong. In fact he did a beautiful job - boob and back look great, I don't have the loaf, seromas or any of the issues I read about
What I can say is that I do have residual pain - They are displacing one of the largest muscles in your body - I mean really, lets really think about what they are cutting here. Am I able to live a pretty normal life? yes BUT when I'm stressed, or lift too much or twist a certain way it triggers pain and ache that can last for days- I stretch and work on it and its a constant battle but I can keep in in check without it disabling me (for now..terrified of the future as I get old)
and you can have the best surgeon in the world and this can still happen -
you can be in great shape and this can still happen -
I am being truthful and sincere and not trying to scare anyone - just telling my story in hopes that it gives someone pause about what they are willing to risk
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Same here, rozem. My result is absolutely gorgeous. But look with what I have to deal with as late complications. And the remaining of my life being on disability.
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I just had my nipple building procedure as well as a revision today. I'm home. The PS was running a bit late so I didn't get out of there until 6 pm. I was really hungry by the time they knocked me out. Everyone was super nice though. I like this surgery center even though it's not in the most modern, fanciest building.
Everything went well, or so I was told. I was even able to put the EKG sticky pads where I thought they looked best for positioning the nipples. It was far enough above the scar (just barely above it) to satisfy my PS and close enough to center to satisfy me. I think. I'm dying to peek, but the compression "tube tops" must stay on until Monday when I have an appointment at his office. I have one around my abdomen where they suctioned the fat as well as one around my chest. I got blue ones this time instead of pastel pink. Yay! I'm practicing being grateful for small things. I also have some kind of nipple protector cups on. I have no pain at the moment. The only pain I've felt so far was a slight burning like a friction burn on the left side of my sternum. Fingers crossed that I am now beeyouteaful!
I did have one sad piece of news. My podiatrist who also used this surgery center, died suddenly from a heart attack a few months ago. I wonder what her receptionist is doing now. It was a solo practice so she'd have to find a new job. Maybe she retired. They were both really nice, and Dr. Purdy wasn't old! I'd say in her late 50s or early 60s. Now, who am I going to trust with my bunion when the time comes? She was so nice, and had a great sense of humor as well as being a good doc.
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Rozem.....six months down the track what you describe is me too. I am having painful physiotherapy every week but I am still struggling. I am not saying don't do it. The cosmetic results are really good but I had serious complications during my reconstruction and functionally I am not doing so well because of swelling (loaf?), pain and general loss of arm function. To be honest, I don't think my surgeons had much choice as my mastectomy ( which resulted in 3kg of tissue removal) left a huge hole in my chest and something had to go into that hole.
I remain optimistic that with my commitment to physiotherapy I will regain function and that over time my painful episodes will diminish. I guess my take away message would be that it takes much longer to recover from this procedure than you might expect so be prepared dear sisters . ( oh, and prepare yourselves for those automatic pats on the sore bits of your back whenever anyone gives you a hug !!!)
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2T, - Sorry to read about your podiatrist, - but happy that you are moving along with your reconstruction! I am thinking to have 3D tattoos from Vinnie, - but I know that my ps will be insulted if I dont have him finish his work. He is wonderful, but I realllly would like to avoid skin grafts and more stitches, etc. I will see him in Feb for fat grafting, and that's enough as far as I'm thinking right now!
Jacfin, - I hope that you feel better soon. My pt seems to be helping, but I doubt that I will ever feel like my old self again.
Jo, - I hope that you are feeling better, too!
Lets keep fingers crossed to be healthy, most of all!
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anotherNYCG, I didn't have a skin graft to build nipples. He cuts the skin on the foob, but leaves it intact. Then folds it up and around itself to form a nipple. Maybe you should ask your PS how he does it then make a decision. I don't know if there are stitches since it's all covered up. I would assume there are unless he used super blue.
Jo, thanks for the prayers. I hope you're doing well.
Jacfin, I hope physiotherapy is working for your arm.
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Jo, thanks for the update. It sounds like things are not great but not too bad. I hope your backpain, loaf, etc. eventually resolve.
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Tabbies - Toot toot! You're moving along! I'm scheduled for my tattoos with Vinnie Myers on Friday. Yea! You'll be surprised what you can get away with wearing without a bra. I purchased the nipple covers at Ulta for the tight clingy camisoles. Let me know if you need a brand name and I'll look for it. Stick them on and Wah Lah...no bra needed with sheer clingy clothes.
Kthielen - I've had cording on an off beginning with my BMX. One visit to my PT usually fixes it. He massages it and then I literally hear a popping sound. I don't know about the popping but it takes care of the issue. I only had a SNB with one node.
Friel - Hi! I'm the person who continuously advises having an experienced LD Flap surgeon for this surgery along with a PT who specializes in LD Flaps if you can find one in your area. I was actually told to start PT for months before the surgery. I've had excellent results aesthetically and physically I'm fine. I have full ROM, no pain and no limitations. Anecdotal information doesn't paint an accurate picture. This surgery, like the other flap surgeries has positive and negative outcomes. Some are very positive and some are nightmares. I thought long and hard about proceeding ahead and in my case, I found it best to speak openly and directly to my surgeons and other cancer care specialists. Don't assume the experience of anyone on BCO will be the same as your experience.
Jo - That's bitter sweet news. I was of the belief that with patience anything can be fixed. I'm sure the news of discharge is disappointing.
Friday I get my tattoos. This will mark the end of over 2 years of reconstruction. I'll post pics when everything is healed. My husband and I are planning a Valentine's Day celebration. We just returned home from a couple weeks in SE Asia. There was a time not long ago that I would not have risked this type of adventure. I wasn't able to predict 2 weeks without treatment and didn't want the disappointment of cancelling or finding myself with an issue in a foreign country. Interestingly, I met a breast surgeon from the States on my trip. There was some comfort in meeting him.
I hope everyone is having a healthy start to 2016.
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No bra? I envy you that. I could never get away with that before bc and I can tell already that I won't be able to once I get my new squishy's. I've already got quite the droop with just my expanders.
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Hi all! 2T, I had nipple reconstruction Dec 23rd....it has healed well and I am happy that I did it. Now just have the tattoo to do and will hopefully be done with surgeries forever!!! I originally had decided I didn't want nipples but now that I have them I feel like my foobs are more like boobs, lol! Still get pain in my back and burning along the incision....does anyone else have that?
Take care,
Kathy
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Kthielen - Is the back pain muscular? Have you tried exercises to develop the other muscles in your back?
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Warrior, good luck with the tattoos! I'll be doing that locally here when I'm healed up enough. My PS told me the nips should flatten out enough that I won't need a bra to camouflage them. He better be right. I'm not sure if I could use the nipple covers you got because adhesives give me a rash. Have you had that problem? Right now I'm dying to get rid of the dressings that are taped to my chest even though they used the tape that supposedly works best on people with sensitive skin. It itches, and I can't get at it!
Kthielen, I originally didn't want to bother with nipples either, but my PS insisted they would make my foobs seem more like real breasts. Sounds like that's true for you. I guess I'll find out soon. Dressings come off tomorrow. The plastic protectors covering the new nips don't line up vertically. One is way lower than the other. That must be just because of how they bandaged me, I'm assuming. If the nips are this uneven, we have a problem. I've had hardly any pain with this procedure. Took Tylenol a couple times, and that's it. I am, however, way more tired and foggy feeling than I've been after previous surgeries. I guess it's adding up. I don't have back pain. The scar on my back feels tight but is not painful. I'm hoping to loosen it up with massage. I hope PT or something can help you with yours.
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Warrior, it probably is muscular....I have been working out but with my revision in Sept he didn't want me doing push ups, rows or any pushing or pulling. I see him next Friday so will see if my restrictions will be lifted! The burning feeling seems like it would be more from the nerves trying to come back? I might try acupuncture too to see if that will help. When is your tattooing scheduled?
2tabbies, good luck tomorrow!! Just to warn you a bit, your nips will be swollen and reddened at first so don't get discouraged!
Kathy
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Kthielen, very careful about "building the remaining muscles in your back". Doing that I got herniated muscles that needed extra surgery (I had it 2 weeks ago). Don't push yourself. And yes, I had the same burning sensation. By my understanding the "burning" comes from cut nerves.
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kthielen, I was pleasantly surprised that my nipples look fairly natural right out of the chute. The size and shape are virtually identical to my originals. That's amazing since my PS never saw mine even in photos. I know they'll shrink as the heal which is fine too since I don't want to have to wear a bra. They do look like Franken-nipples with all the sutures at the moment. I posted photos on the picture forum if you want to go look. I agree with everyone else about the burning pain being nerve pain. I had that horribly after my mastectomy. I couldn't even let clothing touch the area for a while. Although, I've also had muscles "burn" from overuse. That doesn't usually last long though. My opinion, fwiw, on working out when recovering is go slow, and if any exercise hurts, stop doing it.
Jo, I'm glad to hear you've regained some ROM.
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pt has helped me to regain some rom, but these foobs still feel like a tight bra that i want to take off!!
2T, - I have access to the picture forum, but i have no idea how to find things there. I hope my ps will do nips that dont require more skin grafts!
Stay warm and feel well everyone!!
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AnotherNYCG and Jo, here's a link to my thread on the picture forum. I hope it works for you. It's in the the "Under Construction" section. That site is a bit challenging to use. A while back the Under Construction section was pretty active. It's gotten a bit less so, but there are a few of us that are keeping up with each other.
AnotherNYCG, your PS should be able to make nipples like mine did without doing a skin graft. I think it's the more common method these days. If he/she doesn't do it that way, I'd sure ask why.
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