Latissimus Dorsi Breast Reconstruction
Comments
-
I used a herbal ointment of my own concoction and where I used it you can barely see any scar. Actually on one of the LD prelevation scars I used it on half of the scar and Mederma on the other half. The difference is astounding. I'll try getting a photo of it and post it.
0 -
I'm glad this thread is getting more active, as I'm (sort of) getting closer to some kind of surgery date. I haven't finished chemo yet, so I haven't started rads. There's still awhile.
One thing I wanted to raise, and someone else had mentioned, was pain/tightness on the MX side even more reconstruction. Mine is off and on, along with lymphedema (and cellulitis - yay me!). But right now my side through my underarm is very stiff, not to mention still numb post MX. Ugh, I can't imagine what it's going to be like when I have the other side done with recon on both sides.
Is this pain/discomfort like a harbinger of things to come with lat flap? I will be back in PT in a couple of weeks (hopefully). Insurance is being a pill about coverage past the measly 30 sessions. I'm just worried that I'm going to be compounding things, or that something is going on. I keep complaining to every doctor I see about this. FINALLY the pain doctor heard me.
Seachain, what's your magic scar disappearance recipe? I hope you put stretches up, although I know with real life stuff - heck, I'd much rather deal with anything related to anything other than this.
0 -
Frill, if you're having lymphedema and cellulitis, that could certainly cause pain. I don't have any pain. I'm coming up on a year after my exchange procedure. There is tightness. The scar on my back is somewhat tight, and the muscles over the implants tend to feel tight. It's more noticeable at some times than others. After I do any exercises that use those muscles for example. I'm glad the pain doc is paying attention. PT might actually help depending on what is causing the pain.
Seachain, I'm interested in your magic scar fading recipe too. My PS said nothing worked. It just depends on your skin type, and that keeping the scar moisturized was the best you can do. I've tried all sorts of creams and oils as well as silicon strips. The scars have certainly faded from what they were originally, but I couldn't tell you if they're any better than they would have been using nothing. At the moment I have a hand made moisturizer that has a bunch of essential oils in it. I mainly bought it because the maker uses some of the proceeds for a non-profit she started to help victims of domestic abuse, but it's supposed to be great for sun damaged or aging skin. I'm hoping it will fade the radiation damage, but maybe it will help the scars too.
0 -
To All the Lat Ladies:
I just wanted to ask you if your PS put the breast implant under your chest muscle or did he just put it under the Lat muscle? I hope you guys don't mind my asking.
0 -
In a LD Flap breast reconstruction using an implant, usually the implant is set like this: top 1/3 or 1/2 under the pectoralis major (which is responsible for most of the "breast animation"), in some cases - depending on the PS - bottom 1/3 under the serratus anterior (the muscle covering the ribs) - hence coughing and sneezing will hurt for a while after surgery - and the LD comes on top and pretty much covers everything.
But it depends a lot if you have skin flap or if you had skin-sparing mastectomy, the approaches are different. If you have a skin flap reconstruction, it's possible that only LD covers the implant, while in the case of skin-sparing mastectomy (like mine) they must make sure that the layer covering the implant is thick enough to ensure survivability of the skin so they will pull the pectoral down to cover the top of the implant, like in a regular breast enhancement or BR with tissue expanders.
0 -
Seachain - thank your for the detailed information, I will need a skin flap from my lat dorsi, so I guess it will just be under the lat muscle and not under my pectoralis muscle. I will need to confirm this with my PS when we start discussing his plans with me.
The TE on my right breast is under my pectoralis muscle, so it moves funny when I vacuum or squeeze a lemon. 😀😀
0 -
Journey, I needed a skin flap also, and my implant is under both the lat and the pec. It may vary by surgeon and patient.
0 -
2Tabbies - so I guess it depends on what PS would prefer to do. Thank you for your input.
0 -
Yes, I said "it's possible that only the LD". Of course it depends on the patient, the size of the implant, and most importantly, how the PS prefers to do it.
0 -
It's been 7 weeks since my lat flap surgery. I am filled to about 320cc on the lat sideand 410 on the other side. I am just starting to get some projection but still feel very flat and wide. I was told they will do one more fill after I am happy with the size because the final implants will look smaller than TE's.
I am curious how much they can fill me with having the lat flap. Did anyone have any limitations as far as size because of the lat flap?
0 -
Madison, I wasn't told there was any limitation because of the lat flap. I didn't want to go really big though, so that question didn't come up. Maybe somebody else wanted to push the envelope, so to speak, and specifically asked that question.
0 -
Thank you 2Tabbies. I don't want to be overly large I just want a little projection which I am starting to see after today's fill. The nurse keeps saying the flap side will determine how big I can go so I was curious what others experienced.
0 -
Hi Madison,
I was big my entire life and aiming for proportionate. I'm a petite person and I finally have normal sized boobs. As they fill them you'll see yourself get bigger and you'll know when you want to stop. Unless you have a skin issues, you should be able to go to the size you'd like. One thing to consider, however, is that you don't have the LD muscles in your back and the bigger you go the more you'll need to develop your back muscles to support good posture. Tell your PS what you want and they will advise you. Also, implants can help achieve the projection you're looking for.
0 -
It is not the size of the implant that will make you not feel flat, it's the "profile".
I did not have TEs, I had skin sparing BMX with immediate LD recon with direct implants. I have a very petite frame, the implants are only 400cc, but they are Mentor high profile. Right now I am a 34DD, if I lose more weight I'll be a 32 DDD or 32E. As you can see, the "profile" does the trick. I'm posting photos both from left and right - the breast with horizontal scar is the one that had BC. I am 7 years from the initial surgery and I had a total of 5 revision surgeries. I am very happy with my results - I don't need a bra (unless I need to cover the poking nipples) and they look very natural in clothing and very perky. For my age of 55, I really am happy even if they aren't really flawless. The photos aren't terrific, I'll try to get my BF get better ones when he gets back from doing errands.
I suggest you ask WhippetMom, she is the most knowleadgeable on this forum.
0 -
Sorry, I forgot. Warrior Woman makes an excellent point, the more developed your LD muscles are before surgery, the more work you will need to put in after the surgery to develop the remaining back muscles to compensate for the lack of the LD. As I said multiple times, usually former athletes have lots of issues, because their LD is very developed and has a huge role in keeping the torso upright - once taken away it can cause severe back muscle pain issues as well as spine issues. I got them really bad, I'm on disability because of it.
0 -
Hi,
This is my first time posting on this site, although I have been reading the message boards for some time. I had a BMX 3/26/15, followed by chemo and radiation. I just had LD flap reconstruction with TE's on 6/7/16 and I think I'm recovering pretty well. I have some pain/pressure in my chest, but from what I've read, that's common. (My PS says the nerves are angry.) The LD incision and skin around it feels very sensitive, almost like I'm bruised inside. I'm thinking this will get better with time, but it would be reassuring to hear others have had a similar experience.
Thank you!
0 -
Oh goodness, Wildtulip, you are doing more than great! When I had my BMX+ immediate reconstruction I was practically blue, purple and black from the base of my neck to my waist!
Yes, the pressure will ease with time. Make sure to ask for a referral for physical rehabilitation therapy as soon as you are done with the surgeries, it will make a world of difference.
0 -
Thank you, seachain, I appreciate the reassurance!
People around me just don't get how big of a surgery this was. I'm less than 3 weeks out and I had two people ask me yesterday is I was planning to go out in the evening. I'm going for short walks and stretching, but I'm physically beat by evening.
0 -
Unfortunately, you are correct. People don't realize what a major surgery this is and the fact that you need MONTHS to recover from it.
0 -
I am somewhat confused about the lat dorsi procedure. Some say it produces great cosmetic results (especially for radiated areas), others talk about discolored "football" shaped skin patches being visible on the affected breast. I'm hoping for some clarification! Does it depend on whether you need the flap for muscle vs. skin rebuilding? I don't care about back scars but really want to avoid additional scarring on breast.
Another question - if I'm having masctetomy, then TEs, then rads, then exchange to silicone implants, at what point do they do the lat dorsi? With the first or second surgery?
0 -
elise24601,
To answer your questions:
1. The first one you kind of answered it yourself. If you have skin-sparing mastectomy and no radiation, then you only need the muscle and no skin from the back, and you will only bear the scars of the mastectomy itself (like in the photos I've posted two days ago). The need for skin flap is only if you already had radiation then the skin is compromised and loses the capacity to stretch to accommodate an implant. Usually the LD flap with skin flap reconstruction is used in delayed reconstruction AFTER radiation. Otherwise it would be useless as the new skin brought in from the back would suffer the same damage. Obviously if you have skin from another area the color will be different and will be noticeable (even the texture).
2. As you can deduct from the above answer, the reconstruction with skin flap will happen AFTER radiation. The TEs still have the function of stretching the muscles under which the implant will be positioned.
0 -
Thank you Warrior Woman and Seachain you both have excellent results! I definitely don't want to be huge I just want to look as close to "normal" as possible. I have been very lucky with the Lat surgery, I do not notice any difference with my Lat muscle or have any physical deficits than before surgery.
Wildtulip- I am younger than most (24) and I was still exhausted until about the 7 week mark. And no people do not unederstand this is a big surgery to recover from! I am just graduating from college as an engineer and I had to start a new job after the 5th week and I was SO TIRED!! lol I work with mostlyall men and it is very difficult to explain what I had just been through so I told them I had back surgery.
Elise-So far I have had an excellent cosmetic result with the Lat flap. I am 8 weeks post op with TE's and I am already so happy with the way I look! Yes my football shaped skin flap is a slightly different color but not enough to really bother me. My skin is slightly discolored from radiation anyways. I think in time it will all blend nicely. As far as when they do it, it will depend on your treatment plan. I had to wait one year after finishing rads because of the high recurrence rate of inflammatory BC. I am really glad I chose the Lat. Many others I have talk to that had radiation tried to do just implants with no flap have had nothing but problems.
0 -
Madison, Thanks for your input! Congratulations on your graduation and new job. It must have been difficult to go through treatment during college!
Thankfully I was able to plan reconstruction now, when I have the summer off of one of my jobs. I do, however, have two children with special needs. Fortunately they are almost 16, and high functioning, so they have helped me some around the house. Today is 3 weeks since my LD flap and I still need pain meds at night, but I'm doing pretty good during the day. The last few days my skin has felt SO tender, particularly on my side at the incision, and it now looks like there is some bruising under one breast and on my side.
Seachain, I'm so glad you mentioned your bruising, or I would have been startled when mine showed up!
Thanks for sharing your experiences!
0 -
Wildtulip, I am glad to hear you are making progress in your recovery. I can't imagine going through all of this and having to take care of a family too. I give moms a lot of credit who have to deal with BC and all that goes with it. I thinks it's perfectlynormal to take pain pills still. I definitely needed them at night because I had back pain from having to sleep only on my back and also needed them during the day sometimes until the 5th week. I also had periodic tenderness as I healed. Before you know it you will be feeling back to normal. 😊
0 -
Madison, Thanks so much! I appreciate your encouragement!!
0 -
Wildtulip - You're only a few weeks out. It's too soon to assess anything. Most of us turned the corner and started feeling better around 6 weeks but even then you're far from recovered.
elise - The shape and size of the skin flap depends upon the surgeons technique. Some do an ellipse and the skin moved from the back is football shaped and may have different pigmentation. My PS does circles that become the foundation for areolas. My tattoos went over the flaps and hid them. I appreciate this technique.
Madison - Congratulations on your success. I love seeing women succeed in male dominated industries. Hang in there.
Seachain - You look great.
0 -
Warrior Woman, thank you. The few family and friends I have don't understand and keep expecting me to be back to my full schedule by now. It's nice to have a place where people can give me perspective.
0 -
Warrior Woman - Thanks for that info. How large were the circles your surgeon made? It seems like if they were areola size they couldn't be very big? And your doctor said you could have tats done over them - how long after? Did they hurt? Sorry for all the questions!
0 -
elise, don't be worried about tattoo hurting. We get so many nerves cut that the whole area will be numb. Takes a while for the nerves to regenerate, and you will consider yourself lucky if they do - so you can get a little bit of feeling on your foobs.
0 -
Elise - I posted this a while back. I had a total of 11 surgeries and my husband did not see me from the time of my BMX until my tattoos were complete (a couple years). He actually walked into Vinnie Myer's office as Vinnie was complimenting my reconstruction. (Perfect timing Vinnie!) We celebrated Valentine's Day a few days later and he took these photos. I'm obviously dolled up for the occasion. However, if you zoom you can see the scars and see the circles of my skin flaps under where Vinnie tattooed. I think they look proportionate. I have no idea of my bra size as I've yet to wear a fitted one. I'm a small framed person. I didn't feel the tattooing at all and I didn't need numbing cream. I did need something when the PS did my nipple reconstruction. BTW, don't watch during the nipple reconstruction if you have it done. They held up a mirror and I almost passed out. I forget how long Vinnie required I wait for the tattoos. 5 Months? I think some will do it at 3 months. I've learned this isn't a race.
Wildtulip - The good news is that you must be looking better if everyone thinks you're back to normal. Much of what I'm dealing with now are SEs from the AIs but that's another story. There is always something haunting us from BC.
I adopted a large breed puppy. It's the best distraction from cancer that I've found.
0
