Latissimus Dorsi Breast Reconstruction
Comments
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lonnie, I had a lat flap on one side, and just an implant on the other. I'm not sure what swelling in particular you're talking about, but I think the worst of mine was gone in a few weeks. The fullness under my arm from the lat muscle being tunneled to my chest took the longest.
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Nash, how long did the tightening feeling go away for you? I had bilat LD recon on May 19th, I'm 9 weeks in feel I made a horrible decision with this surgery. My PS didn't want to do implants with this, just do LD, which...I'm so disappointed with , too. I'm hardly an A, they don't look good, no upper breast at all. I'm so overwhelmed and this pain, tightening feel will not go away. I had a horrible hematoma, they tried to drain too soon then had a seroma form onto of Hematoma it was 9 inches long. The took 2 of the 4 drains out way too early. I'm so drpressed about all this. I'm going to end up with more surgeries now and feel like my back will NEVER be the same. Thanks.
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NotThereYet, you're only a few weeks out from surgery. Do not despair. I'm sorry you had that big hematoma and seroma. I'm sure that's added to your discomfort. That's quite the bruise in your photo. It's hard to be patient, but the tightness gradually eases over time I give you an exact timeline because it is a gradual process. It's been over a year and a half since my lat flap surgery. I no longer feel like something tight is wrapped around me where a bra band would be. The scar on my back has some tightness, but is not uncomfortable. I'm hoping massage might help but haven't found time have any yet. I do have implants, and the muscles over them often feel tight. It's less than it was originally though. I don't know if it ever goes away completely, but it isn't a real problem for me. Your upper photo is blurry, but what I'm seeing looks pretty good. However, you're the one living with it. If you aren't happy with the size and shape, and your current PS isn't inclined to change anything, get an opinion from a different surgeon. Or 2. You're the one having to live with it. Explore your options. You deserve to have results you're happy with to the extent it's surgically possible. I hope your back starts feeling better soon.
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I'm curious if others have experienced a difference on their LD flap side vs non flap side during expansion? I actually like the shape & projection so far on my flap side, but not the non flap side. I'm about 2/3 way through the fill process, so I know things can change. I'm not concerned, but don't really like being lop sided either.
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Wildtulip, - The implant on my lat side is a little bit smaller than the non lat side, but looks larger! My ps said it is because of lat muscle over implant. However, the top of non lat side looks better to me, even after fat grafting on lat side. I guess most was reabsorbed in my case.
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anotherNYCgirl, Thank you. I appreciate your input!
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Wildtulip, my lat and non-lat sides are also a little different. I don't remember how different they were during expansion. I think the overall size is pretty much equal now, but my lat flap side is a little lower and also less full in the upper pole. Fat grafting helped that some, but there's still a difference. Probably nobody else notices because they aren't looking as closely as I am. I wish they were perfectly symmetrical. but they're probably as close as can be expected since different procedures were done on each side.
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2T, your description fits me as well. My ps wants to do more fat grafting this fall, - but I am not so inclined. Most was absorbed last time.
I am curious if your lat flap side is more uncomfortable than the other side? My lat flap was done over a year ago (non lat side done 6 months before that). PT helped my shoulder rom, but the implant/chest area are not nearly as comfortable as I would have expected.
Hoping all here are doing well!
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Thank you 2Tabbies, that's helpful!
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I honestly think that the way the PS positions the LD muscle over the implant has a lot to do with the final shape of the reconstructed breast. I have read over and over from a lot of the ladies who had this procedure that they don't seem to have enough fullness on the top of the breast.
I have plenty of fullness, but it seems that in my case the PS has positioned the LD muscle very low, covering practically only the bottom half. The implant on the upper half seems to be covered only by the pectoral muscle.
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Seachain, that's interesting info. I suppose, too, it's a matter of perspective. Currently, after 4 fills my LD flap side looks more anatomical, whereas my non flap side has a wider base and less projection. The nurse told me this week that the non flap side will project with more fills, which is what I figured. I would have thought that both expanders would react in the same way, but it seems the flap makes a difference.
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AnotherNYC, I don't notice any difference in comfort level between the 2 sides. There's a bit more tightness my armpit when I raise my arm on my lat flap side than on the other. That's the only difference I notice. I'm doing well. I got started on my nipple tats a couple weeks ago. I'm also going to get a bird and flower tattoo to camouflage the flap and it's scars a bit. I never thought I'd get a tattoo, but if I have to look at something the rest of my life, at least it will be something I choose. Hope you are doing well too.
Seachain, I'm sure the positioning of the muscle makes a difference in the shape, but the implant type certainly does as well. I have anatomicals which have less volume in the upper pole. I think it's more pronounced on the lat flap side because more tissue was scraped out of there during the mastectomy than on my prophylactic side. My PS actually removed a bit some on my prophylactic side to even things up a bit.
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2T, - Good luck with the tattoos!!
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Thanks, NYC! The first pass looks pretty good.
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AnotherNYC, I also do not notice any difference in comfort between the two sides, but since I'm just in expansion, they both feel like rocks!
2Tabbies, are you happy with your anatomicals?
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I did. I had a good doctor - 2 years out and it's caused a lot of pain in my back and chest. I'd never do it if I had the chance to turn back time.
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Ah. If only we could turn back time...
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I have been off the boards for quite some time. I am looking for any of my Lat Flap sisters who may have Natrelle anatomically shaped implants. I am experiencing some issues on the left side muscle spasms and the PS is wanting to switch me out from Mentor high profile into Natrelle with fat grafting. Anyone have the Natrelle's and like them or dislike them?
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Wildtulip and westiluv, I have Natrelle 410 FF's and I'm pretty happy with them. Westiluv, I posted in your thread on the picture forum too. They do look a bit droopy compared to rounds, and at first I wasn't thrilled. But after some fat grafting in the upper pole, I'm satisfied with the shape. You can check out my photos over on the picture forum.
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2Tabbies, Thank you. I just recently got on the picture forum, so will check it out. I haven't actually discussed round vs anatomicals with PS, but had a brief discussion with a nurse and she told me they have had patients who went with anatomicals but then were unhappy with them. Sounds like they encourage the round mentor memory gel and the nurse gave me the impression that it settles to a natural shape. Wish I had a crystal ball!!
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Wildtulip, I've seen photos of good results with both round and anatomicals. My PS said the opposite from what that nurse told you. In his experience, his patients aren't happy with rounds. Go figure. I have seen some women get the "coconut bra" look with rounds, but certainly not all. And some who have that look, which I definitely didn't want, seem thrilled with it. Yeah, a crystal ball would be a wonderful thing. Maybe you can show your PS a photo of how you'd like to look. Or look through photos of his work and find one you like.
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2Tabbies, I've taken a few photos of myself with the fills, but it's a good idea to go on the PS website and look at what's there. I did once, but it's been a long time. My LD side looks really good so far, but left TE turned, is high, and I'm lopsided. I said to PS, "I don't like having a boob in my face..you can fix this, right?" He assured me he will fix at exchanged and told me to only look at right side as far as size. I also do not like the coconut look. The nurse held up a sample implant for me and showed me how the gel settles into the lower pole. I'm anxious to have the implant discussion with PS, but at the same time, glad I have time to think and research. I've had a sick child all this week, so hopefully this weekend I'll be able to spend more time doing my research. Thank you for sharing!!
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I don't know if this has been discussed on the forum or not before....but I think that with this reconstruction type, keeping a stable weight and size in the upper body is very important. All of the issues I have been having lately seem to be triggered by a 10 pound weight gain. Suddenly my tight left side is jumping around in a spasm and I am experiencing intermittent pain in my back where the muscle is relocated. I tend to gain weight all over and not in a specific area, so if you are lucky enough to just gain it in the lower half of your body, then it may not be an issue for you.
There are so many things that we deal with as a result of this procedure and when you are going through it, you just want to be put back together as best you can be. By sharing with others, I hope that newbie girls considering this surgery know that weight management is something that will affect their lives in the future with this reconstruction technique.
I know that a 10 pound gain may not sound like much to many people. However, I had an advanced lat flap procedure that used the entire muscle with maximum skin flaps that cover the entire lower pole of my breast. Mine was a maximum use of that skin flap to cover the whole area I had damaged by complications. So far, my experience has been that I need to control that weight level so that I don't stress the areas rearranged.
Another tip I have learned since my surgery in 2011. Don't do any exercises that put stress on the pectoral muscle or the latissimus. I still lift weights but I have completely modified what I do to avoid inflammation of the muscle relocation.
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Westieluv, thank you for sharing your insight! Ten pounds is a lot of weight and I can see what you're saying. I'm curious if you have any thoughts about any impact with losing a little weight?
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I will be sure to let you all know. I have a date for cleaning up my eating and getting back to the exercise routine that I know is needed for me to lose weight and then maintain the loss. As the pounds come off, I will be paying attention to see if the spasms and the back pain lessen.
This weekend is my "last hooray" before I knuckle down and give it my all again. Hoping you all enjoy the Labor Day weekend.
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Another question: How many of you still wear a bra daily after this procedure?
I manage to make it through my office hours, but by the time I am at home, I want that contraption off. I am undecided, as of 5 years post surgery, whether wearing the bra is necessary. Does anyone think they are sagging from not wearing one?
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I can answer the question about losing weight. I had put on about 40 lbs during the first 8 months after the mastectomy/reconstruction - went from 151 lbs to 191 lbs. As soon as I was off the AIs i started dropping them off - and some. The difference is tremendous. Westieluv, yes, having weight on your bottom can be really bad too. Think that you have to move that heavy butt and heavy belly. Also, going to the bathroom, you have to wipe and have to stretch all around those fat rolls. I don't lift weights (cervical spine issue) but I do a lot of exercises to stregthen the remaining back muscles (I had total muscle without skin pad, bilaterally) to compensate for the lack of the LD. I use 3 lbs dumb bells with LOTS of repetitions. TBH I've been pondering for a while about opening a channel on Youtube with examples of exercises that help with recovery and rehabilitation after LD breast reconstruction. I know I looked for something like this for years before I started putting together my own exercises, using my experience as a former gymnast and alternative therapist.
Regarding the bra - I only wear a bra when I have to go in a situation where it wouldn't be nice to have my fipples poke through the fabric, or when I want to impress with my cleavage - of course it's a push up, not that i need a push up per se, it just brings them together better and also the padding helps with concealing really good the fipples. Otherwise, I can never have that wonderful feeling of "took my bra off" because I have that Alloderm sling that is practically an internal bra, so I always feel the bra there.
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I had my exchange surgery one week ago. I have mentor high profile silcone rounds, 650 cc on the Lat flap side and 700cc on the other side. They look good except the Lat flap side kind of looks flat or sloped on the upper poleand the other side is nice and round and looks larger than the Lat flap side. I can see the size difference in a shirt. They both look much flatter than TE's which I expected. Can anyone tell me if the Lat flap muscle will relax and if it will round out like the other side and get more projection?
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Once you get the thoracodorsal nerve cut, and in time, it athrophies and completely relaxes.
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I had a UMX about a year ago, and am scheduled for a prophylactic MX on the non cancer side and Lat flap reconstruction with TEs for both on September 19. The PS thinks we'll do the exchange in December. I've always been small (A/B) and don't plan to get much bigger, so I guess there's not much expanding to do.
I had a really fast recovery from the UMX/ALND. After a week, I was working from home. The last drain came out in 13 days, and I was back in the office the next day. Because only one side was affected, I was driving in a week and a half. At 3.5 weeks, I went backpack camping for three days. But this surgery will be more extensive and impacts both sides. I'm worried about how long I might be on the disabled list this time
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