Latissimus Dorsi Breast Reconstruction
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Westieluv, like Seachain, I don't wear a bra unless I need to hide my fipples. My PS said that droopage shouldn't be a problem. I think the muscles and alloderm give me as much "bra" as I need.
Madison, even though I haven't had my thoracodorsal nerve cut, I do feel the lat muscle has relaxed some. It's been very slow though. It's over a year since my exchange, but I think the muscles are feeling less tight. I don't think there has been any significant change in projection though. My PS does not cut the nerve because he says the muscle will atrophy and reduce in volume. I don't have complete symmetry either. I see the difference even in clothes, but honestly, I doubt anyone else notices.
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Scotland, I think you will find this surgery more challenging because of all the muscles involved. I tend to recover pretty quickly from surgery like you do, but after my lat flap, I took 6 weeks off. That said, if I had really needed too, I probably could have gone back to work a bit sooner maybe at about 4 weeks. I had a lat flap and TE placement on the cancer side and just TE placement on the prophylactic side. The thing that was most difficult was being able to lay down comfortably to sleep. It was painful to try to reposition when horizontal. The trouble spot was a band around my chest where a bra band would sit. I think there was quite a bit of suturing of muscles in that area, and it took a while to heal. Sleeping propped up on my futon helped. Good luck and let us know how you make out.
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2Tabbies: I am NOT looking forward to sleeping on my back/propped up. I've never been good at it, and I'm already sleeping badly (thanks, Tamoxifen). I've also told my husband that I won't be driving a week after this one. Last time, my right/dominant arm was untouched. Even driving a manual transmission was no problem. Although he's 100% onboard with reconstruction, he still seems slightly dismissive of the increased recovery time. He'll learn!
I work part time, and can work from home if I need to. I *should* be able to start working as soon as my brain is free of narco. I'm starting a new project next week that might require me to go to Africa for a couple of weeks. That's going to have to wait until November!
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Scotland, I daresay hubby is going to have to adjust. This is major surgery. They move muscles around for heaven's sake. It's not like having a root canal or something. The sleeping situation is one of the most annoying parts, and major travel definitely has to wait. Good luck!
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He'll get over it. He's only had outpatient surgeries to pin a broken elbow and fix a knee, so he has no clue. My favorite part of the post surgical instructions: "you may have some soreness for the first 3-5 days after your surgery." Ya think?
The PS was initially against sparing the nipple on the remaining side because he'll never be able to match it. Then he saw my existing nipple and wants to take half of it and graft it onto the other side after the exchange. I must admit that possibility had never crossed my mind.
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- post lattissimus dorsi breast reconstruction with expander ...Pain still after 6wks post op.
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I am scheduled to have delayed reconstruction with the LAT MUSCLE.
How long did it take you to recover?
Did the scars on your back fade?
My surgery is scheduled on September 15, 2016.
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What type of pain are you experiencing?
How long did the surgery take?
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I still have pain after 7 years lol.
Anyway, it depends if you have one side or both, it usually is around 2-3 hours per side. Not all surgeons do the incisions on the back, some make them on the sides. It takes over a year for the scars to get skin-color without pink. Recovery is not a one-size fits all thing. Some ladies recovered wonderfully after 4 weeks while others (like me) have life-time side effects.
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Njohnson, I would say it took me about 5-6 weeks to fully recover, but after the first week I was also caring for my children and maybe not resting as much as some do. My surgery was 3.5-4 hours and I had LD flap on one side and TE's placed on both. I am 3 months out and for the past week have been sick with Pneumonia. I highly suggest avoiding germs as much as possible while you recover because coughing can hurt at first, and even now with illness it's hurt a lot.
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For me, the surgery wasn't painful, per se. My issues have been with overwhelming tightness in my chest, side and back. Not "gee I need to stretch" tightness. Tightness like a vice that won't let up. I also have movement restrictions in my back when I reach forward, such as when doing housework. It's mainly due to edema, muscle spasms and fascia restrictions. Perhaps I would have had these same issues or worse had I done DIEP or SGAP, so I don't know if they are necessarily specific to lat flap.
My situation is unusual, so I won't go on too much about it b/c I don't want to needlessly scare you. But I will say that the women I've met online who have had the same problems with lat flap have all had similar body types (thin and athletic). Being young, thin and athletic seems to add to post-op problems with the lat flap surgery--I had this observation confirmed by two surgeons as well.
My situation is particularly unusual in that I am a competitive athlete--one surgeon I talked to said my lifelong athletic endeavors go far beyond what the majority of women who go to the gym or go for runs in the neighborhood are doing, and that fact has greatly contributed to my problems. For one, my lat muscle is much stronger than average (the PS had trouble moving it during surgery), and two, I move my body in ways most people my age don't. My PS knew of my background and proceeded anyhow. Had I known any of this before hand, I wouldn't have done the lat flap. So I'm just putting it out there in case you happen to have a similar background.
Most women seem to be very happy with this surgery and don't have any major issues.
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After the surgery, will chest bel flat?
Also, when is the permanent implant put in? 3 to 6 months?
I only want to be between a B and a C?
Last question, after my double mastectomy 5 years ago, I have extra fat under my arms, some people call them dog ears. Will this go away. I am paranoid when this extra skin or fat appears in my clothes. Kind of like back fat.
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Ah, nash, we're in the same boat here. My observations are the same, the more athletic you are (and especially in a sport that requires a well worked LD) the more problems you will have. Former gymnast here (and swimmer), the remaining muscles in my back were never able to compensate, I'm disabled due to this surgery, and also I had the fascia over the abdominal obliques shredded and had to go for a muscle hernia repair this past January. My surgery lasted 10 1/2 hours and I had severe bleeding when they prelevated the LD.
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Njohnson, Assuming you are getting TE's placed during LD flap, you will not be flat afterward. The amount that is put in them during surgery varies greatly from person to person. I looked like I was in puberty, but better than the concave look! Surgeons have different opinions about when they do the exchange to implants, for me it's 6 months after the LD flap. Perhaps someone else can chime in with an answer to your last question. Best wishes!!
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Njohnson, I assume you're having an expander put in at the time of the surgery. They may add a little fluid to the expander at that time. If so, you might have a little roundness. I had been concave prior to the surgery so even that little bit of fullness made me feel more normal. The exchange to the permanent implant happens at 3-6 months. My surgeon waited a full 6 months. Actually, a bit longer due to his busy schedule. He likes to wait to give the muscles and skin plenty of time to relax after we're done expanding. I think that may be why I didn't have as much change (drop and fluff) in the weeks following the exchange as some others have. I'm not sure what your question is regarding cup size. I would think you'd have no trouble achieving a B or C. Regarding the dog ears, these can be fixed surgically. Ask your PS.
Others have answered your previous questions, but I'll add my 2 cents worth. My surgery took about 5 hours. I had the lat flap and expander put in on one side, and just an expander on the other. Most of my post-op pain was in the area around my chest where a bra band would sit because there was lots of suturing there. The worst part was trying to reposition when lying down. It took about 5 weeks before I could sleep flat. At about that time, I'd say I was fully recovered. I didn't have too much pain otherwise after what you'd expect the first few days. All of my scars take at least a year to turn white. That was true of my back scars. They actually healed faster than some of the others. My surgeon did what he calls an evening gown incision. It's angled down my rib cage in back where the edge of a low backed evening gown would be. It doesn't show in a 1 piece bathing suit.
Please keep asking if you have more questions.
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I had direct implant put in at the time of the surgery. So I had a lot of tightness and pain but didn't have to do and extra surgery to switch. They were very high positioned and I had to wear an Ace bandage on the top to help them drop and "fluff".
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Hello Ladies!!
I had My reconstruction in 2012, issuing the lasstisimus muscle, I want to know has anyone had any problems with heavy lifting?
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I'm still not supposed to lift more than 5 lbs.
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Coni - I am 5 years out from bilateral lat surgery and I still can't lift much using upper body without having swelling and pain as a result the following day. I am not in pain while doing it, but swell up like a michelin tire under my arms where the muscle is tunneled and that isn't fun. My lat muscles want to engage no matter what body mechanics I attempt in lifting...so I try not to lift too much.
Editing to say that this is when I lift more than approximately 20 pounds. Lower amounts aren't an issue, but lifting 40 pound sacks of feed does it to me every time.
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I had my surgery today. So far so good. I'm drowsy from taking the pain medication.
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Great news, Njohnson8i! I hope you have an easy recovery.
My surgery is scheduled for Monday. So much to do between now and then
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Njohnson, I hope you have a comfortable recovery.
Scotland, Best wishes on your surgery.
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seachain- when did you have your surgery?
Westieluv- that explains why I feel like my left arm feels tight, when I do heavy lifting. My doctor didn't explain much about after the surgery. I was too eager to have breast again, I didn't research.
NJohnson- I'll pray for a fast recovery
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My surgery was Monday, and I came home from the hospital Tuesday after lunch. So far, so good. Yesterday, I had some nausea and couldn't stay awake. Today, I feel OK. I don't seem to need the narcotics, as pain is controlled by Tylenol. I am taking the muscle relaxers, and can tell the second they start to wear off. The surgeons are very pleased with my progress and results. I probably have a AA on the cancer side (MX/ALND last year, followed by radiation), and maybe an A on the non-cancer side. I started as an A/B, and will probably end up a B. I see the PS on Monday, and will hopefully lose a couple of drains (I have 4). I'm curious to find out when fills will start. I'm so thankful to be on the other side of surgery.
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Scotland, I wish you continued good healing. Every PS is different..mine started fills one month after my LD flap.
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coni,
It's in my signature.
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I am scheduled to have a latissimus flap reconstruction, just right side, at the end of November. I am super scared and don't want to do it. I had bilateral mastectomy with unclear margins, right side, in May. So then i had radiation, right side, in August. Is it just crazy to ask the doctor to reconstruct without using the flap? I am really athletic and I cant bear to loose that muscle and function. Do I have any other options?
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My doctor recommended the flap because the radiation kills the tissue and you need something there to hold the implant.
It has been 12 days since my surgery and I am feeling OK. No pain just want the drains remove so that I can move around more.
This Thursday, I am going to see my PS. I hope he will remove 2 of the 4 drains. In 2 of the drains, I can't measure the fluid because it is almost none existent.
I feel some tightness as if someone is squeezing me. It happens a few times a day and it is not painful.
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Kroge6,
I'd seek other options if I were you -there are other flap types if you can't go the regular TW to implant or one-step with Alloderm sling. As it was stated many times, the more athletic you are, the higher the chances to have to deal with bad after-surgery issues that can last a lifetime.
Jo,
I'm celebrating 7 years from BMX in a couple of weeks, and I still have fatigue. I think it's the chemo not the surgery, honestly. Or maybe just a cumulation of all the crap we had to go through. Also, we're not getting younger. If you're worried though, see your doc and maybe ask for tumor markers, just for your peace of mind.
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JO, I had my LD flap in June, and I'm still more tired than before the surgery. My body just requires more sleep, but then pain from med SE's don't help either. I agree with Seachain..probably a combination of things.
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