Latissimus Dorsi Breast Reconstruction
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Hi,
Just wanted to share my experience as well. I originally had bilateral mastectomy with expanders; a few weeks after I started to have complications on left (radiated) side; expanders exchanged for implants; had several infections on left side with hospital stays and abx thru picc line; finally after 5 months told surgeon I want implant out of left side; she suggested lat flap with fat grafting and it was the best thing for me- after all the issues I found out there was a 20% chance of failure with radiated side and implant. I wish I had known that- would have gone straight to lat flap! Anyway, I had it done in June, and another fat grafting procedure in Nov to fill in and round out. Before I had fat grafting I was back in the gym after 6 weeks. Still have pain periodically on left side- from back and pec area, but I figure it is expected. I am almost back to my "new" normal- strength is diminished on left side, but I will eventually build it back up. I still have implant on right side- no issues there. I actually forget that it is there most of the time- it looks and feels natural.This has been an incredibly difficult journey- worse than cancer treatment- but reading through boards here helped tremendously- to know I wasn't alone or crazy.
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Hello Wonderwoman74
Hello Wildtulip
Our children are 8 & 10 , old enough to help out a bit!! Fortunately my sister is a nurse and will be spending a week post surgery to help out , my mother n law has been gracious enough to make some ready to go meals🙏🏼
I am very fortunate to have a good support team since the beginning. It is, as you all now a process. I find it encouraging to hear other's speak about their experiences and I Appreciate the time you have taken to reply. It is a big decision and I suppose because it is elective it seems harder to make. Are you physically able to get the kids off to school right after surgery ? It is nice to know you are not alone and not everybody understands nor should I expect them to
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Chery, I had my flap in summer, so didn't have to contend with the pressure of school mornings. I'm thinking your sister will need to get your kids ready for school the week she is with you post op, but you can likely manage after that. It will be good for you to then have the day time to rest while they are at school! Best Wishes!!
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Thank you kindly, I will try to update as I go along
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HI All -
It has been a while since I've posted to this board. My bilateral mx & bilateral lat flap (day after mx) is approaching the three year mark (April). I had radiation on both breasts prior (dx'd three times over 16 years), so my options were very limited as to reconstruction. My PS was adamant that the only procedure that would work was the lat flap. I'll be honest, the recovery was difficult at times, but I think that was mostly due to my own expectations. My physicians informed me as to what to expect following the surgeries, but I still thought I would be up & about & back to routines within a week. It was more like 5 1/2 - 6 weeks before I really started to turn the corner & back to my normal activities. Looking back, there were times I wished I didn't have the surgery based on those unreasonable expectations, however, I am so happy that I did. My PS is awesome, & I am amazed at how natural & symmetrical everything looks. I also had nipple sparing, so I think that contributes to looking very natural as well.
My life today is a new normal, & I'm ok with that. I have no limitations, maybe feels a little weird when pushing myself to lift, pull or tug, but it's all good. I have some tightness now & then, but not uncomfortable, & certainly no pain. Again, the decision to have this procedure was definitely the right one for me.
I wish you all much luck & health as you move forward in this journey.
Soft hugs...
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LD flap is not at all "less invasive". Anyway, DPiggy mentioned a thing that has to be said. The recovery is much longer than on regular implant, can be anywhere from 4 weeks to 6 months or even a year. One thing that you have to keep in mind is to not try to do things too fast, all you will do is to extend your recovery. Especially if you are taking pain meds after the surgery, it will mask what you should and shouldn't do, as you don't feel the pain - the body's way to tell you "stop doing this". And you can not just extend the recovery time but actually injure yourself and need more surgeries down the road.
Honestly I do not know how much of my issues happened because of the convulsions I had after surgery. My surgery (BMX + immediate bilateral LD flap reconstruction) lasted over 10 hours, so because I was under for so long and it was such an extensive invasive surgery my body reacted with convulsions as soon as I came awake. I was perfectly conscious but couldn't stop the convulsions, my body didn't listen. I was terrified and I remember thinking "something will break, it's impossible with such horrible convulsions something not to break somewhere". It took them more than 10 minutes to get the convulsions to stop. I remember I was COLD all the time the convulsions lasted, horribly cold. It was way past simple shivering, my body was shaking so bad they had to hold me down so I wouldn't fall off the bed. No idea why this episode came to mind just now.
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Seachain, I'm sorry for all you have been through.
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Hi,
I had a BMX and we tried to get by without a flap and just with fat injections and implants. I just don't have enough skin there to match my other side. It's like a small B vs a C cup. I am debating a Latissimus Flap. My Doc said he could maybe get away with just the skin flap but recommends the entire flap including the muscle. I know this will make my left side less strong but does anyone know how long this might last? I am 38 (36 @ diagnosis) and lifted weights (10-15 lbs) before this and would like to get back to that if I have this surgery. I fear it will hinder that side and in result my bones will suffer (on Zometa and I am mild Osteopenia).
Does anyone have good and bad experiences with their results and their journey of recovery? I have read a little bit of this thread and understand that everyone is different and some have issues along the way. A woman in my get together group that we meet with through out the year just had it but her experience going into the surgery was a difficult one. She had to do the flap due to extensive irritation and swelling of fluid above the expander.
Any advice is greatly appreciated
Alicia
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Sweetheart, you might get really bad issues. Can't they do a DIEP flap?
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Seachain, i don't believe so. I don't think I have enough down there to use. But I'll definitly doubel check
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I would definitely get a second opinion from a doctor that specializes in DIEP flap surgery. I had a lat flap done on my left breast (because of prior radiation) with tissue expanders during my BMX in October 2015. Had implants put in February 2016, then had both removed in November 2016 because of capsular contracture on left breast. I decided to see a surgeon that does many DIEP surgeries to find out if I would be a candidate. He said I was and he could help fix my issues from the lat flap. I'm scheduled for surgery in March and I just wish I had this surgery to begin with. Most plastic surgeons push the surgeries that they are able to do I'm finding out now. My biggest regret so far has been dealing with the lat flap.
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Not just the ones they are able to do, but the ones they try to get experience in and increase their portfolio. The thing is, the LD flap is irreversible. So are any of the others involving muscle (TRAM, GAP, etc). But the LD is the biggest muscle in the body and it's there for a reason. You may encounter severe side effects from the surgery. Yes, there are many ladies who did just fine with it, but then there are the others (like me) who became disabled for life.
DIEP only takes fat and skin. Research everything before taking such a major decision that will effect the rest of your life. Doctors don't tell you everything. Ever.
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Hi there , I was just getting ready to post an update of my LDF, I am 1 week post op, and have to say I am very fortunate . I have no pain at all in my back can twist already and sleep on my back. I was very concerned and nervous about having the surgery because of the risks mentioned above. Finding a PS who specializes in these surgeries, And is patient in surgery I think is very important. I have tightness in my chest from Expanders. The problem I am having is the muscle that is at the front is very tight, which causing pain from the contracting muscle. So I keep it warm and take muscle relaxers at night. This is very helpful. I hope this was helpful. My experience but a very good one thank God. Also personally speaking I would not go to a PS who would do it any other way, because the failure rate is too high and they know this !
Best fo luck in your decision
Cher
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Good morning,
Bilateral Lat flap was December 26th and my ps placed expanders at the same time. Exactly one month (January 26th) the incisions opened on both sides and I was told, nope it didn't work. I had one more surgery to remove and clean out (debried) the area. The news and consequential surgery broke me mentally. I will try not exaggerate here, but I will say that the lat flap was by far and away the most pain I've ever had from a surgery. Worse than childbirth, mastectomy, implant removal, impact exchange, all of it. It took every bit of willpower just to get up and down in bed and I would have survived the trauma mentally if it had worked. To go through it only to have it still fail was devastating.
So now I have two very small nubs with nipples on them, a v-shaped scar on my back, a lump of something under my right arm, and i have to wear prosthetics to work every day. My PS says "let your body rest and we will try to place a small boyish size implant in July". I don't know if I have it in me to do it. If I go for that one last surgery and it fails again, I will feel like I put my family through more recovery and pain for nothing.
For now, i am focusing on trying to get mobility back in my arms and back and not worrying about what I will do next.
Lat flap, especially bilateral, is nothing to sniff at. My daughter is 12 and a pretty tough kid. She helped me everyday and stood by my side through all of it. She has withdrawn from me to a degree because it was so hard for her to see her mom in such a state of pain and pain induced craziness (I started having spasms and was told I was digging through old prescriptions with tears streaming down my face, begging to be given anything that would make them stop). She was witness to weeks of alternately sleeping, being high from the pain medicine, begging for more medicine, and generally being a child. Now that I am lucid and more myself, we are getting back to where we were, but I am daily aware of what this surgery has and will continue to cost me.
If I could go back, I would stay away from lat flap and save myself that heartache. I could not have known it would fail, so I don't kick myself too hard, but I feel like my ps should have given me more realistic failure scenarios and less raw confidence that this would absolutely work. I still respect him as a surgeon. I just think they all think they are the greek god who can fix it this time and don't like to fail.
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Rltoomey--I am so sorry for your experience. I wish there were magical answers out there for us all. There is no right or wrong answer.
Take your time learn to love yourself and really decide what is best for you.
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I am new to this and I am terrified. My story:
May 2016 breast reduction
July 2016 mastectomy in both breasts due to cancer cells in both
August 2016 emergency surgery to remove expanders (horrible "new" product)
Due to constant leaking from all over both breasts my doctor wants to do the latissimus dorsi flap surgery to help in healing, and he said it would help with my reconstruction. My surgery is scheduled March 28th
I am terrified. Not being cut on my chest (this will be #5-- had a breast lift 25 years ago) but I am beyond scared about being cut on my back. The FOUR drains I will have to deal with aren't helping my fear.
Psychologically this is damaging. I feel picked on. Cursed. Like nothing is ever going to go right, and this nightmare will never end. I have an appointment to see a shrink in a few weeks to get me something to get me through this. Sick and tired of the crying for no reason. (cried during a Wayfair commercial!!!!)
Also, does anyone know how they flip you over during surgery? I am also having nightmares about this. I can't find anything online to tell you how this happens. (and I am a google queen)
Thank you in advance for your help!
Angie
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Angie, - I had one lat flap, not both, and I, too, was terrified, but I must admit, - the anticipation was worse than reality. I do not know how the back was worked on, but you have to trust your surgeon to do it well. Be SURE that your surgeon has a great deal of experience in the lat flap procedure! The drains were annoying more than painful, and the general recoup time is longer than other reconstruction procedures. I was fortunate in only needing extra strength tylenol once home from the hospital, - but I had the pain meds on hand, just in case! Some people have pt, which does help gain back range of motion. I have a wonderful ps, - I hope yours is, too!
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PS Gluteus Maximus is the largest muscle in the body.
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Please look into DIEP Flap reconstruction before you decide on the Lat Flap surgery. I had BMX with lat flap placed in left breast. Later had implants that were removed because of capsular contracture in left breast. I am now scheduled to have DIEP next month. My new PS said he can fix the issues I now have with the lat flap.
I have never liked the lat flap and it has been a constant source of pain and discomfort. Do your research into other breast reconstruction options before making this decision.
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As with any procedure, even relatively minor ones, - there are always risks involved. There are stories of people thriving after major procedures, yet others can suffer serious complications after even a dental procedure. You have to do your homework, and make the best choice for your own situation. I was not a candidate for DIEP, because there wasnt enough tissue for double reconstruction, and I was also concerned about abdominal incisions and healing time from that, too.
Look for stellar references and recommendations for any surgeon/doctor!!
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I had a rock star surgeon, nationally renowned, specialized in lat flap, and it didn't make a damn bit of difference for me.
I'm the lady Jo was referencing who had a bruise the shape of a hand on my back. I felt like I'd been hit by a truck after surgery. I feel like they must have dropped me during surgery by mistake. My muscles, both superficial and deep, completely seized up on my surgery side, and I am still working on getting them to un-seize, almost two years out. I feel like my surgery side is encased in cement. Until recently, when I started with my new soft tissue rehab guy, my torso was pulled to the right (surgery was on the left side). Completely out of my control.
I have been through endless hours of PT and other rehab approaches. I am a competitive adult figure skater, so my upper body is very active. It's not like I'm sitting around doing nothing. My new rehab guy said that if I wasn't active, I'd be in even worse shape now. He said the scar tissue lays down webs and gets worse with time if not treated.
The majority of women who have trouble with this surgery seem to be young, thin and athletic. Not all obviously, b/c nothing is absolute, but the majority of those I have spoken with. In addition, the majority my surgeon and my soft tissue rehab guy have seen are also young, thin and athletic. So that has to be a contributing factor.
I may have had trouble with any reconstruction option I chose. I may have had trouble with just having a mx. I have no idea. All I know is that the lat flap was the wrong decision for me.
I'm happy for the gals who have had good success. They are in the majority, fortunately. The cosmetic outcome is quite good with this procedure.
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Angie, I can understand your fear. As with most of us here, whatever surgery we have chosen, the decision is not easy. I wrestled with the possibility of the LD flap for years. Utimately Jo & Nash's experiences rang loudly in my ears. I'm a personal trainer and prior to my failed TE attempts had a muscular upper body. I finally opted to go with a PAP flap since it is muscle sparing and I carry my weight in my thighs. Otherwise, like Fipjoemom, I would have done the DIEP. My surgery is scheduled for July, so still time to agonize! Everyone here has been enormously helpful and I am so grateful for the honesty, openness and caring that you've all shown me. I intend to share my experiences going through the Pap reconstruction. Although quite similar to the Tug, it is a newer procedure. So there isn't a huge amount of information on the Pap online. Best of luck, good health and healing to you all especially Rltoomy, Jo, Nash and anyone reading who's suffering, I am praying you get the relief and the successful result that you desperately need and deserve. HB
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Thank you, HB. Best of luck with your PAP! I'll keep an eye out for your updates.
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Thank you Jo & Nash for the good wishes. Again, I'm so sorry that you are both struggling with the fallout from this surgery. I understand that all of our options are not perfect and involve a trade off, but pain is just too unfair! Seachain, I'm thinking of you too and I thank you for your candor. My surgery is five months away. I've already heard of one dreadful scenario and several successful ones. I'm just so unhappy with my body as it has been these last two years. I'm finally ready to hold on to faith that this will bring me to a more contented normal. Not perfection, not restoration but a reconstrcted more complete feeling me with scars that I look forward to watching fade away.
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hi everyone, I too will be having a lat flap soon with Ing the next couple months. But reading some of these posts on the side effects is so discouraging. My BS and PS both said I'm not a candidate for diep cuz I don't have enough fat tissue. I'm 5'3 109 lbs. so I'm on the thin side. Although I see a pouch on my tummy the said no it's not enough and that that's mostly loose skin from My pregnancies. I'm only having it done on the right side. I had too much skin take at time of my mastectomy due to widespread dcis. I just hopefully I making the right choi
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Hello Hopfull. I'm 5'3½" & 110 lbs. PS also said not enough fat for DIEP. Ihad Dcis twice in the same breast. 2nd time was found after radiation. You don't mention having having rads in your description. If you did NOT have rads that improves your chances of success for any method you choose. If you carry any weight in your thighs, and if you want to explore a muscle sparing option, you may want to meet witha Ps who does PAP flaps. Not risk free or a perfect option, but thought it may be worth checking out for you. Best of luck & good health to you. Knowledge is power.
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I'm having umx on 3/2 with good chance of radiation. Ps recommended waiting on recon. Too thin for diep. I'm 5'6 130. I was shocked I didn't have enough fat. He recommended LD flap. Very scared about that one due to some bad experiences. Anyone out there have good experiences with that
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hi honey badger, no. I didn't need rads. Tomm is my last chemo but no rads after thank goodness. Thanks. I will look into that new procedure
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Hopfull, congratulations on your last chemo!!! It's also great news not to need rads! Imho you will must likely do well with whatever you choose. Jo, you are so right... I hope tomorrow is a better day for you.
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Honeybadger, I think that you and I were considering lat at the same time. I hope your new procedure goes well! It is very encouraging that there are more options all the time.
Hopful2, - Jo is right that many have left the boards and move on, esp when procedures and treatments are happily behind them. One name that hasnt posted lately is warriorwoman. Her final lat results (she posted a photo) were amazing.
Wishing all here comfort and good health!!
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