Latissimus Dorsi Breast Reconstruction
Comments
-
hi everyone, I'm supposed to have the last flap soon. I just do t know how to choose between 2 Drs that I saw. I guess I don't have enough fat to do any other types of flaps and I need a flap because BS DID NOT do a skin sparing bilateral mastectomy due to the widespread dcis. So I guess I don't have enough skin to just put in an implant without flap. I've read the posts here and seems like the lat flap is scary and painful. I'm scared I'm not choosing the right dr. How did you ladies decide on your dr
0 -
Hey hopeful, I'm due to have lat dorsi recon at the end of June, but I've chosen my ps based on his reputation. He's got a very good reputation here in Australia and conducted over 150 lat dorsi ops. He's very active in the research world, pioneered the scarless lat dorsiand recently conducted a study looking at mobility afterwards,which is going to be published by oxford university. He sees his patients several years after the op, because he likes to see how they are doing. He said there is no perfect procedure (all have pros/cons), but this is best one suited to me..I have also spoken to 7 women who had the op by him and all were happy with their results. I'd say if you can meet ladies who had gone under the knife by your surgeons then do so, gain as much info as you can to make an informed decision.
0 -
Hi Hopeful & Lottemarine
I'm scheduling a Lat Flap in May/june too. I heard bad things about it too but I also know it's the best suited for my body as well. I also spoke to a few women that are very happy they did it. I spent awhile tryign to decide. I initially tried recon w/o the flap using an implant and fat injections. They are still different cups so I think the flap will solve that issue and the tightness i get sometimes due to the radiated skin.
0 -
Hi Hopfull2, Lottemarine, & El Tigre, I am very happy I did the LD flap. Make sure you have 2 or 3 consults before choosing your surgeon. I would make sure they have done many LD flaps and ask to see photos of patients they have done a LD flap on. Also, I preferred round implants so I made sure my surgeon used rounds not anatomicals. Also, they took as much skin as possible because I had IBC and it was in my skin. They were still able to expand me to 650cc's with the flap. I am very happy with my results. I have no limitations and I can do everything I was able to do before including interval and strength training. Private message me if you want to see photos or have any questions. Good luck! <
0 -
Jo,
It's called costochondritis. It's a not-so-uncommon (sometimes life-long) side effect of mastectomy. It's not related to the LD flap but to the mastectomy surgery itself. It's part of the so-called "PMPS" (post mastectomy pain syndrome). Even if normally it's a young people temporary condition, it's a chronic condition in post-mastectomy patients, when it appears. I have it. Unfortunately it seems it's here to stay. For me personally a heat pad seems to help, also stretching, and bad or cold weather is definitely making it worse.
So no worries about recurrence or heart conditions - at least not more than usual. I know it freaked me out in the first couple of years and got quite a number of MRIs to rule out everything else, but that's what it is and I got to live with it.
0 -
I just want to warn those that have had radiation to do your homework. I chose to do the ld flap and it went necrosis and had to be removed completely. I now half to go through months of therapy in hopes to be able to do everything again.
The other thing is that if my ps had been honest with me I would not of done it. I had asked about my ability to lift and manipulate 75 pounds above my head and was told that would not be an issue. Because my job requires this I I may never be able to return to a job I loved
0 -
Joanne, I'd check on the lopsided part. Gods forbid, doesn't sound like LE and I hope you didn't get the same problem I did, that I had to have surgery last year to fix. When they harvested the LD muscle they messed up the fascia of the muscle underneath (the abdominal oblique) and that muscle started herniating. I didn't notice until I lost weight.
May I suggest for you to go ask for an MRI or CT scan of that area? The surgery to fix it is not that bad and fairly short, but if it doesn't get taken care of in time you can get the other stuff in your abdomen starting to herniate on that spot and that can be really nasty.
0 -
Smpr, welcome to the BCO boards. Glad you found this wonderful website. I am so sorry your surgery has complications.
I am going to have to have a Lat Flap soon. My implant became infected and had to be removed, now the tissue is not healing. Two surgeons have given this as my best option. It will provide healthy tissue for the chest wall to heal.
My questions are, does this mean I will still have the skin on my chest? I understand they will slide muscle around to my chest wall, but is the skin on top new skin, or the skin that is already there? It is the skin that won't heal...the surgeon said putting healthy muscle with a good blood supply will give the skin something to heal to. And as Smpr said, I did have rads, which is the problem...have others of you here had the flap fail and become necrotic? Then what happens? What is the treatment for that?
Admittedly, kind of scared here.
0 -
I agree with SMPR DO YOUR HOMEWORK. Having the Lat Flap was the BIGGEST mistake of my life. I wonder if I could possible have the Lat muscles put back into my back? I will probably be in pain the rest of my life because of this surgery. 3 years out and still daily pain. SOOO not worth it!!!!!!!!!!!
0 -
tangles...oh no, so very sorry!
0 -
unfortunately, I don't really have a choice. My wound is gaping open, will not heal. The tissue is not healthy enough to grow together, needs to be replaced. What else can I do?
0 -
Tangles, unfortunately, no, the surgery is not reversible. I would suggest you get in touch with Gina Maisano on that. She had the LD flap reconstruction at about the same time as I did, and she used to be an athlete as well (swimmer). She had in the end to remove the LD alltogether by what I remember. She went ahead and founded the "No Surrender" foundation and also has published a few books. This is the link to her foundation, try to get in touch with her:
Meadow, yes, the LD flap doesn't have to have skin flap with it. The skin flap is only used when the skin on the chest has been compromised by radiation. I had skin-sparring bilateral mastectomy and the LD flap was without taking skin from the back, just the muscle. You say the skin is compromised, I don't understand why the surgeon doesn't just remove that skin area and just bring healthy skin from the back when he moves the LD. That is the most common procedure, this type of reconstruction is usually done when the skin on the breast has been compromised.
Not sure how keen you are on natural remedies, but if you don't mind (and you don't have to follow my recommendation) I would suggest you start taking some propolis - in whatever form, tincture, pills, raw. It is one of those miracles of nature and it does help with healing. Just one of the many articles on propolis : Propolis benefits
I usually get my supplements at Puritan's Pride online, I found that nobody can beat their prices and the quality of their products is really good. Being on disability price is quite important for me. Here's their deal of the week for propolis: Bee products
Good luck to you both
0 -
Thanks for the info seachain, I will check it out
0 -
Hi Meadow,
I had the skin graft from the back to replace the damaged radiated skin. It healed just fine!
Yes, it is not as comfortable as the non-lat side, - but it's ok. Takes more time than I thought it would to feel better, but some ladies had more pt and that helped. Remember that many poster do not return to the boards when done with procedures and treatments. They move on and put it all behind them. Think positively!!
Hugs to you and all here
0 -
Tangles - not sure if this is an option for you but I had DIEP flap surgery 6 weeks ago and the surgeon was able to remove the lat flap from the affected breast. I had BMX with lat flap in my left breast back in October 2015. Breast implants were put in February 2016 and then removed both in November 2016 due to capsular contracture in the left breast. I too always had a lot of pain and discomfort from the lat flap side. I tried being flat for a couple of months but I still didn't feel comfortable doing that. I decided to research DIEP flap surgery as my last resort with breast reconstruction. I found a microsurgeon who said he could take care of all my issues and he did. I'm thrilled with my results and how I feel with the lat flap gone.
0 -
Thanks another, my friend. I was thinking of you and your success. Good to hear good stories!
0 -
fipjoemom I can not have DIEP as I had a tummy tuck years ago.
0 -
Jo, not bee pollen, bee propolis. It's a completely different thing. I posted links in my post click on them and read.
0 -
just found out I am scheduled for Lat Flap surgery on Wednesday. Wish me luck.
0 -
Jo and Tangles, - I hope that you both find relief!!
Meadow, - we'll be holding your hand in spirit on Wednesday! One more hurdle, but you'll do it!
Hugs from NYC
0 -
Hi Everyone. I have surgery booked for June 9/17 for lat flap and implant. This will be my 4th surgery on this breast. I'm calling it a RE-reconstruction, because my previous reconstruction failed. I had a tissue expander placed at the time of mastectomy, and we exchanged the expander for implant too soon after radiation (because I needed an MRI on my other breast). My incision couldn't heal that quickly after rads so it opened up, became infected and I needed emergency surgery to remove it. I've been flat since.
My family is being supportive but I can tell by their questions that enough is enough and they want me to stop. But I can't live this way. I am trying to manage my expectations better this time and not expect my results to look perfect... I just want something. So I can look in the mirror again. So I look somewhat normal in clothes. So I'm not fussing with a breast form, trying to make it look right.
I'm getting quite brave about surgeries in general... but this one scares me. I am concerned about the scar on my back, added ROM difficulties (my arm is already unhappy), the pain of recovery, and of course.... what will it look like.
I have seen pictures... some pretty good and some pretty bad. I would like to hear your experience please. Thank you.
0 -
hi sugar, I totally get u. I've done pretty well with my other surgeries. But this one is making me nervous. My surgery is scheduled for 6-16. So a week after yours. I don't know how I'm gonna feel with all these extra scars, I'm not expecting perfection don't think any of US are but given what we have all gone through I just want to look normal and heal properly
0 -
Dear brave ladies, experiences vary so much it's hard to tell. The only thing that can be done is to wait and pray. Me personally I had a horrible experience and I'm disabled for life due to this surgery. The look - now that's a completely different issue. The reconstructed breasts look absolutely gorgeous and once the scars faded, it's very hard to say they're reconstructed. I'll post a photo for you that shows as much as possible without violating any rules of decency, in order to give you some courage that there is a silver lining out there. At least that. Of course results vary from person to person and from plastic surgeon to plastic surgeon, but most of the LD flap reconstructed breasts do look very good. Sp even if I have so many issues, my silver lining is that I'm rapidly growing into the late 50s but I can go out without wearing a bra and still looking fabulous.
So good luck for both of you. Please come here often to tell us how it's going and be sure we'll try and help as much as we can, even if it's just moral support.
0 -
seachain, your boobs look awesome! So sorry that you have pain from the surgery. Thanks for sharing.
0 -
Hey sugar and hopeful, I'm also scheduled to have the scarless lat dorsi on 28th June. I took a long time researching options and finally bit the bullet. It is scary but hopefully everything will go ok with good pt recovery. There's no ideal recon, just gotta hope it goes well.
Sugar- do you know you can get scarless?so no back scars..that's what I'm having done.
Best of luck ladies with you ops and recovery. Look forward to hearing how it goes.
0 -
Thank you all for the support. Another, Madison, seachain, everyone.
0 -
Actually, yes, I know I've watched a video in which they did the whole LD prelevation through the incision in the chest. I thought it was awesome.
0 -
Hello everyone. I'm just going to put it out there once again for those of you still struggling with the enormous reconstruction decision. Consider talking with a PS who does the PAP flap. If you are not a DIEP candidate and carry some weight in your inner thighs, the PAP is a muscle sparing vertion of the TUG using the profunda artery instead of the gracilus (sp?) muscle. I'm having bilateral surgery in July due to failed TE on my radiated side and will let you know how I do. Wishing you all good health.
0 -
tangles- what about SGAP flap to replace your lat dorsi flap?
Anyone looking at doing reconstruction of any type needs to research what their BS/PS is recommending as far as side effects, long term effects and before & after photos (including harvest site). They all have their pros and cons, it comes down to which procedure you think will take away as little as possible from you while you gain breasts. And don't forget that sometimes the BS/PS doesn't even say anything about recon options they don't perform and leave you only with a choice of the procedures that they offer which may not be the best option for you personally.
0 -
Wow, you're all giving me lots to think about. I am sorry several ladies here have also had failed implants / TEs. This is some serious stuff we're contemplating and we have no guarantee of our results and how it will affect the rest of our body. I already have limited ROM in my arm and I don't want to make it worse...
Seachain, wow your breasts do look amazing, your picture does help. But I'm so sorry your surgery has affected your health, leaving you disabled.
It's amazing what we are willing to endure, all these surgeries, expanders, implants, fat grafting and donor sites. When I first met my PS she told me outright what was involved in the process, but not how it would make me feel day to day. And I had no idea the failures...
I need a group hug
0
