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Latissimus Dorsi Breast Reconstruction

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Comments

  • Smpr
    Smpr Member Posts: 9
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    Seachin I am with you if I had known that it would of messed my back and chest up I would not of done it. Right now I am having an allergic reaction to the implant on the other side and trying to deal with the pain and burning cause they will not deal with anything other than the open wound till that heals. My bad point is that I had asked about complications with the back and told them what I do was told that I would have no problems with any of it. I can not even lift 5 pounds with out wanting to cry. Oh and popping stitches around the implant hurts like an sob

    I did find the stretches on there to help with the tightness in combination with the flexiral I am on. She does state the complications that the doctors will not tell you.

  • Amosmoses1
    Amosmoses1 Member Posts: 1
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    I'm not sure if this is the right place to post this, but here goes... my ps told me initially that a lat flap was the only choice for me. I delayed reconstruction for a year and a half due to circumstances beyond my control. Now, he has agreed that I can get an expander (surgery date set for June 28) and "possibly" stretch my skin to get an implant. But the real plan is to stretch a little because of radiation, then do the lat flap next summer. I work at a school, so waiting another year is my decision. I guess what I want to know is, has anyone else done the expander, then lat flap on a radiated mx site? Not planning on getting an implant unless there's a need for more bulk to make the breasts match. My ps said doing it this way would give me the most aesthetic look he could give me, because I still have one natural breast that is, according to him, quite perky. lol! Hope that all made sense!

  • leftduetostupidmods
    leftduetostupidmods Member Posts: 346
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    It does make sense and that's how it's done. I would advise you though to check with your insurance. Health insurance is mandated to cover reconstruction costs only for 2 years after the initial mastectomy. Anything that is beyond that, unless it's life-threatening or complication (capsular contracture, infection, etc) is NOT covered. So make sure you get your timing right, taking into consideration that you might need revisions for at least 6 months after the surgery. It took me 2 years and 4 revisions after the reconstruction.

  • anothernycgirl
    anothernycgirl Member Posts: 821
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    Amos, - I went direct to small implant with lat flap procedure. Skin graft provided the needed healthy (un-radiated) skin.

  • sam2u
    sam2u Member Posts: 43
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    Seachain---"Health insurance is mandated to cover reconstruction costs only for 2 years after the initial mastectomy. Anything that is beyond that, unless it's life-threatening or complication (capsular contracture, infection, etc) is NOT covered."

    Where did you get that information from? I can't find any time constraints in the The Women's Health and Cancer Rights Act of 1998.

  • Journey2014
    Journey2014 Member Posts: 65
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    Sam2U,

    Is this mandated insurance including the military insurance?

  • motheroftwins
    motheroftwins Member Posts: 14
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    Getting really nervous.. Surgery is Monday. I am 5 years out from surgery. I do have capsular constracture. No problem with BCBS at all. Please keep me in your prayers.

  • sam2u
    sam2u Member Posts: 43
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    Journey2014--I am not sure I think it is group coverage. Private coverage may be a state by state. Not sure where military coverage falls in that, but the Tricare "Is It Covered" page says that it does cover reconstruction with no mention of time constraints.

    motheroftwins--sending you positive vibes!!


  • diannep
    diannep Member Posts: 4
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    Hello! I am glad to find this forum. I was just diagnosed stage 2a and need a mastectomy on my left breast. My PS is encouraging me to do the Lat Dorsi. Are you all happy with the results?

  • diannep
    diannep Member Posts: 4
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    Hi! So, from what I understand, you didn't like the lat dor reconstruction?

  • Hopfull2
    Hopfull2 Member Posts: 287
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    hi everyone. I had my lat flap on June 9. So I'm 2 days post surgery. I had mat flap on right side only and prophylactic mastectomy on left side with TE on both. I have 5 drains and a pain pump. So that's a drag. My pain is ok so far. I was discharged today from the hospital. Surgery took like 7 hours so this is def a long procedure. My TE's are not filled a lot. I think she said like 140 ccs. But she will start filling once I'm healed up a bit. So far it's not as bad as I thought it would be. But we will see. It's only day 2.

  • meadow
    meadow Member Posts: 998
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    Hello ladies, and a big hello to the newbies!

    I am 5 weeks out post lat flap, healing well, looking good. Happy I did it, and I was very reluctant. Good luck and healing to all!

  • anothernycgirl
    anothernycgirl Member Posts: 821
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    Hi Meadow! Happy to read that you are doing well!

    I hope everyone else here is, too!

  • meadow
    meadow Member Posts: 998
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    Hello dear another! Thank you for being so encouraging during this surgery. It helped me more than I can ever say.

  • anothernycgirl
    anothernycgirl Member Posts: 821
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    Meadow, - Thank you for your sweet words. I am so glad that you are healing well!!


  • TWills
    TWills Member Posts: 509
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    Hello, new here:)

    I had my BMX in Dec and my PS didn't end up placing my TE's in at that time because during surgery they found I had one node involved and she doesn't place TE's if there is a chance of radiation. Waking up to find out I didn't have the TE's was upsetting to say the least. Anyway, I just went for a second PS opinion and I also just finished chemo last Thursday, the new PS said that we could place the TE's now and then do radiation so we could form the pocket before the skin is radiated. RO is perfectly fine with this btw. He also said that the exchange would be a year after radiation ends with likely LDF on the radiated left side. My main question is, is LDF typically done when TE's are placed or when exchange/implant is done?

    I'm also extremely anxious to have the TE's in for a year given how uncomfortable it sounds like they are!



  • Smpr
    Smpr Member Posts: 9
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    twills63763 it can be done either way. Most common is expander first. If you wait until after radiation to start then it should be 6 months to a year after completion of radiation. At that time it would be the ld flap and expanders with exchange done months after last fill. Either way the expanders will be left in place for months before exchange and any revision can be done.

    My warning/reminder is that radiation can cause complications during and after reconstruction especially with implants.

  • TWills
    TWills Member Posts: 509
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    Thanks Smpr, so much to consider and so much info to weed through. I'm glad there are options but my goodness it's hard to make decisions when you don't know every question to ask. Overwhelming to say the least.

    Thanks!

  • meadow
    meadow Member Posts: 998
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    TWills, as Smpr has said, radiated skin does not respond to surgery as you might hope. I had implants at mastectomy, then rads, this was 3 and a half years ago. 6 months ago I had a revision to my radiated side to correct some contracture and scarring. This revision surgery did not have a good outcome... I got a severe infection, and the incision just refused to heal...that old radiated tissue just did not remember how to grow back together! I had an open wound for months. I finally had to have a Lat Flap, using tissue from my back to replace the skin on the front. The Lat Flap surgery has been great so far, I am about 7 weeks out from it, and it feels good, looks good, thank you God! I tell you this to let you know, my PS expected a good outcome for me with the first revision surgery. But my skin did not do well, at all. And it looked good before, it looked healthy enough, but it was not. You may have a totally different result, I just wanted you to know there is this side of the coin.

  • TWills
    TWills Member Posts: 509
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    Thank you Meadow, I'm glad it's going well this time:) BothPS's I've seen definitely said I would need a LD Flap on the radiated side to have the best chance at a positive outcome. The second PS just suggested to put the TE's in now before the skin is radiated to create the pocket before the damage is done. Either way I know it will be a work in progress. Although I'm not looking forward to having TE's for a year minimum if we do it this way, I'm hoping it could give me a better outcome or at least the chance at it.


  • motheroftwins
    motheroftwins Member Posts: 14
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    Hello, I am 8 days post Lat flap on the left side. I was inpatient for 2 days and have two drains, Today is my post op appt. So far I think it is going better than I was expecting. So I happy with that. My back incision is a lot bigger than I thought. But pain is manageable. Prayers one or both tubes come out toda

  • meadow
    meadow Member Posts: 998
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    Hoping for your drain to come out! The back scar is a big one!

  • Hopfull2
    Hopfull2 Member Posts: 287
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    hi everyone. I'm 11 days post surgery. I have one drain left in out of 5. And it's the one in the back in the lat flap side. Everything still feels very tight. The non flap side hurts more for some reason. Maybe due to the mastectomy they did also on that side idk but it hurts where the drains were. I'm sure I'm just still Tender still. But other than that Dr sats im healing well. I can start filling my TE in about a week or 2. I'm not on hard pain meds just ibuprofen when needed

    Motheroftwins, I'm only couple days ahead of you. How's your pain and arm mobility.

  • motheroftwins
    motheroftwins Member Posts: 14
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    Hopefull2. I am doing good, No more pain meds. Just taking ibuprofen. My drains were not removed yesterday but should be tomorrow. Surgeon said he will start filling expander in 2 weeks. I am happy how my foob looks already. I was so lopsided prior to surgery due to radiation damage raised my left side so high. I look even. Tears of happiness!!

  • motheroftwins
    motheroftwins Member Posts: 14
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    I'm not sure how much was filled in expander during surgery. ?? Maybe 200?? 250? I have a little boob. But even:

  • Lula73
    Lula73 Member Posts: 705
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    TWills- have you considered a DIEP flap instead of a LD flap? No expanders and no implants. You can learn more about the procedure at www.breastcenter.com. My BS wanted to do LD even though both he and my ob/gyn stated that radiated skin and/or chest wall don't do well with implants. I did my own research and glad I did. Had DIEP flap at same time as mastectomy in Feb. very happy with results so far. BS never mentioned this option because There aren't any surgeons locally a who do it. We did not mind travelling to get the better odds outcome. Feel free to pm me with any questions

  • Lula73
    Lula73 Member Posts: 705
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    TWills- have you considered a DIEP flap instead of a LD flap? No expanders and no implants. And you can do it before rads.You can learn more about the procedure at www.breastcenter.com. My BS wanted to do LD even though both he and my ob/gyn stated that radiated skin and/or chest wall don't do well with implants. I did my own research and glad I did. Had DIEP flap at same time as mastectomy in Feb. very happy with results so far. BS never mentioned this option because There aren't any surgeons locally a who do it. We did not mind travelling to get the better odds outcome. Feel free to pm me with any questions

  • Smpr
    Smpr Member Posts: 9
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    twills63763 like meadow said radiated skin is more prone to infection. I am 16 weeks out from a failed ld flap and in that time I have had 4 infections and an open wound that will not heal. They are going to be starting hyperbaric chamber treatment in hopes to get everything to start healing.

  • anothernycgirl
    anothernycgirl Member Posts: 821
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    Happy to read updates of those doing well!

    Smpr, - did you have skin from elsewhere used with the flap?

    Wishing all here a speedy recovery!!

  • Smpr
    Smpr Member Posts: 9
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    Anothernycgirl They only used the skin from my back that was attached to the muscle.