Latissimus Dorsi Breast Reconstruction
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Lula73, I'm definetly learning as I go, unfortunately you kinda have to stumble across options(that's how I feel anyway) Neither of the PS's I saw do the Diep and when I made those appts I didnt know about that options to even ask if they did. I'm sure someone in my area does, I'm in the Tampa area. Unfortunately timelines don't always work out and I feel like I wouldn't have time for that's surgery this point since I didn't plan enough in advance:/ I just finished chemo last week.
It's so unfortunate that this diagnosis comes at you like a freight train and so many important decisions have to be made so quickly. I really like all of my Dr's but wow there could be a better standard of info given that could help one navigate the system. The info on this board is so helpful but I was in no mindset to find it when I was first diagnosed in Nov, I was just trying to schedule my surgery asap. I was trying to get rid of "them" and it was hard to also think/plan ongetting them back at that time. 😳
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TWills- I know what you mean, it's a literal whirlwind when first diagnosed. It's also frustrating when the dr you're supposed to trust doesn't lay out all your options, just the ones they offer. I'm from Tampa originally and I'm pretty certain there are some docs there that do DIEP (I think they're at Moffitt) - just make sure to insist on seeing their before & after pics, and ask their failure, infection and complication rates. For comparison, NOLA's failure rate is 1% and infection rate is less than 2%. I would say NOLA's before and after pics on their website are quite accurate from how I look and from seeing other women's pics who had their recon there but aren't one of the ones posted on the center's site, In my experience at NOLA the turnaround time from the initial phone call for information to surgery (if you decide to do DIEP) is about 3 weeks. So plenty of time. It's worth a phone call to them if nothing else to discuss the possibility and options. After rads our potential for issues increases so now is the time
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twirls the easiest way is to ask if they do micro vascular or free flap procedures. That way you would have more options available along with better chances of less complications. I also will agree with Lula73 that if you are getting radiation that you should consider reconstruction before hand. Radiation causes a lot of issues and complications with reconstruction.
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I don't have plenty of time Lula73, I would have to cancel my surgery. My pre op is in less than a week with surgery two weeks after that and rads mapping two weeks later. I don't want to delay radiation any longer than I have to. I understand the risks and options and feel comfortable, as possible, moving forward with my plan. I appreciate all the advice, and good luck to everyone in the healing process! 😃
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Has anyone had a bad skin reaction on a scar away gel sheet? Any recommendation on what to use for the scars darken incisions?
Thank you in advance....
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Thank you for your input Jo-5
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My drains are out! I feel human again. I am sure you know how that is! I'm 12 days out. No pain meds needed. My range of motion is not the best. I am slowly trying the arm walks with my hand. My never did have great rom after the radiation 5 yrs again, I'm feeling better each da
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motheroftwins, yay. No more drains. I had my last drain taken out 2days ago. I still feel lots of tightness on my back and on my chest. More so the opposite side of lat flap where I had my prophylactic mastectomy done under my arm it's extremely sore It's wierd I feel worse on that side than on the latflap side. I take ibuprofen still to ease the discomfort feeling. Do u have expanders? I get my first fill July 5th. I just wish I can sleep on my side. I'm a side sleeper.
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Hopefull2, I have the expander on the Lat side. (Left). 8/2011 I had BMx so I have an 650 implant on the right. I am a side sleeper too. I normally flipped side to side all night. So sleeping has been hard only sleeping on right all night. July 10 will be my first expander fill. I think the dr does about 60cc each time. I am a bigger girl. I was very disappointed in he small size last time of 650 implants. Dr said with the lat surgery he thinks he can get 800 implants in. Time will tell! Praying 800 cc with more projecti
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Well. Let me tell you some "good news" about this whole LD flap reconstruction.
It seems that there might be even more in terms of long-term effects of it.
When I visited with my spine specialist, there was an issue with my spine slowly getting a little bit "humpy" between the shoulder blades.
Dr. said that the LD muscle DOES have a role in holding the torso upright, and that the lack of the muscle in the back does have consequences on spine alignment. And that he has encountered in his experience some hump appearing overtime, as patients grow older.
I asked "and why doesn't anyone do something to stop this surgery from being done?"
Answer "there's no study for long-term effects on the spine".
There ya go. One more thing to worry about. Like I didn't have enough.
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I have been having drainage off and on since my TE replacement with Silicone/fat graphing in June 2016.
Now, my PS recommends the LD flap, so it gets the radiated skin out and gives the best look. But that scares me. At this point I dont care about the look if no one can tell me what the problem is I am having and if LD can fix it. And am I trading front problems for back problems. It's another risky surgery, etc.
I would like to wait and see if this is just the radiation healing. But I risk emergency surgery waiting. Which I am sure will be at the worse time.
Has anyone had the LD flap to correct complications from radiation? Is it possible to have no complications from the LD?
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I had scarless lat dorsi op over 10 days now. The recovery is tough both physically and emotionally but getting there. I do have the iron bra across my chest, but find with painkillers and physio stretches the tightness is getting more manageable, as my tissues/muscles heal. I've had air expanders put in, so hoping with small regular fills it won't be so painful. Only want to be a B cup, so don't anticipate too many fills. Definitely not a walk in the park, but everyday find it gets a bit easier.
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Had my first fill today . I guess I was filled with 180 air during surgery. Today surgeon took out air. And put 240 cc. So additional 60 cc. I definitely feel tight. I go next week for another 6
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hi mother of twins, I had my 1st fill last Wednesday she just filled 60cc but only on my non lat side. She said she wants my lat side to heal a bit more so I see her again in 2weeks. I think on surgery day I got filled to 120cc. So I'm still fairly small. I just want to be a full b. So we wil SE. I know I'm feeling tight as well. I have lots of wierd sensation on both breast like the way it feels when we are breast feeding and are swollen with milk. They hurt like that. And it feels wierd Where my nipples used to be.
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Hopfull2, How are you doing? I had my 3rd fill yesterday. Im at 420cc. Today I am very uncomfortable... Very tight in armpit, shoulder blade and chest. Took Tylenol and ibuprofen and that seem to help tremdously. Thinking of you.. Hope you are doing well!!!
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hi motheroftwins, I had my 2nd fill today. My PS said she wants to take her time in doing the fills to make sure I heal properly. I'm still small. I'm only at I think 250cc. But my goal is a full b so I think that's like 300-350 cc my ps said. I was a C before (I had implants) but I'm good with a full b since I'm small framed. I too feeling lots of tightness. I still have the burning sunburn feeling on my left side and very soar on that side so today she referred me to a physical therapist. I'm glad your doing well. My next fill is in 3 weeks. What size are you trying to get to. ? Did you have nipple sparing ? I didn't so can't wait to get some tattoos put on .
Hu
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hi!
Valium helps with the fills, relieves the tightness for a little bit, poop one about 45 min before a fill if you have a driver
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I am 7 weeks out of my surgery. I was skeptical of the lat dorsi reconstruction, but so far I am satisfied. I am on my 2nd day of Tamoxifen. Luckily, I do not need chemo. I am back to exercising a little bit. I would like to get rid of my right side "back fat," now that my left side has none!
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hi diannep, I'm glad your recovery is going well. I had mine 10 weeks ago and I'm also recovering well. Your ps can probably do fat grafting once you have your exchange surgery, assuming you have TE now
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Hi ladies, My 1st time posting in this group. I had my mastectomy June 13 with expander. My skin went necrotic and had a debridement a few weeks later. I just had my 2nd fill yesterday. Now, the P.S. Is talking about a lat dorsi because of the thin skin tissue. I really don't want to go thru another major surgery and recovery. Is this the norm? Has that happened to any of you?
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Seaster, it happens more often than you think. Do you not qualify for DIEP? Normally the LD flap is done for women who don't have enough fat to qualify for any of the other procedures. Please check the new thread I made on the breast reconstruction forum. The recovery from LD reconstruction is usually longer than any of the other ones.
Sorry it happened to you. I know, sometimes we have the feeling that this will never end.
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Hi ladies! I haven't been on here in years and I'm so sorry if this question has been asked before...I didn't see it as I was browsing through...does anyone know if a LD flap can be "undone"? It's been 5 1/2 years for me and I am still uncomfortable and miserable with my LD and implants. Does anyone else have this problem? I keep thinking if they could just snip out the flap part and put smaller implants in (I think I have 700's?) I'd feel somewhat normal again? Has anyone had the it's reversed? Is it even a thing? Thanks!
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hi twinmom- I think I saw someone post about trading out their Lat Dorsi for a DIEP flap on the DIEP flap 2017 or 2016 thread and they were glad they did it after. Haven't seen where anyone just did implants though
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Thank you! I'll take a look. There will be no more flap procedures for me though! One was nightmare enough!
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Well not really "undone" as they can't put the LD muscle back, but yes, they can take it out. There are a few ladies who had it done.
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Really seachain?! Do you happen to know any of their names? That's what I'm wanting - just removed. I wish they could put the muscle back but I know that's not possible. I'd just really love to talk to someone that has it done but I can't find anywhere online where anyone is even doing it. I see my general surgeon today for a checkup so I'll ask her too (I fired my PS long ago when he told me I really need to "move on" from the pain & I haven't found a good new one yet). Thanks for letting me know this, it gives me hope!
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Twinmom, - I, too, am more uncomfortable on the lat side than the non-lat, - but I bet you would feel better with a smaller implant. Where are you located? My ps is truly a gem.
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The first one that comes to mind is Gina Maisano. She founded since a foundation, I am going to post the link for you so you can contact her.
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I saw my ps today, and asked him about the discomfort on lat flap side. He said that the implant has dropped a bit and that may be causing it. He has suggested a procedure that would lift (and maybe replace?) that implant, which would improve appearance and may help the discomfort. In my previous visit last spring, he also said that the muscle was pulling the implant back a bit and he could fix that.
As always, there is risk involved, -the possibility of infection (rare but happens) and also the unknown response of the underlying radiated tissue.
I have an appt with my onc on friday. If she gives me the ok, I will have to decide what to tell my ps re the procedure that he suggests.
Those of you who've had radiation, - have you had implant issues after lat? I wouldnt do the procedure if only for asthetics, but would if it can make things more comfortable.
Thanks for your thoughts.
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another, I had direct to implants at mastectomy, then rads. Over the next 3 years, I had a lot of contraction to that side, that implant, which my PS told me would happen but I rolled the dice and took a chance. Then as you know I had a revision to that surgery in Jan this year, and that old radiated tissue did not respond at all to that surgery. So I had the Lat Flap, and I am doing great. Not really the sequence you are asking about. Hoping you are getting some answers soon. I am interested in people's responses too. I do not have an implant on my lat flap side. I did not want one and my PS agreed that as I had so much trouble healing, let's go without. He made a small breast with my tissue, at first I hated it as it reminded me of the contractured implant...smaller than the non radiated side. Now it is good, it is warm and feels more like me, so I got this implant in one side, lat- no- implant on the other. I am very happy with it. Sending you a big o hug today!
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