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Latissimus Dorsi Breast Reconstruction

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Comments

  • anothernycgirl
    anothernycgirl Member Posts: 821
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    Hi Meadow! I am happy to read your response and SO glad that you are doing well. Yes, that is why I am concerned about how the radiated areas would respond. I am leaning towards leaving things as they are, at least for as long as possible. Your lat side without an implant is no doubt far better than having implant issues. My PS did not suggest that to me. To avoid the flap, I had asked about fat graft and no implant, but he didnt think my radiated area would accept that and a lat flap was needed no matter what. The idea that your lat is warm and natural feeling sounds wonderful.

    Thank you for your responses and friendship.

    To all here, - Feel good and STAY SAFE. All this hurricane news is very scary.

    Hugs to all.

  • tangles
    tangles Member Posts: 211
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    twinmom I have too been totally miserable since my last flap. It is the one thing in life I wish I had never done and would give anything to take back. I am always in pain and have discomfort. I am constantly being put through test. This week my doctor ordered an echo treadmill although I don't think anything's wrong with my heart I think it's the pressure from the encapsulated in plant and the messed up lat flap. I am also having a gallbladder functioning test because I have so much pain in my upper back. I don't think my gallbladder is an issue but of course we have to roll it out once again I think it's all the Reconstruction nightmare I have been through. My next step will be to probably see another plastic surgeon for yet another opinion. This would be number 4. I don't know if it's the implant or the after effects of radiation but I constantly am in pain. I was told a smaller implant would not make a difference because my skin would just incapsulate around a smaller one. My only hope is possible fat grafting. The Mayo Clinic does it, but it's A 4 hour drive and quite a few trips and no guarantees.

  • leftduetostupidmods
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    tangles, I have a spot on one of the sides (I have the bilateral LD flap) that has been hurting since I had the surgery. It's pretty much the myofascial spot between the shoulder blade and the spine. It feels like there's a dagger in there all the time and then from time to time someone comes and starts twisting it pushing it deeper. The only thing that helps is steroid shots right in that spot. The pain management dr. says he thinks one tendon there got injured during prelevation of the LD muscle and is in permanent contraction and that is what hurts.

  • el_tigre
    el_tigre Member Posts: 453
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    hi,

    who here did physical therapy after the flap surgery? and how long?

    thanks



  • leftduetostupidmods
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    I did about 3 weeks 3 times a week. Could have gone longer but insurance only paid 15 sessions a year so I wanted to have some left just in case. Proved to be a good idea as I developed axillary web syndrome after the ALND and needed more PT.

  • Frill
    Frill Member Posts: 104
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    I had my LD flap surgery Aug. 17. At the very beginning in 2015, I had asked my PS about losing weight - if it would effect the surgery, the size I could get, anything. My weight tends to fluctuate and it was at the higher end at DX. Well, fast forward to reconstruction and I've lost 70 pounds. Now all I hear is how petite I am.

    I want to say I've had about 4 fills. The PA said we'd wait two weeks for the next one and then we'd probably be done. I'm barely the size I was before surgery. My goal was always to be bigger. My sister was ready to say - TOO BIG! I just need to communicate this to the PS.

    I am in so much pain unless I'm just doing nothing it's unreal. After a month the stitches in my back opened up and had to be redone. Anything involving bending over where I can't compensate with core muscles nearly brings tears to eyes. Will this subside?


  • el_tigre
    el_tigre Member Posts: 453
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    So sorry Seachain & Frill that you have pain.

    Seachain, after my BMX and node removal i too had lymphatic cording develop on both sides. I still feel it under the skin but PT helped with range of movement.

    Frill are you on Valium for the fills? I was after my BMX and will be again after the flap surgery. It does help with the pain but yeah can't be on that 24/7. That is my worry that the incision will open up. Is it looking better after they closed it up again?

    I hope to have my Lattissimus flap surgery in December and recover by spring break. How long did either of you take time off work? How long were the drains in? I know everything varies with each person. I am planning for 10 days off work (I have a desk job) and hoping that i get both drains out by the time i go back to work.

    PT will start about then as well for how ever long I'll need it for. I'm on High deductible so my PT can go all year if i need them, I will unfortunately reach my deductible by June due to lupron shots I get every month anyways.

    thank you

  • believe3
    believe3 Member Posts: 1
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    Hi, After a double mastectomy in 2015, chemo, radiation, infections, and so far three surgeries I'm now facing Latissimus Dorsi reconstruction. I am so scared. My cancer treatment has left me with so many permanent side effects the thought of having more pain and discomfort terrifies me. After reading these comments I'm even more confused than before, I don't know what to do. Is there anyone who had a good experience with this type of reconstruction?

  • anothernycgirl
    anothernycgirl Member Posts: 821
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    believe, - I surely understand your feelings. I think most of us who have LD have had problems and issues with other, earlier reconstruction attempts. It is not an easy surgery, but in the long run I am glad that I did it. Would you be a candidate for diep reconstruction? I was not, but that is a good option if you are. As for the LD, - those who post are usually the people with concerns, questions, and problems. Many, many who feel well after having the procedure go back to their routines and busy schedules and dont come back to post!

    Good luck with your decision!



  • meadow
    meadow Member Posts: 998
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    Believe, like another said, I too am thankful for this surgery. It resolved some serious issues I was having. I did not have an implant again on that side, I am done with that. My radiated skin was too damaged to heal, too damaged for an implant without getting contractured. I am not symmetrical...bigger on the non affected side as I still have an implant there. I do not care! I am happy and healthy. Moving passed boobs to the rest of living, the rest of my life. My heart goes out to those that do not have that kind of success.

  • Sara208
    Sara208 Member Posts: 9
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    I'm in the same boat as you, believe. My mastectomy was Sept. 2015, and I've had seven surgeries in all, five specifically related to reconstruction. My reconstruction failed this past August due to the damages of radiation. I have terrible scar tissue on my chest where the implant was removed--rock hard, like bone. If I do decide to try again to reconstruct, it would be for purely cosmetic reasons, and it would need to be the lat flap surgery--I don't have enough fat anywhere. I've been reading a lot of these posts and feeling more and more like maybe it's too great a risk to take for cosmetic reasons. Has anyone had extreme scar tissue issues and been happy with their lat flap result?

  • nash
    nash Member Posts: 146
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    I'm one of the gals who has had a horrendous time with the LD flap as far as the permanent physical effects on my body. But I wanted to emphasize that my situation is unique given my body type, my athletic background and current high level of activity.

    I also wanted to share that my surgeon has been particularly mystified on why I've had so much trouble. In her experience, her patients usually feel better after having the LD flap done if they were having radiation damage problems after mx or implants prior to the LD flap. I was not one of those patients (I had a local recurrence post-lumpectomy/radiation, thus the LD flap), but she has had much success with the LD flap helping women who were having scar tissue/radiation damage issues.

  • Hopfull2
    Hopfull2 Member Posts: 287
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    hi believe, I'm I'm 4 1/2 months out from my ld flap surgery. I'm doing great. I have my exchange surgery early January. I think it just depends. Not all to be scared but I hope it works for you. Hugs

  • Journey2014
    Journey2014 Member Posts: 65
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    Hi everyone, I just had a revision on October 11 with the original exchange date that I had last May 18. My PS did a great job. I am still healing from the surgery but no pain meds needed. Lat Dorsi on both sides last October 2016, had the exchange on May 2017 and revision on October 2017.

    I tried the push up bra just to see how it looks once I am all healed.


    image


    image

    image


  • leftduetostupidmods
    leftduetostupidmods Member Posts: 346
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    Oh, I never criticized the esthetics of it. As I said before, my "foobs" look absolutely wonderful, I don't even need a push-up bra, the PS did a wonderful natural curve and they don't have the "balloon" aspect. Here, I'll post another pic to show you. Keep in mind, I'm 56, so it's a great boost of confidence on the self-image.

    It's the disabling result of the surgery that I'm complaining about. It made me go from a very active woman to a woman who can't even open jars by herself. Forget about any exercises that involve arm and upper body strength, I can't even do basic yoga poses. Then it's the pain from my spine being severely affected because of the lack of the LD keeping a proper post of the torso. Added to the other chronic pain issues I have from this whole treatment.

    I'd gladly give up looking good and any confidence boost and all that, if I could get my normal upper torso and arms and hands function back and not be disabled anymore.

    image


  • Journey2014
    Journey2014 Member Posts: 65
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    Good looking result Seachain, I was just wondering why you need to have the LD Flaps if you did not had radiation treatments?

    I am so glad and thankful that I have a good arm mobility after my LD Flap, and to be able to work out with upper body movements.

    Hoping for everyone to have good results after this type of surgery.

  • Not-happy2
    Not-happy2 Member Posts: 1
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    Good afternoon,


    I had my Latissimus done in May 2017. It was a botched job, I had double mastectomy in May 2016. I developed a very small whole in the right breast where the tumor was located after the surgery, that is why we opted for this procedure. This Doctor put the implants under the muscle-now I look like a body builder with large nipples. Under my right arm-there is too much muscle, it feels like I have something in between my arm and body torso. Right below the armpit on the right side, i sometime get this burning sensation if the arm is too close to the torso. I press down on the right breast in the front where the flap was placed, and I can feel my nerves moving in my back area. There is aching in the right breast on and off as well. This man did a very HORRIBLE job. I am now going for a second opinion for a corrective surgery. ANYONE HAVE ANY SUGGESTIONS?

  • leftduetostupidmods
    leftduetostupidmods Member Posts: 346
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    Journey, because I had a PS who wanted to increase his portfolio and who lied to me and I believed him. Not-happy, if you can afford it, NOLA is your answer

  • tangles
    tangles Member Posts: 211
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    just wanted to quickly share my experience. Last week I went for a opinion for a plastic surgeon. The first thing he asked me is why on Earth that you have the latissimus surgery on both sides? I said to him the plastic surgeon said I would have more symmetry if I did that. He shook his head and rolled his eyes and said there was no need to take both of your lat muscles out you did not have cancer on both sides that is a total ridiculous thing he said. He said when getting plastic surgery always get three or four opinions. He said had I gone to another plastic surgeon and told them what this plastic surgeon was going to do they would have stopped me. Now I will live with pain on both sides of my back for the rest of my life instead of just one. The entire surgery was a failure anyway the radiated side is as hard as a rock. Totally encapsulated. The side I should never have had done has fallen and looks like a pancake. I ask the plastic surgeon why this happened he said easy answer you didn't need skin over there you didn't have radiated damage skin now you have too much skin that is why the implant Has Fallen. I'm not sure if I will go in and have it fixed. My main goal is to find some way to maintain this pain that this horrible surgery has cost me. The plastic surgeon I saw last week suggested I go to the pain clinic as I have tried everything else. This latissimus surgery has ruined my life. I'm happy that others have had good luck with it. I would highly suggest for those considering it to Google what your latissimus muscle does for you. When you Google it it says it's the most important muscle in your back. I believe this now that I don't have any lat muscles and I suffer in pain daily

  • NCchris
    NCchris Member Posts: 1
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    I am trying to find out about side effects of women who had a Latissiumus Dorsi Flap done over 5 years. When having to couch or sneeze it makes my chest hurt with sharp pains. I have to hold a pillow to my chest to cough. Figured it was built up scar tissue over the years on front chest wall. I had the flap put on both breast. in 2010. Once in a great while have a itching felling in my back at the area they cut. A back scratchier does seem to help. Other from the pain if have to cough I do great as long as stretching my arms and move my upper body with exercise every day. Just wanted to see if other women have pain from having to couch from a cold or sinus issues? Also did anyone go to doctor over this problem and what did they say ?

  • Frill
    Frill Member Posts: 104
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    Im in PT hoping they can do something for me. I can hardly move my arms. It hurts all down my sides. I had normal pain until this weekend and i woke up Monday and thought I was going to die. I’m happy with the results- haven’t gone to implants yet, but this fatigue and pain is killing me

  • leftduetostupidmods
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    As many know I'm in the group of women who have become disabled due to this cursed surgery. As Tangles said, google what the muscle does. I have my cervical spine shattering practically because it got so bad out of line due to the muscles not being there anymore to help with holding the torso up. After many PT sessions that didn't do a thing, I went on pain management. That was 6 years ago. Still am on pain management and will be til the end of my life. I can't even open a jar by myself. Had to cut my beautiful long hair because it had become too painful to take care of it. Same thing as Tangles "I would be more symmetrical". And I didn't even have to have radiation!

  • tangles
    tangles Member Posts: 211
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    seachain what do you do for pain management?

  • leftduetostupidmods
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    Besides opiates, muscle relaxers, shots in the spine and stretching exercises. Now lately I found Kratom and I'm trying to switch to it from opiates. It is obviously more expensive as it's not covered by insurance but I am so sick and tired both of opiates and of the whole buzz that's up lately. Kratom doesn't give me nausea or any of the side effects of opiates and controls the pain almost as well.

  • el_tigre
    el_tigre Member Posts: 453
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    Hi all

    quick question, how many nights did you end up staying after the latissimus dorsi flap surgery?

    I wanted 2 nights but my doc will only be there for 1 and 99% of his patients only stay 1 night. Any thoughts?

    thank you

  • tangles
    tangles Member Posts: 211
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    I stayed four nights. It was HELL. I could have used more nights. Everyone recovers differently and has different experiences so it's really hard to compare

  • el_tigre
    el_tigre Member Posts: 453
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    tangles - did you have one side or both done? 4 nights i find is the max on the recommended scale of it

  • shannonlee66
    shannonlee66 Member Posts: 14
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    Hi there. It's been a while since I've been on the boards. I had a lat flap almost five years ago and am in chronic pain all of the time. Sometimes it is worse than others, but it has severely altered my life. I used to be in PR, but I am unable to sit at a computer for long periods of time.

    I've been to physical therapy, tried acupuncture (which does help, but the effects are short lasting), massage (again, helps, but doesn't last long). I've also seen a rolfer, who has been amazing. She is the only practitioner who has been able to help me. She completely loosens up the muscles and the relief lasts almost a month with continued easy stretching. However, I still have pain, though not as severe.

    I had my implants removed a year and a half ago. Still no relief. I have not tried injections. One pain doctor recommended an epidural because he thinks the thoracic nerve is the issue. He believes if I can relieve the pain, my muscles will be able to stretch. Another doctor recommends cutting the lat from the humerus, but that is not guaranteed. Has anyone tried injections, an epidural or had the muscle cut?

    Pain meds do not work for me. The return is not worth the side effects.

  • shannonlee66
    shannonlee66 Member Posts: 14
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    Also, I am tall, thin and athletic. Am I right in thinking a lat flap is not the best choice for women with this body type?

  • tangles
    tangles Member Posts: 211
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    I had both done which was a huge mistake. I have seen several plastic surgeries since my lap flap and they all said there was no need to have both sides done unless you had radiation on both sides. They both said I should have never sacrifice both of those muscles in my back. I am not tall but I am very average weight. Not overweight at all.

    As for my pain the plastic surgeon I saw last month said I will probably live with back pain for the rest of my life. I had trigger point injections a week ago, and they did help, but I'm already noticing they are wearing off. I had an epidural with little success. Pain meds take the edge off but after a while they tear your stomach up. I thought about removing the implants as they look horrible anyway. The lt flap was a huge FAIL. My implant encapsulated anyway and the other side fell because it did not need the extra skin and now I have too much skin.