Latissimus Dorsi Breast Reconstruction
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everything has gone well (except having to wait in recovery a long time before a room was available). I know I am on pain meds, but I’m not feeling pain. I am up walking on my own (to and from the bathroom). I haven’t seen what my boob or back looks like, but the Dr. says it went very well and the nurses are all come ring that things look really good. Dr say something I had some scar tissue unlike any she’s ever seen. She said particularly in the area that I griped about in the upper pole. She said there was some across and stuck to the implant that look like braided wire.
I have an expanded which she says She may or may not feel. It’s just a place holder. She will go in later and address both breasts with new implants.
Thank you ladies for the thoughts and well wishes! I will keep you posted!
Oh! My stay has changed from 3-4 nights to 1-2 nights. Not sure how I feel about that. I’m enjoying the almost zero cares in the world right now, lo
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HI everyone,
I haven't posted much yet, but I've been avidly reading. My reconstruction failed last summer after MANY surgeries due to the damages from radiation. My first PS went the traditional route for recon even though he knew I had to do radiation. I'm living with one breast, but I'm not happy about it--constantly tugging at my bra because it won't stay centered and my boobs are always pointing toward the right, I can't wear anything with a lower neckline, etc. I like my current PS but am scheduled to see someone for a second opinion tomorrow (and will probably seek at least one more 2nd opinion). I can only do the lat dorsi surgery because I don't have enough body fat for the better alternative (chemo brain--can't think of its name).
Here are the concerns that I've read about on this forum and will discuss with her: chronic pain, weakness, limited range of motion, back spasms, nerve damage, spine alignment, emergence of a hump, LE, possibility that being athletic/muscular is a risk factor. Two of my hobbies are rowing and cross country skiing. Does anyone have any advice for beginning this investigative process? Other risks or concerns to bring up?
I'd really appreciate any feedback if anyone has any. Thank you!
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NICE SUGARCAKES!
I stayed 2 nights with mine (after waiting for a room too lol).
I am glad it went well and you are not feeling any pain, I love that "no cares in the world" feeling. Attentive nurses are awesome! I was numb for awhile on my back then the feeling came back and felt a little more pain, just FYI. I have puffy scar tissue above my left breast from BMX in 2015 and the doc was able to work with it, so I'm sure yours went ahead and separated your unique scar tissue from you implant.
Good vibes for a speedy recovery and no painful fills if you need them
Sara208, I'm still in the early stages of recovery (12/20/17 was my surgery). I have some:
numbness in the back area
dull pain near my shoulder blade
range of motion is 70% back, working with a physical therapist every 2 weeks
Had 2 fills and I planned my swap out in March
located above the flap i have slight varicose veins from radiation and expanding, I think that is a unique and rare occurrence. I have some from my BMX in 2015 on my ribs.
I have not begun crunches or weights yet, so i cannot tell the level of weakness. My physical therapist said i should be able to do everything I could do before. If i was a big pull ups girl I would have to give that up, but I'm not.
I know it's a hard descision but you shoudl get alot of feedback on here
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Sara208 please ask your doctor about damage to your long thoracic nerve. Ask what the chances are and if it happens can it be repaired. This happened to me. My experience unlike some of these other women was not good. I have back spasms depending on what position I'm in mostly when I bend over a certain way. I have pain between my shoulder blades almost daily. With the long thoracic nerve being damaged I have a limited amount of mobility and strength. I am 3 years out and live with pain daily.
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hi ladies
haven't been on this thread in forever but I do keep up - I am one of those who did not have a good experience with this surgery - it has gotten much better but not pain free (its been 5 years) the trick for me was seeing a physiatrist - she did pain point injections and I followed a very regimented stretching plan -when I get tight the pain creeps up again (like when I am stressed)
Seachain - I have communicated (emailed several times) with Gina from "No Surrender" to my knowledge she did not have the lat muscle cut as you stated - she is actually doing ok with the surgery from my understanding
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Sara208, you may find this article helpful to read and to take to the PS. It addresses potential complications in a very clinical manner. Of particular interest is that it cites a study that states 50% of patients will experience post-op numbness and tightness. My PS acted like she'd never seen tightness before:
http://www.livebeyondbreastcancer.com/rehab-take-h...
I am one of the women who has had a hard time with this surgery. I am almost three years out, and have done two and a half years of assorted rehab approaches to no avail. I feel like I am locked in an iron corset 24/7, with a rock duct taped to my chest.
I have been a competitive figure skater for 40 years and continue to skate. I can function both on the ice and in everyday life, but I feel like crap 24/7 no matter what I am doing. I don't have strength deficits, but I do have constant ROM problems in my torso b/c the lat was pulled too tight in my case. The PS actually stated she had trouble getting it to move and that it was a very physical surgery for her to perform. My pec never stretched enough to accommodate the implant, b/c I went direct to implant with no expanders. It's like my body is strangling itself.
One thing that has improved on its own is the extreme skin hypersensitivity I had over my ribs on the surgery side and around my back incision. So that's something at least.
I had a uni mx/LD flap. It now appears that I have a new primary on the "good" side, so here we go again. All I know is that I will not be opting for the LD flap on the that side.
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Glad to hear you are doing well, SugarCakes!
I didn't question the PS about the risks of the surgery as much as I might have and I regret this. At least, those of you who are contemplating surgery understand that complications do occur, perhaps more often than you may think. I feel PT is necessary and I pushed for it - not sure it would have been offered if I hadn't asked. I have full ROM and decent strength - the perpetual tightness is what bothers me! I fully relate to the "iron corset", Nash, and have explained the discomfort using those very words. Strength to all.
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Sara, if you don't have a belly for the DIEP method you may carry more weight in your lower body. If so, I urge you to look into TUG or PAP methods which use your thighs. I did the TUG and notice no muscle weakness whatsoever. The PAP method spares the muscle. I had radiation and subsequent tissue expander failure on that side. I then went flat on that side for nearly four years while I researched my options. You do have choices if you can get to highly experienced microsurgeans. I am very happy with my choice. I wish you and everyone here good luck & good health.
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Just checking in. Day 3 post LDF surgery. I came home yesterday. Things continue to go well. Minimal pain. In fact, I haven’t taken pain meds in almost 12 hours. I will take some within the hour, however, just to stay ahead of it.
Range of motion is good. I have to THINK to not overdo things. Chest feels a bit tight. May be the expander. May be the right surgical bra. Not sure, but totally bearable. Slept in recliner.
Hoping things continue to progress this way
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Just checking in. Day 3 post LDF surgery. I came home yesterday. Things continue to go well. Minimal pain. In fact, I haven't taken pain meds in almost 12 hours. I will take some within the hour, however, just to stay ahead of it.
Range of motion is good. I have to THINK to not overdo things. Chest feels a bit tight. May be the expander. May be the tight surgical bra. Not sure, but totally bearable. Slept in recliner.
3 Drains... had them before; so use to them
Hoping things continue to progress this way
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Thanks for the advice, everyone. My scar tissue from losing my implant is really extreme--I have a rock-hard ridge that encircles where my breast used to be. As a result, my doctor felt that the LD surgery would be too risky. She said the best option would be the PAP (thigh) surgery, but even with that, I'd probably only be able to get to an A cup (as opposed to my former and right-side C), and it would leave a divot in my thigh. Seems like an awful lot of agony for quite literally a very small reward. I'd have to have my right implant replaced and breast modified to match. I may seek one more 2nd opinion from a nationally-known surgeon, but this is probably the end of this road for me. I really appreciate everyone's input and willingness to share your experiences, good and bad. It helped to come armed with a lot of questions.
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Thanks for the advice, everyone. My scar tissue from losing my implant is really extreme--I have a rock-hard ridge that encircles where my breast used to be. As a result, my doctor felt that the LD surgery would be too risky. She said the best option would be the PAP (thigh) surgery, but even with that, I'd probably only be able to get to an A cup (as opposed to my former and right-side C), and it would leave a divot in my thigh. Seems like an awful lot of agony for quite literally a very small reward. I'd have to have my right implant replaced and breast modified to match. I may seek one more 2nd opinion from a nationally-known surgeon, but this is probably the end of this road for me. I really appreciate everyone's input and willingness to share your experiences, good and bad. It helped to come armed with a lot of questions.
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Thanks for the advice, everyone. My scar tissue from losing my implant is really extreme--I have a rock-hard ridge that encircles where my breast used to be. As a result, my doctor felt that the LD surgery would be too risky. She said the best option would be the PAP (thigh) surgery, but even with that, I'd probably only be able to get to an A cup (as opposed to my former and right-side C), and it would leave a divot in my thigh. Seems like an awful lot of agony for quite literally a very small reward. I'd have to have my right implant replaced and breast modified to match. I may seek one more 2nd opinion from a nationally-known surgeon, but this is probably the end of this road for me. I really appreciate everyone's input and willingness to share your experiences, good and bad. It helped to come armed with a lot of questions.
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Seachain, I emailed Gina and she actually is not doing well... still a lot of pain:(
Sam208, I encourage you to seek another opinion (if you feel so inclined:). I certainly which I had done that. The right surgeon may be able to help you.
I would love to know how many women are successful with this surgery. I've heard only a small percentage of women (5%) have difficulties, but I hear of more and more, so I'm skeptical of that stat.
Best wishes to you all. It's a loooonnnng road!
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hi ladies, day 7 post surgery and things are going amazingly well. I feel good. Question however...
I have three drains. The volumes in each are decreasing. All had been very similar in color; clear red to reddish orange with no smell. Well one has now gone to a very deep dark red. Looks like red wine! Still clear and no smell. I am going to call the doctor’s office tomorrow, but anyone have this happen or have any thoughts on why it would happen?
I will say I have been pretty mobile, doing things I didn’t necessarily think I’ be doing this soon after surgery, but I’m not in any sort of pain. I’m barely even taking pain pills. Sometimes at night, but more for the sleepy effect vs pain.
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sugar cakes-glad you’re feeling well! Do call the doctors office first thing this morning about that change in drainage color.
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Glad to hear all is going well with you, SugarCakes. Do call the doctor's office tomorrow. Sometimes a simple call, eases your mind and I have found them most willing to answer questions post-surgery.
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Any news, SugarCakes?
Well, ladies, in the past week I've been through Hell each evening. I got to the point that the remaining muscles in the back are doing such a bad job in "compensating" for the missing Latissimus Dorsi that by 6-7 pm I get so much muscle pain that it's actually burning and brings me to tears. Not even the opiates work, the only thing that works is a very strong muscle relaxer and laying down - and the muscle relaxer makes me sleep. I don't want to spend the rest of my life sleeping! But the pain is so horrible.
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seachain what's going on? I don't follow all these post daily so I don't keep up as I should. Did you have a new procedure done? Why so much pain? I still have pain everyday but I'm just learning to live with it. I try to do strength training at the gym but anytime I do anything that has to do with upper-body/ shoulders Etc I suffer in pain the rest of the day. Sure wish there was a. Answer......
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Hi Seachain,
I can really empathise with you! I too, regret more than words can say, in having this surgery. I know "there is no use crying over spilt milk" but I wonder, well and truly, where my brain was when I signed the consent form for surgery! Yes I got my boob back but at the expense of my back and every day quality of life!
I find just keeping busy and trying to keep my mind off the pain does help a littlle magnesium too can help at times! I had a reoccurence unfortunately and my implant was removed.....having to consider radiotherapy now.
My intercostobrachial nerve was severed (99.9%) sure of this during a hookwire procedure and waiting for pet scan and mri to confirm this. Have you looked at nerve blocking? Worth checking out I believe.
Hope you get some relief soon, big hug! X
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Thank you, Bonnie! No, I didn't look at that and not sure if it would be possible.
It's my remaining back muscles that can't compensate for the big one not being there anymore. I did do exercises in the past until it was discovered that in the process of prelevating the LD they had damaged the fascia of the abdominal obliques, so as I started to lose the weight I had put on during cancer treatment, a huge bulge was on my side - the abdominal oblique was herniated. Two years ago (a bit over 6 years after the original surgery) I had to go in again in the OR so they could go in and repair my abdominal wall on the left side and then put meshes to replace the torn fascia. After that, my spine and pain management dr told me "in confidence" that I should be careful about exercising any muscles that were under the LD because who knows what else was damaged.
It's an area that starts pretty much from right under the shoulder blades and ends at the waist, exactly where most of the scar tissue is. It was bearable before but lately it seems that if I don't spend half of the day laying down, I'll end up in tears around 6-7 pm.
I was thinking to ask my pain mgmt doctor to give me a prescription for one of those medical corsets for the lumbar area, it might help. I do have some Renaissance Faire corsets but I can't put them on by myself.
EDITED: I had posted this on a separate thread and you can see the photos of how herniated abdominal oblique looked before the surgery to repair it. As I had put on a lot of weight it wasn't noticeable, but when I started losing it, it started showing. I had initially thought it was a stubborn bulge of fat
LD reconstruction possible severe complication
But here's just the photo
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SugarCakes, hope healing is still going well. Seachain, Tangles, Bonnie and others who are still enduring pain, I am sorry and hope something works to relieve it. My sadness is post-surgery (after initial visits) you are pretty much left to your own devices to find something which reduces pain and discomfort. Lucky we have each other and this forum or we might feel even more isolated. I read on this thread or elsewhere about MFR (myofascial release) and wondered if it helped anyone. Seachain, the photos of the hernia were informative. As I was reading your post I was trying to picture it and there it was. Happy early Valentine's, ladies, just in case I don't post for a bit. XO
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felicia, I get about 3-4 times a year shots in the lower trapezius myofascial release point and that helps tremendously with the pain I have between the shoulder blade and the spine - without the shots it feels like there's a dagger in there that from time to time someone just comes and starts twisting it inside.
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New to this tread. I have had 4 reconstruction revisions with no success. Am now considering a Lat Flap on both sides. I have been told this was the way to go by two different PS but I was afraid to do it so I tried more conservative approaches- fat grafting, thick alloderm, changing implant size and shape, but I still have extensive rippling, redness, messed up nipples, and my breasts are way too far apart. I hate looking at myself in the mirror. My breasts look so angry and hurt and are a constant reminder of my ordeal. On the other hand, I feel great physically and I am afraid to lose my lat muscle and possibly cause myself more harm just to improve my appearance. With clothes on, I look fine, and my husband is very supportive and it doesn't matter to him whether I have beautiful looking breasts or not. He will support me either way, which is wonderful.
It's so sad to say, but I just feel kind of like a monster. I hate constantly being reminded of cancer and surgery. I feel like I have two ugly bags of garbage sewed on to my chest.
Advice? I would love to hear from you ladies what you think I should do. Has the Lat Flap surgery been worth it for you? Did it correct your problems? Cause more problems? One of my reconstructions involved harvesting fat from my belly so I am not a candidate for DIEP. I think its LD or leave it alone. Or maybe go to New Orleans and see what they think?
I like to be active and enjoy being outside. Swimming, hiking, skiing, wake boarding, scuba diving. Don't want to lose my muscle if its not going to make a dramatic improvement in how I feel about myself.
Thanks so much for all of your help !
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seachain and tangles, I am so sorry that you have such lingering pain ! I HOPE that you find relief soon!!
maureen, - I know how you feel. I was so reluctant to have this procedure, but had no option if I wanted recon and my ps was very encouraging. It was not as bad as I feared, but I admit that the lat side is not as comfortable as the other side (which has implant but no lat). The ps feels it may be less comfortable because the implant has shifted a bit, and he will fix that when ever I am ready. I have been putting off having another procedure because it's not on top of my 'to do' list right now! My back does not hurt from lack of muscle, but I do try to be careful when doing strenuous activities. I am still glad that I had the lat done, rather than be so unhappy with my appearance, As with any surgery, it comes down to the surgeons skill, the patient's healing response, and luck! Wishing you the best outcome!
SugarCakes, - how are you?
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Maureen as you will read others have had no issues with this surgery. Myself it is the biggest regret of my life. It will forever have changed my life. I will never be able to do some of the things I enjoy like go for long bike rides, yoga, I can't even shovel snow. There's probably no way of knowing if you'll be one of the lucky ones or join our unfortunate Club. Myself I would give anything to have hideous ugly breasts that look good with clothes on if I could be back to my old self
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Ditto what tangles said. Even more, I'd be happy to have no breasts at all but be back to myself again and not be disabled and in so much pain constantly.
As much as it is true that it's really a crapshoot in terms of "will it work for me or not" there is also the fact that the more muscular/athletic you are, the higher the chances for things to go downwards for you.
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Tangles I am so sorry to hear about what you and others are going through. And what you are saying makes perfect sense. If we could know in advance what we would feel like after surgery, none of us would opt for anything that gave us constant pain and took away our favorite activities in exchange for having pretty breasts. That's the problem- surgery is a risk and we never totally know what the reward, if any, we are going to get from it.
Is there anything you can do to correct the pain and limitations you are dealing with? I know they can't put your muscle back, but is there anything else that can be done to help when a lat flap procedure goes wrong?
I don't want to do another thing I regret. My biggest regret in this whole thing so far is that when I was initially diagnosed, my preferred BS was booked up and couldn't do my mastectomy for a month. Rather than wait for the best surgeon in my area, I picked someone else who could do it the following week. She didn't have as much experience and she "skeletonized" me- taking way too much tissue, according to the 4 PSs I have spoken with since. Of course, I am happy she got rid of the cancer. I am just about 5 years from diagnosis and I'm still here so that's great. But I think many of us just want to look normal so we feel normal and can try to forget once in awhile.
So sorry about what happened to you. Who was your PS? Are we allowed to talk about specific doctors on here?
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Maureen I am also 5 years out congratulations to us both. I am in Iowa and my plastic surgeons name is Andrews. I did report him to the medical board. He did not lose his license but he is no longer able to practice at the facility he was practicing at. He severed my long thoracic nerve in the process of the transfer. Of course this was an accident but can happen. I didn't report him because of the accident, but more because he did not acknowledge it or try to get me any help. I have seen many doctors including the Mayo Clinic. I had a surgery 2 years ago to try to get Mobility back in my arm. This included taking bone out of my arm and sewing it to my scapula area and attaching that to the back of my chest wall. It did give me a little bit more Mobility but it did nothing for the pain. I do get occasional trigger point injections. Unfortunately they are pricey and only give me about a week's relief. I recently went and saw another plastic surgeon and asked him if we just took the implants out would it help I would be willing to go flat to be pain free. He said it would probably not help. The breast that had the radiation that we were trying to fix is still very encapsulated and hard as a rock so I went through all that for nothing. The plastic surgeon I saw a few months ago said he could try some fat grafting and try to remove the implant and put a new implant in but there's no guarantees it would not encapsulate again. I'm just not sure if I want to put myself through all that for fear that it would be for nothing. I asked can you take the latissimus muscle and put it back where it came from? He said no that is not possible.I have constant Pain between my shoulder blade area. And I am extremely weak. My husband and I used to enjoy cycling. We might ride 20 or 30 miles in a day. I cannot do that any longer. My back is just too weak for me to hold myself up on the bike. I would love to do yoga, but I could never support myself, for example the downward dog position. I could never do any type of a push-up or a plank. I wouldn't say I was super athletic before the procedure, but like I said we used to enjoy cycling and I would take different classes at the gym body pump for example I can no longer do. I've never been told that this happened because I was athletic. Good luck with your decision. The only advice I can give is make sure you have several opinions. I will tell you though I went to a plastic surgeon at the University of Iowa. His advice to me was always get three opinions and take two out of three. He told me if I had done that he firmly believes no other plastic surgeon would have taken both my latissimus muscles out of my back. He said there was no need for that. He shook his head in disgust. I asked where do I get opinions? His advice was do not go to a private plastic surgeon office the more they do the more money they make. He said always go somewhere like the University of Chicago, the Mayo Clinic for example. He said the plastic surgeons that work at facilities like this are not getting paid per procedure and will not recommend you do any more than you need. So my advice would be if you have access to a major university or the Mayo Clinic get some opinions from places like this. I wish I had
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Tangles
I am so very sorry this has happened to you. Your experience has me re thinking my decision. I really want to have reconstruction but now I am so very concerned that I may delay doing anything. I just want to start feeling normal again......I know that is what you wanted also.
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