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Latissimus Dorsi Breast Reconstruction

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  • naiviv
    naiviv Member Posts: 308
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    image

  • naiviv
    naiviv Member Posts: 308
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    You can also look him up on instagram. He explains the nerve regrafting for re sensation.

    Correct, I never lost sensation. When I was first dx, I went to him and researched and found that he was a pioneer here in Miami with Nipple sparing for larger breasted women that didnt meet current criteria. He and my breast surgeon made an amazing team. Sadly Dr Torres -Saliche passed away a few months ago to his own battle with C.

    They both went to bat for me, when I chose nipple sparing bmx. And I am so happy that I did.

    If you have the ability to see him, please do so. At least see what he has to say. I personally would not go anywhere else and I have recommended many and to date all have been satisfied and happy with his work.

    Vivian

  • jaybird627
    jaybird627 Member Posts: 1,227
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    Okay, Gals, Lat Flap surgery set for 12/18. Got all sharpie marked up today. Was SO hoping to be able to save the nipple as it's healthy and reactive despite no feeling but he said it's in the zone of thin, damaged radiated skin from 15 years ago so it's got to go. :( Will most likely have an expander as I don't have much back skin or fat. I'm scared, but I don't want to be flat anymore so I'm going to hope for the best.

    Down the road the capsule contracture on the other side will be addressed. :(


    Jaybird

  • anothernycgirl
    anothernycgirl Member Posts: 821
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    Jaybird, Sending wishes for an easy and uneventful procedure! Although the recoup took time, I was not as uncomfortable as I'd feared. You'll be fine!!

    (But for me, it helped to have PT when the healing part was done!)


  • jaybird627
    jaybird627 Member Posts: 1,227
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    Hi All,


    The surgery was maybe 3 1/2 hours? I was knocked out before I left the room. lol! PS put in expander but no fluid yet. He said the muscle was large. Skin too tight yet for expansion. I stayed just the one night. The oxycontin is my best pain reliever. I have excellent mobility so far. PS is very pleased with his work so I guess I am too. The top half of my breast is breast tissue the bottom half is football shaped back tissue.

    Today was day 5 follow-up. Had 1 of 3 drains removed. Bandage is off too. Scar is maybe 9" long? It starts at my spine and angles down. I go back in 1 week for another foillow-up. So far so good. Onward until something else happens. lol


    Jaybird

  • jaybird627
    jaybird627 Member Posts: 1,227
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    Okay, so day 12 post-op. Second follow-up with surgeon. Still have 2 drains because I am a slow drainer.

    Got 60cc in expander. He wants to move slowly. I go back in 1 week to check drains and more fill.

    He said I don't need pt. huh. I assumed I would? Just no exercising for 6 weeks after surgery.

    I want to 'do' physical things but fear doing damage?

    I feel okay, my mobility is okay. So, basically, nothing exciting going on here. lol!


    Jaybird

  • kellymoye
    kellymoye Member Posts: 1
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    I had a lat flap on my radiated side and a conventional mastectomy to prosthesis on my other about 6 months ago. I have not had any physical disability related to the lat flap and it looks better than the conventional sub-pec implant. I do have a scar on the back, and two long ugly scars across both breasts where the nipples were removed. I had beautiful breasts before all this was done and now they look a little frankenstienish while naked, but am happy with the way I look in clothes. I stilll wear a bra whenever I have sex with my husband, I hope to be able to lay naked with him again some day. .....when I do then I will call the surgery a success.

  • jaybird627
    jaybird627 Member Posts: 1,227
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    I'm sorry kellymoye,

    I'm full of scars too. It's so hard to look "good" after all the surgeries. I'm single so I have no intimacy problems. (LOL - kind of).

    Just had R expander removed today so ONE MORE DRAIN SCAR (4 with this lat flap/expander, 3 with BMX, 2 with lumpectomy 15 years ago) and will have more when I get re-expanded or just small implant in a few months. Never-ending.

    Have L side nipple, no feeling, have the football shaped scar on R side which is now my franken-foob, hope to have a fake nipple installed after all is healed. :)

    My lat flap scar is about 10" and somewhat on a down diagonal. I don't care what it looks, it's healing nicely. No regrets. Mobility is good, just the damn radiated skin is my on-going issue and the recent seroma.

    I wish you better days & nights kellymoye!

    Jaybird ~

  • Leaven_Lady
    Leaven_Lady Member Posts: 1
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    Does anyone feel surges? It starts under my armpit and becomes a hot flash. Its been four years since I had a right mastectomy LD breast reconstruction. Its noticeable moreso in the evening when I relax. It started during the healing process and has not ceased. Not convinced that this is menopause related because the sensation is only at the reconstruction site and began right after surgery

  • tangles
    tangles Member Posts: 211
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    Jo-5 I totally feel your pain the surgery has changed my entire life I have spasms in my back do at the surgery. I have constant back pain every day of my life and probably will for the rest of my life. I often think to myself if my breast cancer ever came back in my bones and In my back I would never know it because I have back pain all the time anyway. I have a lot more fatigue. I work on my feet for my job and it is very difficult to get through every day. Right now I'm working 20 hours a week and that is very difficult .This is my biggest regret in life. I just got back from vacation. tried to do some snorkeling it's so hard to swim. I had to pay to have a massage the next day after trying to swim in the water with my shoulder & back so sore. I can't do any type of yoga. I tried to go to the gym but I'm so limited in what I can do anymore. I know a lot of people have success with the surgery but it has been my worst nightmare!

  • starchaser
    starchaser Member Posts: 2
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    I had a BMX last March with immediate reconstruction; simple implant on the right side but LD with implant on the left. I am very unhappy with it. Even after revision surgery, the left is bigger and heavier and the muscle feels like a rubber band stretched across my chest, even though the nerves were severed. I guess I am lucky that the flesh "took", but I was told the muscle would atrophy; has anyone's relocated muscle actually done that? It really inhibits my yoga practice (I WAS a teacher) and bums me out. What has your experience been?

  • moderators
    moderators Posts: 8,085
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    Hi starchaser. We're sorry to hear what you are experiencing, and how it's impacting your yoga practice/job.

    Here is our content on LD implant that you may also find helpful: Latissimus Dorsi Flap. and Latissimus Dorsi Flap Surgery Risks.

    Hopefully the feedback from annie-2 and others and this could be a bit helpful.

    Medicating The Mods

  • starchaser
    starchaser Member Posts: 2
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    Thank you so much for responding!

  • Imkopy2
    Imkopy2 Member Posts: 214
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    I have noticed the activity on this thread is a bit spotty. I’m looking for info on lat:flap. I had BMX in March 2016 w TE, finished 28 rounds of rads on right side in October. In March 2017, I had an implant exchange and my results were meh. With rads my case became a little more difficult and I went to see a PS who specializes in corrective recon. He evened me out and replaced my implants, (April 2019) he was still a bit concerned with my rads side and had me come back in to see him 6mos and 12mos after surgery. After seeing him a week ago he’s concerned about the integrity of my skin on my radiated side. He recommends a lat flap as a proactive procedure. (he said I have a risk at the skin tearing, developing an infection and losing my implant) I’m pretty physical I workout 5-6 days a week...he said I’ll lose about 10% of my strength on flap side. If anyone has advice about surgery, recovery, life after..thank you in advance

    Gentle hugs

  • mariwyl
    mariwyl Member Posts: 33
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    after 8 years post BMX with implants, my left side failed. I was irradiated mainly on the left 45 years ago for Hodgkin’s Lymphoma and the skin that was damaged broke down. I am not in favor of a DIEP flap. Too long a recovery for me. I am seriously considering the LD flap surgery instead. I am currently wearing a prosthesis. It’s a pain, and wearing a bra is a pain after 8 years!! I am concerned about how much scarring results from the LD and does the P insert an implant under the LD muscle to save my skin? Thanks. I still haven’t decided between leaving it flat vs an LD flap.

  • jaybird627
    jaybird627 Member Posts: 1,227
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    Imkopy2,

    and

    Mariwyl,


    I have posted on this thread before. I had my Lat Flap (right side) last December. I didn't want to do it (I lost my so loved nipple - lol) but I had no other choice due to lack of fat on my body. I've healed well. I have good movement. I am actually better on lat flap side than most recent (left) BC side due to cording issues. I do stretches and lift some light weights and am still more mobile on my lat flap side. I am right handed so perhaps that is why? I am currently using a prosthesis and will have another attempt at an expander in October. And as for the back scar, its long but covered mostly under bra. I watched a lot of youtube videos so I could understand exactly how it works. I have a new PS and I think he'll do a better job that my previous PS as I think he has more experience with mastectomy and radiation issues. And for something funny, I can actually flex my foob! You know, like body builders do. Not sure why but I can but I watch my foob flex and figure it's just one more gift that BC has given me. Most of the other gifts haven't been funny!


    Jaybird~

  • beeline
    beeline Member Posts: 193
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    Imkopy2, I don’t have any experience with lat flap surgery, but if it’s the skin on your rads side that’s the worry, it might be worth looking into doing some fat grafting before a bigger surgery. Fat grafting is being used to help heal rads damage before/during recon now. Apparently the stem cells can help the damaged tissue regenerate. There are some good threads here that talk about it. Good luck whatever you decide!

  • Imkopy2
    Imkopy2 Member Posts: 214
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    thank you beeline I have had a couple of rounds of FG already...I even had a capsulectomy. Both of the procedures were helpful but there are still issues, not sure how many more times I want to go under to possibly get the integrity of the skin back. Hope you are doing well

  • dlk53
    dlk53 Member Posts: 2
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    Hi Mariwyl...I had LD surgery in March of 2020. The scar on the back is long and I still have some numbness there. I had bilateral lumpectomies with radiation under the tissue on the right side and whole breast radiation on the left. After 2 surgeries to reconstruct the left breast, I ended up with an infection. Started with a new breast surgeon and a new plastic surgeon. They are great however, due to the damage of the radiation and the infection, the only way to make the left breast look like a breast was to have a mastectomy on the left side and using a LD flap. I had an expander and then an implant. I will say that after 6 months, I feel like I'm wearing a corset on my left side all the time. It's nice having something to fit into a bra but if I had to go back to the beginning and do it all again, I would have had a double, nipple sparing mastectomy. I wouldn't have needed the radiation and I would be able to look at myself and not see all the scars. I laughed at your boob flexing. I just noticed last night that I could too. So funny. I'm now trying to decide if I want her to create a nipple for me. I'm leaning towards yes. I'm so glad you're doing well.

  • megryan57
    megryan57 Member Posts: 7
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    starchaser, I had lat flap immediate reconstruction after BMX 12 years ago. I had a long difficult recovery. After 3 1/2 years of trying everything for the pain and discomfort, I accepted the pain and opiates as my life. Because of a new job, I stopped ALL exercise. Everything, even yoga. And within 3 months the pain and discomfort were basically gone! I can share more info if you want. I see you haven't posted in a few months but in case you do, I'm happy to share more.

  • Paraprofessional70
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    I am considering Lat Flap Reconstruction in Jan 2021. I need some realistic answers quickly. I am more worried about long-term issues.

    1. Long-term back pain.

    2. Mobility

    3. Symmetry (I had a uni-lateral mastectomy) will the lat flap breast match my remaining breast?

    4. How does the lat flap breast feel? (Soft/hard)

    5. May need implant. How do they feel? I probably will want saline filled implants.

    6. Those that had this surgery are you happy or dissatisfied? Do you regret doing it? Would you do it again?

  • cbk
    cbk Member Posts: 323
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    Paraprofessional

    I don’t have long-term back pain. I have tightness numbness and a spasm in my foob on my lat flap side. I’m weighing the odds of going back in for a correction. Numbness is from donor site of muscle site to insertion. Tiny scar from donor site and football shaped scar on foob.

    Unless you are planning on being very small most people have implants as well. I think mine is a 480cc Mentor High Profile Silicone. It’s neither soft nor hard.

    Mobility is not an issue for me in the least but upper body strength is. I can’t be sure though if that is from the BMX and sub-pec placement of my implants. I surmise it’s more the BMX and implant placement.

    There are many people on these boards that have had an extremely rough time with this surgery. Although I don’t fall in that category but if I had a choice to do another flap surgery I would have considered in retrospect.

    Although flap surgeries all have their good and bad stories ! Make sure you trust your surgeon 💯 percent and that your surgeon is truly a breast reconstruction surgeon. Compared to other flap surgeries a Lat Flap can be done by a surgeon with very little reconstruction experience. Make sure your surgeon has experience and positive outcomes!


  • CherylMk
    CherylMk Member Posts: 21
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    Hello , I had a lat flap on left side, I read a lot of stories when I was trying to make my decision about whether to have it or not and waited 3 years post mastectomy before deciding. It is a big decision, my surgeon was excellent and very credited , he is part of a large team of doctors who are active in teaching.

    I believe everyone’s response to surgery is different which is why there will be mixed feedback.

    I was never comfortable with my imol after surgery, a lot of tightness and discomfort from the muscle that wraps around the breast for the support of new implant , I also experienced on going spasms that would occur under the breast area, which was difficult to manage because you can’t get to it to relieve the pain , like a Charlie horse in the calf !

    I am so happy removed it, much more comfortable now, although I still have tightness and shoulder pain, I am able to function at about 75% on that side now !

    I can do yoga with restrictions and lift weights carefully 😊

    Btw I developed cording ( caused by scar tissue I believe) in the auxiliary area that limited mobility a great deal That was removed during the explant & has not returned thankfully

    In the end I went ahead with surgery, because I believed it was the right choice at the time, I would not do it again and 💯 wish I had not done it, but you won’t know the outcome for yourself until you go through it, that is the reality unfortunately.

    All the best ,

    My intention is not to discourage you , I am answering the questions honestly:)

    This is my experience and not all are like this either !


  • SuQu31
    SuQu31 Member Posts: 73
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    Hi there, I'm only two years out, so I can't answer long-term questions, but wanted you to know I have had no problems with my lat flap reconstruction with implants. I do think it is important that your surgeon have lots of experience in this type of reconstruction. I have some tightness from time to time, but only on my cancer side, and I attribute that to re-excision done for a close margin,which took an additional wedge of skin out of the area. Since I had the lat flap on both sides, I can't compare what is attributable to the flap and what is mastectomy-related.

    One thing my surgeon told me is that the flap provides extra tissue which helps with healing issues. I am so glad that I had the flap after having extra skin removed. I had a small issue with healing, but I expect things would have been much tighter without the extra tissue. For me, one extra benefit was the loss of my “back fat."

    I know I haven't been able to answer all of your questions, but did not want you to feel no one was trying to help. Also, if you read through the boards, please pay careful attention to the dates of posts. My sense is that this procedure has improved over time.

    Best wishes!



  • Imkopy2
    Imkopy2 Member Posts: 214
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    Paraprofessional-I responded on the other board but I recommend the fb group Latissimus Dorsi Flap there’s a wealth of knowledge and I can honestly say I probably would’ve bowed out. I am scheduled for surgery in January and am excited about my new surgeon and his plan to get me thru them last leg of this journey.

  • Paraprofessional70
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    Thank you for answering my post. I am 70 years old and have been physically fit, but at my age I wonder if having this procedure done is worth it. I definitely do not want chronic pain the rest of my life. I guess I was hoping this would restore my breast. I do miss it and I don't believe I have fully grieved what has happened to my body. Grateful I am alive, though. I do not believe women would post that they are in pain after lat surgery, if they weren't . For me, with as many negatives that I have read, it is something to strongly consider. I have just started feeling better 19 months after my masectomy. I ask myself if it is worth it to reconstruct, if I will have chronic pain. Right now, I just have discomfort from my masectomy, but I can handle that. Thank you again for your response.

  • jaybird627
    jaybird627 Member Posts: 1,227
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    Hi,


    I've posted elsewhere about my latt flap. Had it done 12/2019. No latt flap issues, only wound healing issue so PS took out the expander so I could heal properly. I now have a new PS (I believe the new one is more experienced with 'issues') and have a new expander. Hope to exchange in about 6 months? I actually have better range of motion on the latt flap side - my R side, I am R handed. I'd do it again simply because my skin broke down from radiation from 1st BC in 2005. The left is fine despite radiation late 2018. I have no pain, no issues from the latt flap.


    Edited to add: I had wound healing issues on R side pretty much from the BMX/1st expander. It was on-going despite antibiotics and silver cream, it had nothing to do with the latt flap. Removing the 2nd expander was from a scar not healing properly. I'm now fine with my 3rd expander.

    J ~

  • Paraprofessional70
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    Thank you so much for your response. It is so appreciated.

  • Paraprofessional70
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    Thank you for your honest input. I appreciate it so much.

  • anothernycgirl
    anothernycgirl Member Posts: 821
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    Para, - You should keep in mind that many of us on these boards are here because we have issues/concerns and we are looking to others for suggestions. Yet countless others have had the same procedure, have no issues, are fine, move on with their lives and rarely, if ever, come back to post.

    Although my lat side is more troublesome than the non-lat side, I think I would have regretted it if I hadn't had the procedure. Lat was my last resort. Perhaps I should have gone for PT earlier, or continued longer with it. I am in my 60's, and consider myself "youthful" for my age. Many years ago, my Mom had a mastectomy when she was 68, no reconstruction, and was never happy with her 'one sidedness'. (She lived another 30 years!)

    Look to find others who are pleased with their lat outcomes before you decide! (There was one poster a few years ago who posted photos of her amazing completed look after double lat with implants, and has returned to her active life which includes workouts and skydiving!). If not on these boards, your plastic surgeon may be able to connect you to some previous patients!