Latissimus Dorsi Breast Reconstruction
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Anyone into Yoga on this board? I know ZERO about it, but a friend recommended that I try some YOGA instead of the weight training for now. Looking for a Yoga instructor/classes in my area. I'm in a rural area, so that is no easy task.
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I tried my first ever Yoga class this evening. I sucked at it but loved the class so much I am willing to keep trying. I had no balance and was tight all over. Can't wait to go again. My instructor was very willing to help me modify poses that may put too much stress on my relocated muscles. It was nice to have someone that actually wanted to help me recover. All the other exercise instructors just look at me and my back scars and freak out. Guess we aren't too common in their world and they don't know how to handle us.
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Hi ladies, I'm going in for my Lat flap surgery in 14 days and I'm terrified!!! I have had my MX on 9/11/03 and i have finally got the gumtion to be complete again, NO MORE RUBBER BOOB!!!I am really active @ 50 I got a Harley and I have never looked back, I have amazing people in my life and it's now time for a man to be in it also. I have not been with a man in 8 yrs since my husband left, I can't imagine even dreaming of being with someone, with this chest , as men are a visual bunch, I know ohhh there's someone out there for you who wouldn't care, but so far no luck.
I hate that rubber boob and now it's time to complete this journey and be whole again.
So ladies I have read all the posts but will I be ever able to ride my Harley again and this is my worst nightmare not to get on that thing and just fly....
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hardtail59
I definitely think you will be able to ride the Harley again! You will be motivated to get the wind in your hair and get back on that bike as soon as possible. You will need to wait until you get medical clearance and be sure to discuss it with your PS, but I do just about everything I used to do (with the exception of tennis). I just modify my movements so that I don't engage the pec muscles or the lat muscle too much.
I say go for it! You can have squishy boobs and ride that Harley!
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Hi Ladies ~ Well tomorrow is the day for what will hopefully be my last surgery. Revision on the right side because it drooped too much, a little on the left and nips. I decided to do the whole thing because I didn't want to have any regrets later. I might even come out with a flatter stomach. I have a great PS!!!!!!
Cindy
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Cindy! Big congrats! Best wishes tomorrow1
I did have my surgery on 9/2. LD on the right and both expanders removed. I am healing well. My range of motion isn't the best, trying to practice reaching my arms over my head.
I'm happy with my decision to have the TEs removed, I really needed a breathe, but I'm pretty sure I will try again at some point.....
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Cindy ~ Hope everything went well on your surgery. Let us know how you are doing when you feel up to posting.
I have a follow-up on Monday with the PS to look at my situation. I would love to be done, but I think some tweeking needs to be done before I move on to nipples.
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Hi Ladies,
Someone may have addressed this earlier, but has there been any studies or info of women having their latissimus dorsi reversed and just having inplants? I wondered if it were even possible to move the lat muscle back to it's old position. I'm sure it couldn't be as it was, but wondered if it's possible to even move it back.
Anyone hear of anything like this?
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Hi all:
Just wanted to put a light at the end of this tricky lat tunnel...I am almost 4 years out now.
I continued to get these subtle changes, month by month. Almost all of the feeling is back in the skin of my breast. Yup, I said breast. What begins as an alien "lump" almost becomes in effect, adopted by you. You come to feel it is your same breast, but just has new "stuffing"..which is true, you know.
I have never heard of anyone putting the lat flap back, but my GS tells me that your other muscles compensate for the lack of it. This was true for me, after two years or so. Everyone is different.
You do need the lat muscle, or the implant wouldn't hold. It's working as a sling. I promise, I promise, hand to heart, your breast, Barbie or cherry on top will feel like your own breast once again. This weird feeling of the alien thing in there passes.
Be gentle with your new girl...both she and you have been thru alot.
It takes alot of time!
xoxo
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Anniealso ~ Thank you for taking the time to come back and let us all know that there are changes over the years! Most of us are still in the pre-op or post-op period and it is so encouraging to hear from the ladies who have gone through it all and are years out from the procedure.
Did you notice the atrophy of the muscle and things calming down gradually? Did you modify any of your activities post surgery or did you find any particular motions to be difficult for an extended time period?
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I am probably having my reconstruction done on 10/11. Bet it's a harder recovery than the mastectomies so I'm nervous. I do yoga- great strength training alternative. Wonder what it will be like after the lat reconstruction. I'm doing just TE on the non- radiated side. Can't believe I've finally signed on for this but after 4+ years I'm clear that I HATE being flat and hate the prostheses (or, as I unaffectionately call them, "fake tits"- not to offend those inclined to express their feelings more delicately
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Baxter - I was going to ask the same question. I've been deciding between a lat flap and DIEP, but my BS is not comfortable with the DIEP and the PS at the hospital is experienced, but the BS felt not experienced enough. I'm past 2 months after I found the lump and just want the surgery as soon as possible. If I get a lat flap, can I go back in a year or so and do the DIEP?
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Rachel, I have read that you can indeed have a DIEP after other surgeries if you are not happy. I read this on JohnsHopkins site. I don't know how long you would have to wait, though.
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Hi all:
No, I have not had any atrophy, per se, not really sure what you mean by that?
I am a little bit weaker on the side that had the lat flap, but overall my strength is the same. I did notice for about two years, that the scar on my back would ache and swell a little bit with exertion. Now, I've pretty much forgotten about it, I do what I want, but I try not to lift excessively heavy stuff altho I can. It'll just let me know about it, the day after and once in awhile the iron bra will kick in if I've done too much. Kind of cause and effect.
My PS did warm me off forever doing pushups and strength training with that arm. He felt it could trigger lymphedema (I do not have it) but also that if I tried a pushup, that my arm would not hold me. This is indeed true. It sounds dramatic, but since I do not do pushups in my daily life, no loss for me. If someone were pushup crazed, this might bother them, I guess.
Some yoga poses I can't do. But I should think that a very good instructor, having been told what muscle is affected and the need for strengthening the muscles around it, could modify your routine? My arm will just collapse under me if I try it; however, since I did not do anything to strengthen it, that's probably why. My GS was very specific that the other muscles can and will compensate. There are lat flap ladies that kayak, rapel (sp?), strength train, etc. It can be done.
My breast looks amazing. Lat flap recovery is long. It's not painful, but you can get some muscle spasms afterwards. I heartily endorse PT and a PT that is trained in lat flap recovery. Ask at your cancer center, they have names there or should. I did many, many, many stretches in recovery for months. 3x daily. It only took about 10 minutes, but so worthwhile. For a few years after I got iron bra, off and on. If you do a good stretch against it so that your chest wall gets that pull, that can fix that. Many times I'd do it while shopping, driving, etc.
Nowadays, I barely need to do it, but after we moved my daughter out of her dorm room, yes, that night I had iron bra and had to do stretches. Otherwise, I barely even think about it anymore. The scars on my breast are gone, the one down my side is just a thin white line.
When I think of what they did, I am still amazed. It's an incredible operation, if well done and well worth it. I would never elect to have it, but since I had to go there (previous rads and lumpectomy) I would call it an unqualified success.
My PS was astounding. I have regained all feeling in the breast except for the very tip.
PM me anyone with any other questions, I will try to help.
Best of luck, all. Lat flap is a beautiful, natural result, the best one out there.
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Thanks Annie. I'm still awaiting further discussions with my PS and BS about what's going to work best, but it was reassuring to hear positive things about lat flap. I had read a lot about migrating implants, discomfort and bulges under the arm. At this point I'd be comfortable with either, though DIEP really sounds like a great option if it works for me.
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My appointment with the PS was rescheduled to October 17th. I emailed a question to him about the lats not wanting to relax and alot of involuntary flap movement that exacberates the situation. I had Whippetmom look at my current pics and she suggested I try an implant stabilizer band. PS said NO to that and explained that it is the lat muscle that is causing me the problem. Using an implant stabilizer won't help if the muscle itself won't relax. He said he needed to see me. If he would quit rescheduling my appointments, then it wouldn't be a problem.
I have decided that I am not moving forward with nipples until we address the flatness issue. I am interested in finding any women who have had the lat muscle denervated. I am wondering if this is a viable option for me.
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I'm still totally confused about latissimus dorsi and lat flap surgery - are they the same thing?
It has been aa year and 6 mos. and my back scars still give me a lot of pain and not only are my breasts still totally numb but my back is totally numb.
However, I do exercise and do pushups - no one said not to. My PS said I couldn't hurt anything... hope he is correct. I can swim not as fast as I used to be can swim just fine. Haven't tried tennis but I'm thinking that would be difficult as would rowing be but never have tried that.
My doc said if the lat muscle did create problems he could go in and snip the nerve. However he said he could not fix the dent on one side or the extra fat under my arms that got trapped above the lat muscle. He said after the initial reconstruction then it all becomes cosmetic and not covered by insurance which still doesn't seem right to me. Anyway, he did say it was possible to keep the blood supply but still can cut the nerve. Hope you can get help on this. I too have some flatness and had asked about taking some of that fat under my arms and puting it behind the nipple are to make it more "pointed" which he said he could do "cosmetically". However with what I've read just injecting fat it will melt away and not stay.... now why doesn't that work with the fat we want to get rid of - maybe a really extreme way of losing fat??
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H Stanzie, yes they are the same thing.
Any PS usually does what is covered by insurance only. PSs can charge outrageous fees by not participating in insurance plans.
See if he's got a payment plan in place for this. You might wish to consult a different PS in network, as this can be fixed by lipo (the dent and the extra). It is true that the fat might reabsorb, but in many cases, sometimes the second or third try, it stays. It's kind of a crap shoot on it.
If you have pain in your back scar and elsewhere near any surgical site, that would probably be the pushups. No, you can't hurt anything, but the reason that my PS said not to is that my back scars would swell and cause me pain. Even vacuuming did that for about a year. Ditto with the swimming. It takes a long time (years, sometimes) for other muscles to take over and if you keep inflaming the surgical site with these types of exercises (plank poses in yoga, swimming, weights, push ups) it won't be able to stop pain or swelling. It will aggravate it. That's my PS's take and my PT's take on it. In my own experience, it certainly did cause both.
This does not leave us with much exercise for the upper body which is a shame, but flabby upper arms are the price for a pretty boob I guess. Lat flap has it's limitations and this is one.
Everybody is different, perhaps you feel that the pushups and the swimming are worth it. If so, I
'd do stretches before, after and continually in the days following. Expect pain and swelling tho. and if you get the "iron bra", well, at least you'll know why.
Good luck to you!!
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anniealso- Thank you so much. I did not know any of that! I appreciate you taking the time to explain all that.
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I am going to schedule latissimus dorsi recon surgery for Feb 2012, 30 rounds of radiation and mastectomy with TE on left breast first. I am having a difficult time deciding whether to proceed with this, but time seems to be ticking. I have recently recovered from lymph node dissection which took 6 weeks and was very painful. I wonder how this surgery will compare. I am so worried about the pain involved, but also know that it is only a short time out of a lifetime, I am only 41.
If I have one TE on the left and LD on the right, is there a possibility that my breasts will be different? taking this day by day and couldn't do it without this board.
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Nicole, I have had lat flaps on both sides & I did not find it to be that difficult of a recovery. My first lat flap was the right side with TEs placed on both sides. My second lat flap was on the left with placement of implants. I had rads on the right side only; the skin on my left side did not tolerate being stretched by the TEs, which is why I ended up with a 2nd lat flap. In both cases I was able to return to my full time job 2 weeks after surgery. The recovery time after the second lat flap was much easier. The TEs caused much more discomfort than than the actual lat flap.
I would say the possibility exists for the breasts to be different, but that is something to be asked of your PS. The radiated tissue could cause the difference, not just the lat flap.
I am only 2 weeks out from exchange, but my non-rads side is already relaxing & becoming softer. The rads side is a lot firmer & tighter.
Good luck to you!
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westieluv: I am scheduled to have the nerve cut on October 24th. He is supposed to cut the nerve and put fat in the dents that have been created by the lat muscle. He will also put a smaller diameter implant since the muscle is flattening and widening the implant.....I am soooo hoping that I am happy with this result as I am really burnt out on these surgeries... I was always told that it was supposed to look better with the lat muscle...NOT so for me....Bummer....Will keep you posted on my progress...
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joiedevivre ~ Interesting option to go with a smaller diameter on the implant. I'm torn on the nerve dissection issue for me. While I don't enjoy the animation, I have seen some of the same animation from BC girls without lat flap, so I wonder how much is from the pectoral muscle and how much is from the latissimus. I will be hoping that it solves the issue for you.
I have some areas where some fat grafting would help, but my lat flap graft sites are thicker and have more subcutaneous fat under that section than the rest of the stretched skin from the TEs. For me, it doesn't give a natural and smooth appearance to the contour. I have heard that some PS are willing to lipo sculpt the flap as long as there is no concern of devascularization in the skin flap. It would be ideal to have fat harvested from those areas and reintroduced to the thinner skin areas of the upper pole where we get the step off.
If I can achieve some sculpting on the sides (under the arm and at the top of the scars on my back), I think I would be happier with my outcome. There just isn't a normal appearance of contour on the sides and I think this adds to the appearance of wide and flat planes.
I'm still looking into the Cook Biodesign nipple cylinder. Not sure my PS will use it, but I really want to try that. They are getting improved results with nipples that don't shrink dramatically and hold their shape long term. If I must have a more flattened breast shape, the least they can do is give me a great nipple.
Good luck with your procedures. It is very hard to volunteer for more surgery, as this reconstruction process is long and very unpredictable. I think it is better to get what you want and take it slower but get the procedures you need spaced out. The multiple anesthesia courses do take a toll on your body.
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I had my lat dorsi surgery Sept. 12.My question is if I over did something to make my incisions to start draining fluid.It started out with one area under my breast that seemed to open up and a little blood came out.Now from that area it just seems wet with a really light coloring to it. It does not look infected ,but it scares me because when I had my lumpectomy,fluid came out of that incision also.Maybe I am worried for nothing,but would like to know if this is normal.I do not go back to see my plastic surgeon until Dec. Should I call them,or just wait to see if it stops draining.It is not a lot of fluid,but I thought my incisions were healed.My breast does not look any differant,like it is filling up with fluid.Can anyone give me some advice as to what I should do or not do? Thank you for all that you have written on here.This is the first time I came on here looking for advice.I have been reading your posts and found some of my questions answered,but not this one. Thanks for any advice. Julie
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jabl1252~ I think that if an incision has opened and has fluid coming out of it, you need to call the PS. There could be trauma below the incision line that needs attention. Err on the side of caution and call them to let them know this happened. You don't want to take any chances here.
All of my incisions were glued with dermabond and did not open at all. Call the PS.
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westieluv,
Thank you for the advice,I will be calling my ps Monday morning.I will let you know what is wrong and why my incisions are opening. Julie
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Linda,
Please tell me more about the "tight bra" feel and how long it takes for it to go away. I am 12 weeks post-op latiss and immediate implant (no expanders). I am not a cryer and usually good with pain but I am about to go out of my mind and have cried each of the last three days. I feel as though I have a very tight straight jacket on (rather than a bra) and while that makes me feel at times as though I have to work hard to breathe, the worst is when the straight jacket feels as though it is lined with bark. Do I just need to be patient, or is there something that I can do. I am already taking a "Gentle Yoga" class twice a week, PT visit once a week, PT exercises every day, and weekly massage (not a regular massage but one that focuses on the incisions to keep them "loose"). I am so afraid that this won't get any better. Thanks for any guidance, Dree
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Dree
Since I had expanders then implants I don't know if I can help you. All I can do is tell you my experience. With the expanders it felt like a boa constrictor tightening up around my chest especially when I would run. I thought it was the expanders and that when I had the exchange all the tightness would go away. I was so very disappointed when it did not. I did all the stretching I was suppose to do and also went for PT. My PT did not specialize in this but she helped me all she could but it did not help. I got back into my strength training but after a while decided that I would no longer use the weight machines that work the lats and also the pecs. I used an exercise ball and did stretching in the floor on my knees with the ball in front of me. I did these everyday until I had a hysterectomy and I had to stop and never got started back with the ball....but I really do not think it had helped much. I think we eventually get use to the feeling and learn to live with it. I hardly notice mine anymore unless like now I am thinking about it and it is still there. But for you dear sister it sounds like you are suffering and could never learn to live with the tightness. You should let your PS know and he is probably gonna tell you "it just takes time".....and it very well could. Like I said, I don't know about going straight to implants and the kind of tightness you arefeeling. Hopefully someone who went straight to implants can give you an answer that will give you hope.
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Dree, I had permanent implants put in right after my DMX with one lat dorsi flap in March. I experienced all you are and did all you are doing. It did start to lessen up - that tight iron band feeling- after about 16 weeks. I know, long time. I don't know how big your implants are compared to what your breasts were but I went 100cc smaller and I think in doing that it helped to put less stress on my pecs, incisions and tissue and skin holding the implants.
I know 12 weeks seems like a long time but it's not for major surgery like this. As Linda said, also check with your PS. I am now 6 months out and really don't notice my implants except if I bump or touch one and feel nothing. That is still so weird. It's like someone stuck some tennis balls onto my chest! Good luck.
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Well I called my ps today and was told that all this was normal,that sometimes incisions open up to let fluids out.The nurse is going to call in a prescription for an antibiotic cream to put on the openings and to let them know if it does not get better in a couple of days.Hope this works.Thanks for the advice.Not so scared now. Julie
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