Latissimus Dorsi Breast Reconstruction
Comments
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Julie, Glad to hear that your PS is not concerned about this spot. Hopefully there won't be any pressure on it and it will close on it's on after letting some of that fluid out. Hang in there!
Well girls, it's back to surgery for me. My PS wants to do a revision on both sides with a smaller implant on the right. I agreed to do it because I do have a symmetry issue and I want results that are more round and less square. This will be surgery #5 for me. The bra shopping has officially stopped. I have a feeling that the ones I've bought may not fit me after the next surgery is over. I am not going for big, just more closely matched. I have just over a month to be nervous over this development. No matter how many times you go in, it's still not something you WANT to do.
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Hi to all,
I'm 10 weeks out from a bilateral and double lat. I've been thinking that this should be feeling better by now, but still am taking tylenol (without codeine) on a regular basis. It sounds like I'm not the only one who still has the tightness and pain. I didn't have implants, but am scheduled to go back in December for liposuction from my stomach being put into my breasts. I'm not entirely sure from what I've been reading that this always works. The last thing I'm looking forward to is more surgery, but hope this will be the last.
Joyce
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Day, Do you still feel this way about your surgery?
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It has been a year and a half since my surgery and last night I was turning over and felt this horrible pain under my left arm - just like I ripped something but was so sleepy somehow got comfortable and went back to sleep. Now I know I pulled the muscle as my whole back is sore but weirdly enough it is worse on the right side just behind my arm. Any ideas on this one - I mean the two muscles aren't connected .... are they? Just feels like a really sore bad pulled muscle so nothing scarey but still painful especially when I breathe which is a good thing to do now and then.... Thanks
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need to read
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Hi Julie - Why wouldn't the PS have you come in so he/she could take a look at it? I don't understand that. I don't know about putting cream on an open wound. It won't dry up to close the incision and let it heal. Sometimes you have to be insistant with doctors. I know if my incision was opening and fluid was coming out my PS would have me in the day I called.
What I would do is get some tape and make a butterfly bandage and close a section of the incision yet let the fluid drain. If it's not better in a couple of days then I would insist the dr see you.
When I had my first attempt at reconstruction and had the TE's removed due to complications I developed an infection in my right side {not the diseased side}. The PS removed the fluid and it took a long time toheal until I let my PT massage around the area and then it healed really quick. I hope this helps.
Cindy
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dharris-
I had lat dorsi flap May 26th. I have the tight pulling feeling too, but I can tell you that it has gotten a lot better over time. I try to massage every night. I dont notice it as much anymore.
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Faythnme,
I described what was going on with the openings to the nurse.She prescribed an antibiotic ointment to put on the openings. It took several days for it to work,there is no more fluids draining and two of the openings are just about healed.The one that is giving me so much trouble is finally healing.I guess I must have done something that made me build up fluids,and my body could not absorb it.I started feeling really good three weeks after surgery,so I decided that I was well enough to do some yard work and vacuum.Big no no.Just a reminder to you all that have gone through this surgery.Be kind to yourself and take it easy.Your body needs time to heal inside and outside.I learned the hard way.
Does anyone out there have any suggestions on stretches for your back where they took our muscle out.Sometimes it feels so tight.
Julie
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Julie have you see a oncology PT? They are great they can work around the skin of your scars so you don't develop scar tissue..at least too much. That's what I did. They helped me a lot.
Cindy0 -
Well, had my revision surgery yesterday. PS changed the implant from a style #20 to a style # 45 which has 1.2 cm. less diameter and 4 mm. more projection. He also disected the nerve and also cut the muscle. There is much much less animation on the side . The animation now is only from the pectoral muscle. and similar to the other side. As far as the wideness, it does not look that different yet than it did before the exchange, but I know there is a lot of swelling and he also lipo suctioned under the arm which is adding much swelling. It still looks flatter than the other one, but much improved..He filled the dents at the bottom, and right now, it looks much better, but don't know how much of the fat I will retain. It still looks flat in one area in the middle, but could be the bamdages and the bra was pushing on it, and causing more of a flat look than it will be once healed. All in all, it is a great improvement... Perfect NO.. but only time will tell...Hoping this will help some of you with decisions..Will keep you posted with progress report..
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joiedevivre ~ Glad to hear that things went well for you. I am interested in how much relief you get with the animation. I so hope that it is everything you wanted and a great relief to you with results that are acceptable and lasting. Keep us informed as you recover.0
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Yes, the animation is much much improved. Like I said, the animation from the pectoral muscle is still there like the other side that did not get the latismus, but the side animation from the latismus was really ugly and disfiguring.. I am very pleased with that part of it. It is very acceptable to me. Only time will tell how much difference the smaller diameter will have done...The indentations seem to be much better also with the fat grafting..I am hoping that I can feel ..job well done and move on with the nipples..It has been long enough.. I am thinking of the 3D tatto....Hoping that will be my next project. I do not think I want the nipples grafted since I do not like to wear a bra, and I would feel uncomfortable with nipples showing under my tight tops...And my temporary tattoes that I ordered from Canada look amazing, but do not last very long at all, but does give an indication of what could be expected....with permanent 3D tattoes... I read that you are planning on a smaller diameter implant also..What size and style are you thinking of?
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I'm going to do the same profile on the implant. We need to leave the left side (that is the one that had all the skin issues) alone. Just replacing the right side with a smaller implant. My left side had a chest wall deformity, so it sunk in quite a bit and so it makes the right side look slightly larger. I hope I am doing the right thing. The left side just looks more like a natural breast...so I think it is best to leave it alone and do the manipulations on the right side where the skin is not so much at issue. It's hard to put yourself in the PS hands again in trying for symmetry, but what can you do? He has told me repeatedly that I will need fat grafting, but he holds off on doing that until the nipple surgery. No grafted nipples for me because of the skin integrity. It's too risky that the graft would not heal to the surrounding tissue that is devascularized.
I feel ok with my decision to move forward on the revision, but I just wish I didn't need to do it.
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That's interesting my revision was on the right side as well. I'm starting to think it has something to do with which side is your strongest side. I do everything with my right arm so gets most of the stretching and pulling.
My PS actually stitched my muscle {with the implant" up further on my chest and tacked down the middle so that I could get some kind of cleavage. It worked. I'm still swollen in some areas but hey they look much better. No flatness in the middle of the breast and no having to wear a cutlet to round it out.
Joeie what kind of bra did you use for support after the revision? I use a front closure sports bra. It's better than any other bra I've tried. It has several hook and eyes that run down the front {6}. I got mine at Fred Meyer for $15.00.
Cindy
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Are the dents & indentations you all are referring to caused by the way the lat muscle is now lying? Just curious because I can see mine along the bottom/side of my right foob. It isn't a huge deal, but if fat grafting can help I will look into it.
Also, how long before you were given the go-ahead to wear a bra & what kind after your lat flap?
Thanks for the help.
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What makes it a revision and what makes it cosmetic? Can't figure out this one. I also agree front closures tend to look better....
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By law anything pertaining to reconstruction cuz of BC should be covered by. This was my 8thapologies surgery for reconstruction.
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DLL66 ~ My PS would not let me go into anything except a soft cup bra for about 3 months post exchange. I felt much better when I went back to an underwire, but finding one that fit properly was a real challenge and my bras are about $80 a piece. I just felt like I needed the extra support.
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Thanks Beth. I'm only a month out, but my PS said no bra right now. I was just curious how long that might last for.
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I had unilateral mastectomy May 26th. I'm scheduled for nipple reconstruction and revision Dec 7th. Has anyone gone a little bigger for symmetry? Will get implant in good side. Im worried about the PS replacing implant in reconstructed side. Also, will I have drains again? Thanks
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I had unilateral mastectomy May 26th. I'm scheduled for nipple reconstruction and revision Dec 7th. Has anyone gone a little bigger for symmetry? Will get implant in good side. Im worried about the PS replacing implant in reconstructed side. Also, will I have drains again? Thanks
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DLL66 I didnt go back to regular bra. I've been wearing a front closure sports bra since my surgery.
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Hello ladies,
I am recovering from lat dorsi surgery on Oct 7th. The only real pain I feel is in the morning. It feels REALLY tight and swollen. I guess the pain comes from lying on it for 7-8 hours. Once I take a shower it feels a heck of a lot better. I still have one drain tube in too so that isn't helping things. I get that little sucker out tomorrow. Yippee. Anyway, I was fortunately enough to get me permanent implants in at the time of my BMX. They are still a bit swollen along with the area where the muscle from my back was twisted around to the front. My PS said that it will go down in time and I need to be paitient.
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Just wanted to report that my iron bra constriction has gotten alot better since I started going to Yoga classes. I've now been doing Yoga for about 1 month and I really can tell the difference. Stretching it all out with regularity seems to be the key for me.
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Hi Nell, glad to hear you're doing great. I know u can't wait until the drains are out! That's is the worst part. I had the lat dorsi flap too. Only on left breast. Now that all of the swelling is down I'm a little uneven. Will get implant on good side in december. So far everything has gone really well. Ready for it to be over though. Good luck at the dr. Tomorrow
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Hi, I just want to thank you, especially Chicago, robo and Wippetmon. I also want to provide a follow up to you all, with the thought that it may provide some help to a few people.
I had a BMX with immediate recon with TE in Ap 2011. Due to an infection, I had the TE taken out 6 weeks later. 2 PS's, one my original and another at a major medical clinic, both said that the only option to proceed was LD. So I researched and discovered that I might be able to get endoscopic LD, and went for a consult with that purpose. I was pleasantly surprised that this PS (at the same major medical hospital as the first) said I did not need LD at all and the TE could simply be put in again. I had to wait months, due to his busy surg schedule, but it was done 2 weeks ago. The procedure went smoothly and I am recovering without any incident. This reinsertion was done in day surg, I was discharged at noon, only used OTC pain meds, no drains, and had only that one day down time (with the exception that he recommended not getting my heart rate up when I work out, until now, due to the risk of a hematoma). I know that my situation is mine alone, but I want to share this with the hope that it may help someone avoid unnecessart major surgery.
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I am at my wits end over my reconstruction failures.
Background: BMX on 11/10/10 with Tram on right DIEP on left. Hematoma evacuation on right 11/11/10. 12/8/10 DIEP failure and removal of tissue. 8/1/10 LD left side.
Two weeks ago I started getting some swelling and pain on the left side. Went into the doctor's office but was only able to see NP because my doctor is out of town till 11/1. NP grabbed someone else at the practice and he drained off 36cc of what looked to me to be melted fat (the same stuff that was leaking out of that breast before they deemed it dead and removed it) Things were ok for 2 days and it started again. I went back in (doctor is still gone) and the NP removed another 20cc of similar gunk from a spot near where the last one was. (that one is sunken in now) This was on Thursday. Today is Saturday and it is swelling even more and there is an area above the scar line that is puffy and honestly looks and feels "thin" like if I bump it it will burst.
I have an appointment first thing in the Morning the 1st (my doctor's first day back). He told me that this one couldn't fail but from all accounts it looks to me exactly like it has done just that. I am in pain, on an antibiotic (even though the culture came back fine on the first batch of fluid)I was wondering if anyone has ever known anyone that had a LD flap removed? I think I will have the Tram side removed as well if I go under again. I have never been pleased with the scaring and hated being lopsided for 8 months before the LD. I think I will just have to accept no breasts and move on with my life. (I do not want implants because I have MS and symptoms of implant leakage resemble the symptoms of MS and my insurance won't pay for the MRI's to monitor)
Sorry this was so long but I've never seen anyone that had a LD fail and yet I think that is exactly where I am now.
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My PS mentioned this surgery as an option for my recently failed implant. I can't say that I support his decision. I've had arm and shoulder issues ever since my BMX this past December and I fail to see how cutting that area even more will make things better for me. I have been doing a lot of research on DIEP. After have 5 babies, I sure like the idea of having a flat tummy ....and great breasts!
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Make sure you research your doctor for DIEP REALLY well first. My LD flap was a replacement for a failed DIEP. The tummy tuck, while is nice on one side, it left a weakend spot on the right side that while is not a hernia is an obvious buldge. 20/20 IS hinesight but I think I would totally do no reconstruction at all if I knew then what I know now.
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Thanks Dawn. I'm looking into going to NOLA. I just have too many issues with that arm and shoulder to even think about another incision or additional muscle tightness in that area. I sailed through a BMX with ALND, plugged along through chemo and rads and now it's the reconstruction that is giving me the most grief, I hear 'ya sister!
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