Latissimus Dorsi Breast Reconstruction
Comments
-
Dawn, I'm so sorry to hear all your difficulities. I too have MS but have never heard anything about implant issues. I had the LD surgery about a year and a half ago with implants. Let me know if there are any questions I might be able to share with my experience.
0 -
Yes I wish NOLA was an option for me. I think they will be able to do things other's couldn't! Good luck!
0 -
momof3sofar ~ I have not heard of anyone removing an LD flap. What part of Illinois does your PS reside? Would you consider going to another PS for a second/third opinion? With autoimmune disease, you are high risk reconstruction patient, and you need the very best of the best when it comes to PS care. Please PM Whippetmom for recommendations of PS within reasonable distance of you. Get another opinion. It sounds like you have fat necrosis going on if there is no positive culture in the sample. IMHO, get thyself to a top notch practice.
Has anyone else heard of a lat flap removal?
0 -
We are in central IL and I'm going to Peoria right now. I don't know what to do. I'm so upset and just want to be DONE with it all.
The reason I chose not to do implants was because they say that symptoms of leakage resemble that of a MS flare and since my insurance will not pay for MRI's to just monitor for ruptures I would not know if I was having a flare or if I had a silent rupture. Saline implants felt "weird" to the touch so I didn't want to go that route. Now I wish I had just gone the easy route of lumpectomy and radiation (even though it was a bad winter and I don't know how I would have driven to the center) But hindsight is always 20/20
I don't know what my insurance will or won't pay as far as second opinions. My doctor has really good references and it seems that I am just one of the "statistical anomolies"
I am hoping that I can hold on till Tuesday when the doctor does come back in, the skin above the incision area is stretched soooo thin right now. I worry it will just split and all the melted fat will come spilling out. (sorry it that's TMI)
0 -
momof3sofar~ Report back after you see the PS. I hope he addresses your issues quickly!0
-
I sure will. I go in first thing tomorrow morning. I'm not sure if I'm scared or excited to hear what the actual doctor has to say. I hope he won't say that I'm an "emergency case" now since this has been going on for 2 weeks.
0 -
Well, the doctor was concerned but not worried. He said that the flap part still looks and feels excellant. The problems are all in the area above the flap. He ended up reopening up part of the incision and releasing about 50cc of fluid. He then inserted a small tube to help it drain for the next couple days and will look at taking that out on Friday.
He wasn't really sure why the seroma had gotten so big, he suspected that the draining of it just wasn't enough and then more fluid built up behind where it was removed from. The pain from the pressure of all that fluid feels better but I am pretty sore right now from the proceedure.
I just hope this works. I still have more work that needs to be done to that breast to make it match the other and now I'm scared to do anything.
0 -
Just thought I'd share for those women a bit behind me in the process
I had my surgery a week ago today- Lat flap on the left TE on the right. I've been pretty exhausted since the surgery but other than that it's not been bad. This afternoon all of a sudden I'm feeling surprisingly well- off the couch for a few minutes a few times this afternoon. I'm happy with my results so far- more than I expected I would be. I am glad that my husband was able to take time off to be with me and take care of meals, dogs, etc., etc. I can't imagine how anyone would do this without help for at least a week. So far I am doing okay with the TEs- I'd worried about how they'd feel, since I could stand how the prostheses felt. Anyhow- so far so good. Wish I'd done this sooner but I just wasn't ready. 0 -
Momof3sofar ~ Positive thoughts are coming your way! Sorry it was painful to get the seroma drained, but getting the drainage tube should help keep it cleared up and get you moving in the right direction. ((((Hugs))))
paige-allyson ~ I am amazed at how well our bodies can recover from something like this. It's scary to commit to the procedure, but the fears are usually bigger than the actual hurdles we face. Glad to hear you have a great husband that is helping you. The TEs are really amazing. It is a process to watch them fill them and see that breast mound changing shape. If your pain level is controlled and you feel good enough to get off the couch, this is a good, good sign!
0 -
Westieluv- thanks. I think I may try a short walk tomorrow. Hope also to get 2 of the 3 drains out- I have my first post-surgery follow up tomorrow too-don't think the 3rd drain is ready to go yet.
What have others experiences been as far as needing pain meds? I know everyone is different but still interested in hearing other women's actual experience.0 -
Paige-allyson ~ I was able to wean myself off the pain medication after bilateral advanced lat flap recon in about 4 weeks. I cut down the number of pills I was taking by the end of the 3rd week and was moved to ibuprofen by the end of the fourth week.0
-
Well I thought I'd check back in. I had my drain (or noodle as my 7 year old called it) taken out on Friday and I must say that I am surprised it is still draining. I plan to call tomorrow but I have to change it a couple times a day. I'm not sure where all this fluid is coming from. The only improvement I can see is that it is clear now and not cloudy/pink.
0 -
Hi, I posted this on a thread named "drains" but thought maybe this was a better place to post my question. This is regarding the one drain left in my back after the lat reconstruction. I think the drain winds up under my skin all the way near the top of my incision, but the fluid buildup seems to be near the bottom of the back incision.
Well, my drain stopped working. I think it's clogged or because of it's location, isn't reaching where the fluid is located. I did phone my PS this weekend and he said I could go to the ER and get it pulled. But the ER is a hassle and costs money and and if I went to the ER they would just remove it and I would have fluid build up. It does leak around the drain insertion so I'm able to get some fluid out by gently pressing on it. He did say as long as it's not looking bad, no sign of infection, then I would be ok to wait until Monday. I have an appt to see a PS tomorrow, mine is out of the office. I've been seeing a buildup of fluid under my skin and trying to make sure the compression garmet is tight. No sign of infection.
Anyone else had this happen? What did they do? I would imagine they are taking out the drain tomorrow, but do they put in another? Can they do that in the office without you being under? I'm worried.
0 -
Hi Paige-allyson I am new to this site. I had a LD flap recon on LHS and TE fitted 27th August this year. I felt fab no pain meds after two weeks however I took great care with my flap recon and used my RHS too much. Because I felt so well I was walking to the shops and walking to and fro from school with the kids when out of the blue my TE breast got all red and started leaking fluid. To cut a long story short my rhs TE had to be removed on 19th September the wound broke down and I am now having it packed every other day until it heals and a new TE can be put in. It has put my recovery back months. So please please take it easy and treat bothsides carefully even though the TE side feels better as it has had less work done on it dont risk it.
I hope to be getting my new TE on 19th November so it is just a bump on the road to recovery but one I wished I couold have avoided.I hope all is going well for you. I am not trying to scare you just dont want you to take care. Debbie.
0 -
Whoops! I meant want you to take care not, not as I put.
0 -
Bumped for a newbie....
0 -
I remembered why I went onto this thread. Can anyone let me know when the swelling under your arm goes down and becomes comfortable after a LD flap. mine has been done 9 weeks and the scars are healed but under my arm the swelling is so big I find it difficult to put my arm down comfortably. Also I have a couple of hard lumps on the top half of my breast. My PS doesnt seem to be concerned about them but I know I will spend my days worrying they are malignant if they dont go away. Has anyone had the same thing and how did they develop? Let me know
Debbie
0 -
Debbiey: I had latismus back in January.That side looked so much bigger than the other side even though both sides had the same implant.. Got the implant changed to a smaller diameter one a little over two weeks ago. PS also cut the nerve, so I don't have as much animation. Although it looks much better than before, it still looks bigger than the other side at this time. Hopefully the muscle will atrophy and take up less space, but yes, there seems to be more material under the arm..Cutting the nerve was certainly a positive, and so was the smaller implant..but still need some healing time...I have some small bumps underneath where some fat grafting was done for dents from the muscle....I would not call them lumps, but could be stitches that need to dissolve....You might want to talk to your surgeon about it to alleviate your fears..
0 -
In regards to IRON BRA - you will always have an iron bra effect some what. Especially in the morning or if you've been sedentary for a period of time. It's important to stretch when given permission from your PS. This will help alleviate the tightness. It does get better.
On another note I have my last surgery on 12/20 for my nips. Yeah!! That makes 9 surgeries for this reconstruction. No surgeries for 2012!!!!
Cindy
0 -
How exactly do they do the nipples? I have a small circle of skin that I think is the part from my back, do they use that area? Does it have projection? I'm not at that point yet but I'm curious.
0 -
It's been explained that if it's done in the hospital what they will do it with is alloderm. They do what they call an oragami type of design and attach it to the skin. Once that is healed then they will tattoo the areolas on. Sometimes they will make a cut in the breast and pull it up to form a nipple. I guess it all depends on the plastic surgeon. On this website under Secondary procedures/Nipple Areola Reconstruction it has a pretty good explanation of the procedure.
Hope this helps. I'll check back when it's all done.
Cindy
0 -
I had a mastectomy back in 2007 and after being on a list for 2 1/2 years, received a call for reconstruction on Dec. 12. I had pretty much given up and decided to learn to live with my flat chest. Then I got really excited about the possibility of having a breast again so said yes to the surgery. The next thing i know I'm having anxiety attacks about the brest cancer coming back and now worries about the surgery. I thought i was doing okay. Is this normal? I'm scheduled to have a latissimus dorsi flap done. Is the surgery worth it? I'm seeing a lot of mixed responses on this forum and can feel another panic attack coming on. Help!!!
0 -
Faythnme:
I have been away from BCO forever and boy do I miss it! I had my DMX with immed. LD recon about 1 1/2 yrs ago. I just had my nips reconstructed 2 weeks ago. I really wasnt into doing it but for a few reasons went ahead even though i was undecided. OMG! I really feel like they make a huge difference in feeling complete again. I was really expecting to hate them but i really love the way they look. Mine are not perfect but boy I can not wait to finish with the tattoos. My DH is away in Afghanistan again and he has no idea he will be coming home to new "girls"! My little surprise to him for all his love and support through the tough times.
To all of you in the midst of all this, please know it can get so much better. I worked through the recovery and 1 yr. after surgery I ran my first EVER 5k race and have not looked back. I am enjoying my 3 young children and practicing yoga and running 3-5 times a week. I have almost no limitatiions from the muscles being moved. There are a few yoga poses I have yet to master but all things considered I am rocking it! And i wish all of you a similar recovery story. Keep believing in your self and cherish each day!
0 -
Debbiey thank for your cautionary advice and good luck with your upcoming TE surgery. I ended up taking a third week off work (sedentary job) and this made a world of difference. I'm feeling for the most part myself and have almost full mobility/ROM.
Tamgam- like you I had no clue what a huge difference this would make in how I feel about my body. It's Ben so positive for me emotionally and I'm not even done yet. Just the initial surgery has made such an improvement. I'm so glad I decided to take the leap. It's been an easy recovery. Never needed button down shirts after the first 2 days. Off pain meds after 2 1/2 weeks.0 -
Just curious how many of you had additional "tweeking" done to your latissimus reconstruction? I was at my PS appt yesterday to FINALLY get my last drain removed (surgery was 10/11) and he asked when I wanted to do the next surgery. I knew there would be the nipple portion and probably some fat grafting, but he also implied maybe something else to not make it look so wide at the bottom. Did anyone have additional surgeries?
0 -
Hi jwilco - I have had 8 surgeries to date starting with a lumpectomy in 2009. December will be my 9th surgery and hopefully final one. From the time my implants went in in November 2010 until Sept 2011 the rights side drooped a bit. I have very stretchable skin apparently. So I had it revised this past September and they looked really good now.
So I have had 2 attempts at reconstruction first one failed {not Lat Flap} the 2nd was a success {Lat Flap}.
If your PS implied something else to be done have him be explicit. If you don't ask all the questions you won't get the answers and you will worry. Just know what you want them to look like or what is acceptable to you not just now but down the road. Granted they won't be the same as the originals but you want to be satisfied as much as possible.
Oh yes this next surgery is a 2nd revision with nips.
Hope this helps some.
Cindy
0 -
Hi Sandra ~ dont' be afraid. Everyone has a different experience with their reconstruction what ever kind they go with. I did notice that for me the Lat Flap turned out to be less painful then the 1st time they attempted with just the pectoral muscle, for me that was painful, I cried all the time. With the Lat Flap I came out with TE's and 6 drains. 2 drains came out within 2 weeks. The rest came out the following week. They gave me pain pills but I didn't really need them. I may have taken a couple at night to sleep. Then somewhere between the 3rd and 4th week I started with the fills. Started out small but each week increased by quite a bit, by the beginning of July I had 800 cc in both TE's, then had my exchange in November 2010.
If you decide to do the surgery ask your PS about under the arms. I know that some women have talked about a roll underneath the arm pit {the muscle}. I don't have that, my surgeon did something to make it as smooth as possible. It looks great, even my breast surgeon made a comment on it.
If you feel you need more information you can send me a private message too. If you want,you can find the surgery on a website. Just google of Latissimus Doris Flap Video. Its pretty descriptive so be prepared. Just keep in mind not all PS's do it this way.
Have a good day!
Cindy
0 -
Tamgam ~ Hey girl welcome back!
Good to hear things are going well. I am excited about the nips but nervous at the same time. I just don't want headlights.
Cindy
0 -
Thanks Cindy. I was so happy to get the last drain out that I wasn't into thinking about my next surgery. I will be sure to talk to him more about any changes I will need/want at the next appointment. I do notice now that the swelling is pretty much down that there will be a need for the fat grafting. I also would like them a little more rounded at the bottom. I think it's the lat muscle that is there making them a little weird, at least to me. I also have an implant in the non BC side that needs to be replaced since it's been a number of years and he said that we can swap it out and maybe lift it to better match the new side. This has all been hard. Not just the obvious BC diagnosis, but the reconstruction. Years ago I had lost a lot of weight and I had a breast lift with implants put in basically to fill in the sagging breast after the weight loss. So that prior surgery dictated my choices when I was faced with BC. Of course this is a different PS than I had for my cosmetic surgery so his approach is different too.
I see a lot of posts on the site about the DIEP procedure and I wasn't able to have that due to a lower body lift after the extreme weight loss. So I've had a lot of prior surgeries and I realize that there is usually some follow up surgery required.
Thank you for sharing what you have been through. It helps to have this site where there are some others that had this type of reconstruction.
jen
Wanted to add that I didn't have the TEs prior. My surgery was skin sparing with immediate lat reconstruction and implant.
0 -
Home from the hospital after my latest revision surgery. I'm swollen and in some pain, but doing ok.
My PS exchanged out a Mentor medium profile 450cc silicone for a 400cc on the right side and extended the scar line from the flap edges into my underarm area on both sides to help make the results more rounded and less square. He also tightened up the IMF on the right side towards the sternum. At this point, what's a few more scars? Hoping that I have better symmetry with the implants now.
I'll heal up from this and see how things look. Maybe I'll get fipples sometime next year.
0
