Latissimus Dorsi Breast Reconstruction
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Thanks for the information on the therapy. I went to the BS yesterday and she set up an apointment with a physical therapist and a massage therapist for today. Not covered by insurance, but only a 10 dollar co-pay. -
April Joy My surgery was Dec 1 - UMX right side with LD and expander Came home on Dec 4. No pain pills during the day, one muscle relaxer at night. First two days at home needed one Percocet during the day. Have been sleeping in my own bed, with three pillows and one pillow under my leg. Getting up was a challange at first, but so much easier after one week. No pain at all in my back, howeve the skin feels so tight and the staples itch a bit. My biggest complaints are that I can't lift my right arm (node biopsy) and sometimes I forget I can't turn and try to (like in bed as sleeping on my back is not normal for me) and there is a 'pull' in my back. And of course the inabiity to soak in a bubble bath - oh I miss that.
Clear a space in the bathroom for your supplies - getting all you need within reach. I also cut my hair short so it would be easy to deal with. Soft button front pajamas are so necessary, but also get some outside shirts - I forgot to do that and have just one I can wear - no idea why I thought I would be wearing pajamas all the time. Ask for non-child proof lids on your medicine so you can open them easily.
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Hi, I am new here. Although this is not my first ride with BC. I had my surgery, bilateral BMX/bilateral LD flap surgery on Oct 21. I am a teacher and luckily before this all happened I had many sick days accrued. I will not be returning to work until Jan 3 when the kids and teachers come back from the holiday break. This is giving me plenty of time to recoup and get strong. Although I have been working from home, doing the lesson plans and grading, as the subs have done the teaching. It took about 4 weeks for me to reach the point where I was strong enough to sit and look at the school work and I did 4 weeks worth of lesson plans before I left. I planned to go back to work on Dec 5th, which would have been four weeks, but I decided that I was not ready, still too many doctor appointments and I had my first Herceptin infusion on December 1st. I wanted to know what the complications would be for me before I went back to work. With all my sick days accrued and an allowance under our contract for an extra 20 paid days, I will go back to work feeling much stronger and ready to deal with my 7th grade students.
The only issues I have with the healing process is when I wear supporting clothes, such as bras or shelf camis for the TE's, it bothers the LD incisions on my back. I live alone, kids are all gone. So I had to make something to reach those scars to massage or put lotion on them for comfort. I took an old wooden spoon and wrapped in in a soft face towel and use that on my back several times a day. It helps!!! I also still find it uncomfortable after fills to move. Alot of pull on the back. I do sleep on my side, sort of, I put pillows behind my back to support kind of a side lay without pushing my TE too much to the center or out of line. Until I could do that I had miserable nights sleep, as I have arthritis in my spine and sleeping all night on my back was miserable.
I have noticed with the TE's and the LD surgery that my posture has improved. I feel less pressure all around sitting or standing straight up. It also helps to project my new breasts!!!! I have some issues with the stretching process where the old lumpectomy scar is, but it lasts about a week after the fill and I'm fine.I have recovered rather quickly in all aspects and we are planning my exchange in mid February. I am done with the fillups. I am where I want to be.
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Hi all,
I'm just finishing up rads and had an initial meeting with my PS. He recommended doing LD surgery this summer. I'm meeting with him again in April. He did say that I would need either silicone or saline implants in addition to the LD. Have any of you had experience with this. Not quite sure what to expect. Just trying to gather information for the April meeting so I can ask intelligent questions.
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Nans: Your PS is recommending LD straight to implants?
I'm finishing up rads tomorrow, and am wondering if my surgeon will recommend this as well.
I had a TE failure during chemo back in July.
TTay
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ttay-My PS says he will need to do implants in addition to the LD. It was just our first meeting so at our next one I want to find out why. I thought it was normal to have both at the same time but I'm seeing that this isn't always the case. I don't know if I just don't have enough muscle on my back or what.
Are you doing TEs again? My PS says they are a no go because of the rads.
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ttay - I had skin-sparing with immediate LD flap direct to implants. Some PS's do it that way.
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Hi ladies. Hoping someone here can help me. I had bilateral lat flaps in June of this year. Great outcome. No regrets. For about the last 6weeks, so 6 months after surgery, I started having pain that seemed like muscle pain on my right (dominant) side. It's in the same spot maybe an inch to the right of my spine not far from the scar. Its better when I rest but I feel it almost all the time when up and awake. Ps says likely a result of the surgery as other muscles learn to compensate for the ones they took. That makes sense. The more i do (activity/exercise), the worse it is. Then again, since it's so frequent I'm starting to worry about mets. I have been working out, doing planks, abs, etc and I suppose that could be playing a part. I don't want a scan unless I really need it. Has anyone had this type of chronic pain? Thanks!
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bcisnofun
I never experienced anything like that. April will be 4 yrs since my surgery. I think you may be doing too much too soon. Try taking it easy. You can still workout but I would stop doing the planks and do an easy workout. I ran early on and did light weight workouts. You will eventually get back to your fitness level. So ease off and see if the pain lessens. Keep in touch.
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thanks Linda. So tough to take it easy, but you're right. I'll give it a rest and see if it improves again. thanks again!
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I see that we have some new ladies in our group. Welcome to you all!
I've been laying around with NO exercise while I healed from the last revision surgery. my DH and I start the new year off with a return to the gym and my yoga class. Anyone else getting on the post holiday diet and exercise bus with me? He's getting me started on the flat belly diet. Oh boy!
I have a few more days to wallow in the land of sugar and all that's yummy!
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Count me in for the diet and exercise although still have no idea what type of exercises I should be doing!!
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I have chronic pain after 2+ years and it doesn't get any better. Trying to work out made things worse. The "muscles are trying to compensate" I think is a standard response with PS's who never bothered to tell you before the surgery that chronic back muscle pain may be a long-term side effect (among other) of this type of surgery.
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Sorry for the late reply. Been so tired from rads.
nans: I'm not sure if he'll do a TE again. I'm UMX. I'm heavier also, so it may be LD with immediate implant; lift and implant on the other side. I had the TE for over a month, so I'm not totally flat on the right side...not sure if that will factor in at all.
I do have a consult with a different PS on Thursday...just to get a different opinion about things and to check out his work.
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ttay-What does UMX mean? I think my surgeon intended to do the LD with immediate implant with a lift and implant on the other side too.
Day-sorry you've got back problems. That is definitely something I will ask my PS about in April.
Westieluv-so glad you mentioned yoga. That is one of my favorite forms of exercise. I'm looking forward to getting back into it as soon as my rads burn heals a little more. Have you had to modify any poses because of your LD?
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nans ~ I do modified planks instead of full planks but it is really the only pose that bothers me since it is such a concentrated pectoral/core body move. I am starting back next Monday to my class. I also take my time to ease into my poses and don't worry about keeping up exactly with the group. I am looking forward to getting back to the gym, doing my yoga at least 2-3 times a week and feeling better. I feel like a slug with all this laying around....and I've gained about 10 lbs in the process of recovery.
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Wishing all the ladies on this board a Happy New Year! I resolve to finish my recon procedures in 2012 and get on with my life. God speed to you all dealing with various stages of treatment, reconstruction and healing.
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UMX means unilateral mastectomy. Just my right side.
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I'm confused!! I thought "Lat Flaps" were an alternative to DIEP, not something one does with TE and Implants?? Help!! My PS and I went over my choices very quickly and at the time I didn't qualify for DIEP (nor did I want it...my first choice was to do nothing, but I'm convinced I won't feel good that way now), but she mentioned the Latissimus as an alternative to DIEP - which I totally dismissed (atleast in my mind). I thought we had settled on Alloderm, TE and Implants. Did I possibly misunderstand something and she plans to do what I thought we were doing plus a Lat Flap???
I guess my question is, what is the necessity of a Lat Flap if one does a skin sparing BMX???
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Hi Kam - I had the latissimus dorsi surgery on Dec 1 - I did not consider it to be an alternative to DIEP but just one of the options available for reconstruction. (I did not meet the requirement for a DIEP as have had previous abdominal surgery.) The surgery was done for a right UMX, so only on that side. I also have a TE as the reconstruction will be augmented later - either through liposuction or with an implant (probably lipo as not much more 'fill' is needed). The TE stretches the skin for the later surgery. I also had a skin sparing sugery, but not a nipple sparing. So the lat flap (the skin taken) was not significant. But the scar is long and the back is still tight.
Teresa
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Ok - still confused. Do I need the skin from the lat if I'm doing this (TE to later) reconstruction at the same time as the BMX?? I have enough skin now lol, btw!!! At one time, the BS said to me, "we only do skin sparing masectomies here," if that helps. I feel like I'm missing something here....I thought the lat flap was about harvesting fat (and skin) for a reconstruciton...not for needed skin.
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The procedure does not use fat, but rather the muscle from the back. And with a skin sparing mastectomy the nipple and the aerola are removed, so you will need 'new' skin.
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Seriously? Even if I'm going smaller?? This is major news to me as I'm scheduled for TE/Implants in 3 weeks (and a BMX). Do they always do a Lat Flap. Always?? (I am rather upset thinking this is going to happen, so looking for exact reasons why they would do this)
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NO - you decide what type of reconstruction you want based on what will work for you. I could not have a DIEP so decided on the lat suegry after discussion with my PS on all available options, even options she did not do.
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I think I'm just confused and am still not understanding why when a lat flap is done in addition to TE, and when it is not needed with a TE and Implants. When I last saw my PS, my take away was that I could have done a Lat Flap and it had nothing to do with TE and implants. Apparently I was wrong based on what you are saying, I think. Now I wonder what PS surgery I'm really scheduled for in 3 weeks. I understand it is my choice, but I'm just trying to figure out what choice the PS thought I made or what choices the PS offered, as separate and distinct choices.0
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In my experience, I had a lat flap done on one side with a TE because of impaired circulation due to radiation. I later ended up needing a second lat flap on my non-rads side due to skin integrity issues; because I was almost expanded enough, my PS was able to go straight to an implant on that side.
I do not believe lat flaps are normally done unless there is a skin issue or you have had radiation.
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I had the lat flap on my left UMX side because I didn't qualify for DIEP due to prior ab surgery. I also already had a previous breast lift and had an implant. I had skin sparring but they couldn't keep the nipple. So I needed the skin from the lat flap for the nipple area. I also think the muscle from the lat flap is being used to help support the implaint. Oh, and mine was straight to implant, no TE. I think the circumstances vary based on your situation. If you feel at all like you aren't clear on exactly what procedure is being done and why, then I would suggest a visit back with the PS prior to your surgery. You are entitled to know what to expect and to feel comfortable with that procedure. I felt that way after my initial appt with both the BS and then the PS. It was so much information when all you have in your head is the word "cancer" and "mastectomy".
BTW, I had my surgery on Oct 11 and will have some reconstruction and the nipple done in March. I have gone back to working out and am slowly building up my free weight routine. So far, knock on wood, although I do feel it differently in my lat flap side, I'm able to do my usual exercises. For me this surgery was a blessing and I feel very very lucky to have been able to basically go back to work looking like I did when I left. 2012 will be my year for seeing the glass have FULL.
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Ofcourse I will go back to the PS, though last week everyone took off for the holiday and tomorrow may be a holiday. I'm just having this epiphany now, anyway, after reading this thread.
Up until reading this thread, I never conflated the lap flap with my planned surgery. The only reason I'm conflating it now is because after reading this I just don't get why one would do a lap flap with a TE and Implant. (I've probably stated this before). Then I remembered my PS talking about DIEP, then Lat Flap as another option, then what I thought was my operation to be, Alloderm/TE/Implants. Now I'm wondering if I didn't separate ,mentally, her discussion of Lap Flap with her discussion of Alloderm/TE/Implants, while she was combining the two. Help!
If one is having a lap flat WITH TE & Implant, is it because of radiation?? Is it because reconstruction done years after a masectomy?? Is it because of quality of current breast skin - too thin? Is it because one wants to go bigger than their original breast? I guess I still don't get it. I'm not having radiation.
Sorry for my persistence, but my question maybe hasn't been clear and I can have atleast 2 sleepless nights over this one!
DL66 - Sorry, I missed your post. I think you've explained it to me! Now I just need to clarify with my PS.
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I didn't have radiation. I did already have 36D breasts and the extra muscle was needed to better support the implant.
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jwilco - so it was about muscle, not skin? I have large breasts. She mentioned "building a sling." This was in addition to alloderm (to cover the implant where the pectoralist muscle didn't). I guess I should clarify with the PS what she plans to do with my lat muscle.
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For me I think it was put almost the same way with the phrase "building a sling". The implant is partially under the pec muscle and the rest is covered and supported by the lat muscle. I also think it helps to add a cusion with the lat flap so you don't feel the implant directly under the skin. That first appointment with the PS made me feel a little overwhelmed but my husband was with me during the appointment when the PS discussed everything so he was able to remember the pieces I forgot. I also was able to email the PS after our first appointment and asked a few questions. That helped too.
It's amazing all the ways they can do the reconstruction. I was reading everyone else's stories on this site and realized there are so many options. I had to put faith in my BS and PS that they were selecting the best option for me that would have the best outcome.
Good luck with your surgery. I hope it goes well. If it is the lat flap, check back in with us.
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