Latissimus Dorsi Breast Reconstruction
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Hi all, has anyone besides Day had back issues from the surgery?
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I have not had any back issues. I had mine done in 7/2011 & 9/2011. I can feel occaisional tightness around my ribs, but it is nothing that interferes with daily activities. It's just an odd sensation.
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I did not have radiation but did have the lat. surgery. I will not have implants either. For me it was a decision to have the lat instead of implants. But I do have a TE for future lipo. I also did not need the tissue to 'build a sling' as I am somewhat small breasted. So there are many, many variations of and for this surgery. Only one month out so can't yet tell if I will have back issues....
Teresa
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I just wanted to add my two cents. I am 3+ years out from LD surgery and I have constant muscle issues on the lat flap side. I manage it with streches, motrin, heat and rest. Sometimes it is unmanagable. PS said that my experience is not the norm. Lucky me! If you have an alternative to lat flap for reconstruction, I would consider it. Personally I regret my decision to have it.
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I had the latissimus dorsi procedure 2 months ago with an expander. I had bilateral mastectomy last March. After staph and other setbacks this should be the last surgery before implants. Doing well and the tissue looks good. I am however, still draining around 50 into my jp. Anyone else drain this long? This is my first post so excuse me if not submitted properly.
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I had my drain for the lat flap section from Oct 11 (day of surgery) until week of Thanksgiving. It was still draining a lot but finally started clogging and was evenutally removed because of that and irritation. It's a long time for a drain. I hope you get yours out soon. It made the world of difference in my recovery once it was removed.
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I've had really bad back issues as well, 2.5 years out from my BMX with lat flaps. I work all day with a computer mouse and that's contributed to the problem. Basically, the lat muscle no longer supports the scapula the way it should, all the other muscles are weakened, the traps try and compensate, and I end up with constant severe upper back neck and shoulder pain.
I've tried PT and pain management and nothing has helped. I'm trying another pain clinic this month to see if they can get me on something less addictive than the Fentanyl which the other clinic prescribed.
I wish I had been presented with other options at the time of reconstruction because this pain has impacted my life and is destroying my ability to work.
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Kam170
I had bi-lateral MX with immediate bi-lateral LatDorsi flap recon with TE's. My surgery 4th anniv will be April 28th. After expansion I got silicone implants. I had a lumpectomy with rads 23yrs prior to my 2nd DX. My PS told me that without the flap of new skin and new muscle the expander had a high rate of breaking through the skin and causing infection. I did not want to risk multiple surgeries so I went with his recommendation. I also had the same recon done on my non-cancer side. PS told me that we would get a much better match. They would look more like twins than cousins. When a person has a diep there's usually plenty of belly fat to make nice size boobs. Most people do not have much fat on their backs. If a person did not use an implant with the Lat flap then they would end up with a very small breast. I was going a little larger so I was expanded then had the implants inserted. I am pleased with the lat flap recon..just wish I did not have the tight bra feeling but it has gotten better as time goes by. The best to you. Keep in touch.
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Day, monomee, anyone - I'm interested in your opinions. This constant pain from the surgery is really affecting me (see my above post). I've had a lot of trouble with getting addicted to painkillers, but that's the only thing that helps with the pain. About 4 hours into my job, I am in agony and have to take something. I know I should look for a different type of work, one that doesn't involve me chained to a computer, but right now I'm the only breadwinner and other jobs are tough to come by, especially since my particular job is a highly skilled one.
When I was doing PT they said exercise would strengthen the muscles some, but I would never be free of pain if I stayed in my line of work. I worry that eventually I will lose the use of my arm.
Physical therapy, pain management, a new desk, I feel like I've tried it all. Any other ideas?
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RE drain issues - Teresa/Temcgrat, I had surgery Dec 1 and still have one drain at about 50cc per day. Heading to the PS today to find out how much longer I get to keep my little friend.
Teresa
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Hi ladies - I only had my drains two weeks (bilateral mx with lat flaps and tissue expanders). Felt like an eternity, so I'm feeling for you ladies at a month or two. I will say we probably pulled one of my drains out too soon, and hte fluid built up in one area of my back. PS drained it once with a needle, but the same pocket refilled. doc said it if didn't go down on its own, we would have to do a small surgery and take the lining out that has formed to keep it from refilling. As soon as I had my port removed, I started wearing athletic bras that came low and covered the puffy area and it improved so we didn't do the surgery. I've noticed though since I stopped wearing those bras, it's back. So, long story short, the drains are a pain in the neck, but don't take them out before it's really time.
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Good advice. Back from PS. Drain for one more week. I still drain about 50cc per day however I walk about two miles per day. I could stop walking and probably stop output but then when I become more active there would probably be a fluid build-up. So, drain stays in, I try to stay positive, but it is getting harder by the day,
Teresa
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Happy New Year Ladies!
I go into the PS today to get my stitches out of my brand new nips today. She said there are a cazillion stitches. During surgery during the cocktail hour I apparently put my hands on my breasts and was doing something {probably massaging them} so I ended up with blue ink on my hands from the marker where they marked for the nips to go. Then I wouldn't let them take the breathing tube out of my mouth. They said I was quite entertaining. Love these stories. So now I am back to recovery and back to work today after 2 weeks {vacation/surgery}.
Things are going pretty well. Now I need to concentrate more on changing my lifestyle and increasing my exercise regimen.
Minxie - I too sit in front of a computer all day long; however I don't have the issues you are experiencing. I know that it is real important to be sure you are sitting straight up and doing stretches everyday. I have a ball I sit on periodically that forces me to sit straight and it has helped a lot, but I was doing that before all the surgeries {9 to date}. I hope you are able to find what works for you. All I can say is stretching is important to do everyday.
Cindy @--{--{--
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Hi Minxie,
I didn't take any narcotics. I took flexeril, skelexon and soma. I do strech to help prevent the spasms. When it gets out of control I just suffer. I can't go on an stronger medicine because I have to work too. I work on a computer all day as well. I changed the position of my keyboard and that helped. ( changed to a down pillow too) I often try not to use the arm on the lat flap side so it does not tighten up. I am sorry you are having issues. I remember my PS telling me that I would not miss that muscle at all. Unfortunalty I do, everyday.
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I too was walking daily but the activity kept fluid up. PS immobilized arm with sling and said bed rest. I am down under 40 after 8 weeks! I tried being back to work after just 3 wks causing setback. I think Friday will finally be drain removal! This has been tough. I really appreciate the great feedback. I was feeling like I would never lose my drain...I even named it (Cloris Leachman).
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Minxie, hi, I am 4 years out from lat flap and I am sorry you have this issue.
I agree, with a computer job, and a lat flap, it is all body mechanics. You must take breaks every hour, stand up, stretch (I have some goodies if you need them, PM me) basically put your body into an opposing position from what it sort of "glued" into during your work hours.
I really don't have any issues, unless I lift alot, sit at the computer alot, etc. then I get the "iron bra"...for me, it's all the stretching.
My dr. prescribed me a very small dose of clonazepam as a muscle relaxer. No worries, it is not enought to make me unsafe driving, or drooling...but it sure helps with muscle spasms. Sort of sounds like you've been in spasm so long, you have an impinged nerve and yeah, that is wildly painful.
So, to recap (but Do Not Ascribe Dr. Status To Me, Talk To Your GP!!!)
mild relaxants, stronger dose at night
better posture
stretch every hour, all day long
stretches AM, Lunch time, Dinner, Pre Bed (I mean a more intense stretch and longer time)
Good luck!! You might need an antifinflamatory as well, to break that spasm you have. With time and patience and work, it can be done.
PM me if I can help more.
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My drain is just 'little friend" and after 36 days ready for it to go! Yesterday I went to the PT for a longer session. I had been so afraid to touch my new breast for fear I would damage 'something' but the PT recommended daily massages - and it felt amazing when she did it! I could feel the tissue becoming more supple, more breast-like. There had also been a small knot near my rib; was told it was scar tissue and it was 'popped' - wonderful! The pressure from that is now gone. Also was shown exercises and stretches to do daily. Yes, it pulls a bit, but hope in the long-run I can regain full ROM on the right side.
Faythnme - glad you have your nips - that is in the future for me, so hope you have some words of wisdom; and thanks for your entertaining story! I chuckled when I read it.
Teresa
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Hi all!
Popping in here to provide some helpful information from the main Breastcancer.org site on Latissimus Dorsi Flap reconstruction.
Hope you find this helpful!
--The Mods
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Teresa, just thought I would say that I hope you get yoru "little friend" out soon. I know how you feel and I guarantee you will feel even better without that "buddy" dangling from your side. It's amazing what a difference no drain makes.
I have my revision surgery in March to my left UMX side, along with possible adjustment to the breast on the right. I really hope I don't have a drain again.
I hope everyone is doing well today.
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I have received opinion from plastic surgeon to use Lat Dorsi muscle to repair complications from initital breast reconstruction (with direct one stage implant) as well as some radiation damage.
I also have truncal lymphedema (swelling under breast and under armpit and down my side) due to lymph node removal.
I am wondering if sliding the Lat Dorsi muscle around from my back to the front will cause more problems with the lymphedema as it will pass through exactly where I have the pain, tenderness, swelling spot of lymphedema.
Has anyone had this same problem?
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Just wanted to share a post I submitted in another thread (The Joy of TE - Keep Arms at Your Side!). I have found this site and everyone's contributions, support, and advice so helpful so many times. (Many thanks to Faythnme for taking the time to respond to my questions...) It took me FOREVER to decide to have reconstruction done. I was scared and wasn't sure it was the right thing to do. After all, I was diagnosed early and hugely grateful for that. Anyway, my post is below.
Interesting how doctors prescribe follow-up to this (TE) surgery! I had a delayed latissimus dorsi reconstruction surgery with a one step implant (Mentor) on December 12th. (I had a complete mastectomy in 2007 on the right side.) It was not the easiest surgery and I was happy to stay in the hospital for four nights.
On December 19th I had all four drains removed and was told NOT to wear any kind of bra. After about 10 days of pain killers, I dug up a camisole that I had used with my prosthesis and wore that. It had one of those little shelf pieces of material that held both breasts gently but securely and it was amazing how much better I felt! However, the plastic tube for filling the implant rubs against my ribs and is pretty much a constant source of soreness but other than that, I can't complain too much.
I had my first fill on January 6th which was not too bad at the time. Three days out, I'm feeling a bit uncomfortable and have the sense that my breast extends under my armpit but figure it is just the swelling. Worst time seems to be during the night and in the morning. Circulation must be less and the implant maybe moves or settles somewhere. It can be sore. However, that had disappeared until I got my fill so maybe once everything settles down in the next couple of weeks, that feeling will go away.
I was not given any exercises/stretches to do, told not to lift more than 5 lbs, and encouraged to rest and take walks. I've been pretty good at following the instructions but feel like quite a slug! My kids are grown but I'm used to being busy and being active. I am anxious to get back into yoga but was told to wait another three or four weeks. I was also told I was trying to do too much and to take it easy.
Anyway, I know I am a bit off topic but just thought I would share. It took me a long time to decide to go for the surgery. I've had plenty of surgeries in the last five years and this was one of the toughest for me in terms of pain and discomfort but already I am happy with the results. I will have the left side 'upgraded' when the right is finished. Can't wait!
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update -- Drain is out!!! I can now move! And after another sesson of PT I have almost regained ROM. Still tightness in back (around scar). Big outing today is to buy new bras as my current ones sit wrongly on me now. Plus, am smaller on the recon side still. But having that drain out is great
T
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Yahoo for the drain removal! I know for a fact you feel better. For me it was like I night and day.
Good luck in the bra shopping. Mine sort of fit ok. Funny, they are all the same size, same make and model, yet some fit better than others. My lat side is slightly larger than my other side. But I have my recon in March so I'm holding off on buying any new bras. Check out the discussions on bras. I think it's bras 101 or something.
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Thanks will check it out as yesterday did not go shopping (slight issue with water draining from the washing machine in basement kept me home-bound).
Also have found that PT is really helping me. Some of the stretches and massages she has me do would have never done by self - fear of casuing damage to the site or to the muscle - but with PT support I now know that the exercies are ok, just as it is ok, and recommended by her, to massage the breast every day. Still feel tight, but daily getting better
t
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I will be talking with my PS next week about Lat surgery. We tried the TE route, but my incision kept bursting open. The skin and muscle stretched great, but the mastectomy scar where he re-cut to insert the expander just would not stretch (I had rads there last year). I am greatly encouraged by you ladies who have had success with the Lat procedure. I'm willing to endure the discomfort of the whole thing as long as the result is good. My goal is to get it done over the next few months so that when my daughter gets married next summer I can wear a fabulous dress! I'd love to hear more success stories though. The pre-op anxiety is setting it.
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I am going in March for my surgery. Already had mx on one side, this side will be reconstruted and have a te. The other not affected side will have an implant. How does that work? Will I be lopsided? Do I need to find some shoulder pads? I believe the PS said I would come in to get te filled once a week, not sure for how long though. How do you hide one C cup and one TE????
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Alex56 ~ I continue to do well post surgery in my recovery. It isn't a perfect surgery as far as ease and there are long term effects of repurposing that muscle, but for me, it was the only option to reconstruct. Given the same circumstances, I would do it again. Try not to get to anxious, every time you start feeling that way, sit down and write out your thoughts and what is concerning to you. There are lots of questions to ask in this procedure, so don't feel overwhelmed. We are all here to help you.
fitzdc ~ I'm doing the Hallelujah chorus for you right now on getting that drain out. I'm thinking TV show where the music just fills the room as the relief floods your body from getting the drain out. No more octopus, grenade, etc. Yeah!
ckgrayoh ~ You may be slightly lopsided for awhile. They have to get enough fluid in that TE and it takes awhile to stretch the flap out. Most ladies just stuff the bra with a soft fill form or wear large shirts with vests, etc to camoflauge the eye while the PS is getting things evened up. Matching the sisters is a plastic surgeon's art and they sometimes have to make adjustments as they go. I've seen lots of photos of sisters with the TE side riding high and the native side hanging down a bit. You can usually use cutlets or other supplies to make you look even in your clothes. Good luck on this upcoming surgery. March will be here before you know it!
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Westiluv~ I just sent you a PM.
All~
I'm getting anxious about my consult on Monday at Mayo Clinic-MN for latissimus dorsi surgery and possibly to also surgically remove severe axillary cording issue.
I'm also am wondering how "different" my right breast will be from the left until I have next surgery to revise the left to match the right. After my double mastectomy in July, I had immediate reconstruction with direct, full implants. So I'm looking at the LD as repair work on complications from surgery as well as radiation. I'm hoping that they still go with a direct, full implant again because I really don't want to deal with a TE and having to go for gradual filling and then replacing with full implant later.
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I would hope that since you were already accomodating an implant that they could go directly and add one at the same time as the lat recon.
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