Latissimus Dorsi Breast Reconstruction
Comments
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Faythnme ~ I guess I am thinking the same way, cause I still have mine stored in the closet.0
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you might want to check in your area for a cancer resource center....we have one where I live and they have a special room full of wigs, prosthetics and other things that have been donated to the center and women can come by and get what they need for free. So many women do not have insurance so cannot afford the high cost of these items. It is a wonderful thing to be able to give back.
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Am heading for surgery on March 19. Not a good canidate for DIEP and I did not want to be under for 8 plus hours. One implant and one TE with LD flap. How do I pull that off? How much time should I plan on taking off from work?
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Hi ckgrayoh - Not totally sure on your situation - I did blmx with te's and ld flaps on both sides. I was off work a total of 4 weeks. The first two I didn't drive but the last two I was able to shower, drive, go to the gym to build up stamina, etc. Good luck!
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I am new to the site but I wanted to know if anyone has ever had issues with the latismus flap surgery. I had the surgery 2-1/2 months ago and in the last week I keep feeling pain on that breast. They say problems are rare after this surgery but I'm worried. When my skin failed before this surgery I feel like I have similar pain. Can it fail again? I thought this surgery took care of that. I have been going to physical therapy to get my strength back. Could that be why? I feel it in the new flap part they retrieved from my back. Any help or info on this would be appreciated. Thanks
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Hi everyone! I know I haven't been to active on here but I have been reading the posts every day! This is such a great resource. Anyway, my surgery is on Monday, February 6th... I am excited, but I am also having mild (okay, more than just "mild") anxiety about it.
As I mentioned in my introduction post, I am having a prophylactic bilateral mastectomy with immediate LD reconstruction with an implant... I am having the surgery to reduce my risk since I am hereditarily predisposed to breast cancer.
This surgery is daunting. I've been studying it for a year now (after having consult at the mayo clinic almost exactly a year ago) and I am having the surgery in Canada... I know the risks but wow am I ever nervous still.
Ladies, what can I expect? How did you all feel immediately after the surgery and say the first day after? I feel that's probably got to be the worst in terms of pain and what not... I am just so anxious to have it all over with... I need a little support from some women who have been through this since friends and family dont really know what to tell me other than "you'll be great" etc etc.
I'd appreciate any words of encouragement/comments! Thanks everyone!!!0 -
check out posts from Day on this subject. I know she (and others) have had issues, but don't know if they are the same issue. However I had the surgery on Dec 1 and am feeling rather good. I still have 'twinges' on the flap but those lessen as time goes by.
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April,
I had my BMX with LD reconstruction in October, I am three weeks from exchange. Overall I did really well. My surgery was supposed to be 4-6 hours, I was under for 8hours! It took them 2 hours to wake me up! There were no complications, just that I had lumpectomy and radiation on my right side 10 years ago and more work was needed for that side due to scarring and radiated skin. .
I was finally put in my room around 9pm and found my mom, dad, and daughter waiting for me! My dad refused to leave till he knew that I had my morphine drip, he didn't want me in any pain. I had excellent nurses. Only issues I had were getting up. Having both sides done, there is no muscle to use arms to push up. I had to have people pull me up once I adjusted the bed to straight. I learned to scoot my butt to the edge of the bed without using my arms at all.
The nurses wanted me up and moving immediately and I gave them a hard time, I admit. I kept telling them just give me a day, I know my body, I'll be ready to move in a day, but I was still so out of it from being under the anesthesia for 8 hours. They made me get up anyway, which made me cranky, it hurt! The second day when I finally did get up and walk, was fine, although I didn't walk much. By the time I went home, I was mostly out of the bed and walking.
My real issues came when I got home. Getting out of a hospital bed is easy since it adjusts to sit position. A regular bed not so much. I didn't have the strength to hold my body up. I used my abs to sit up. I tell everyone now that I have the strongest abs in town!! (Not true, but I do like saying that, lol). I have full range of motion now. If I slouch at all my back gets very sore. I have much better posture than I ever have. It's hard to get used to the numbness of the foobs, however, as time goes on, that is getting better. They were rock hard for a long time, I massage 2 to 3 times a day and they have become softer and I even have some jiggle in the upper skin.
I chose to stay off work for 7 weeks, I teach middle school and holiday time is nuts with the kids, and I wanted to go back fully healed. I was driving the third week. But was restricted to lifting only 3 pounds for a month. Then it went to 5 pounds, then 10, now it's 20. I am starting to get itchy on my back, can feel the nerves healing. But overall, I feel pretty good about this. There were no other choices for me, so yeah, I'm doing okay.
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Apriljoy: Nice to hear from a Winnipegian...
That used to be my old stomping ground.. I lived in St Boniface and went shopping at Eaton's and the Bay on Portage Avenue all the time...Went to school at St.Joseph's Academy in St.Boniface with the nuns. Still have many friends and relatives living there. Some lived in Transcona, and some in St.Malo....Small world isn't it? Well, just want to wish you luck on your upcoming surgery on Monday..What hospital will you be at ? Hoping all will go well for you and keep us posted....Hugs to you 0 -
Apriljoy: I was wondering why you are getting the LD surgery along with the double mastectomy. Why does your surgeon feel you need the LD surgery along with the implant..???
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Apriljoy. I will say that post surgery was hard. I felt like a truck hit me. Not trying to scare you just being honest. Blmx, bilateral lat flaps and te's. Every day got better and by the two week mark it was much better. Not easy but temporary. I was off work for a month. Good luck!
Joiedeviere the lat flap over the implant helps it look very natural.0 -
Apriljoy, if you are having prophylactic and skin-sparing, there is no reason for you to use the LD flap. Period. Did you have radiation that burned the skin? I doubt it, as radiation is done after the surgery. Do you know if you will have radiation? If there are chances that you will, again, do not do the flap as that is the only thing they can do afterwards if your skin gets burned.
Make sure you do not do like me, to do a LD flap just because the PS wanted this surgery in his portfolio to get in the Board. There is no need for you to have a flap with implants if you don't have radiation. Go TE+ exchange.
Kerrberlady, sorry you had to deal with idiotic nurses. If it would have been me, I'd have told them to f* off, with no ceremony whatsoever.
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I'm surethat the doc knows what he/she is doing. just ask your doc why he is recommending what he is. I had enough skin too and no rad but the lat flaps with implants looks and feels great. I have a friend with just implants no flaps over it and she's going back next month to do the lat flaps. I've seen her results and she has seen mine and mine do look more natural.
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Hi everyone! Thank you all SO much for your support and comments and tips!
Yes! The reason I am having the LD flaps is because my PS felt it would be a more natural look and since I am so young, it'd look most natural in a bikini and tank tops and what not!
Sorry, this has to be a quick reply! Off to the spa with my boyfriend for a relaxation massage before the big day Monday! I'll reply back to the rest of the comments in a bit!
Thanks again!0 -
Apriljoy: I am concerned about you getting the LD muscle because it is taking muscle from your back that you may need later.. Is he going to do a full LD or a muscle sparing LD? You will have a scar in your back and you will have more animation in the breast than if the implant was just under the pectoral muscle. Now, you will have animation from both muscles.. At your young age and wanting to look good in a bikini, will that bother you when you make certain movements, to see your breast jump and make strange movements... You will not be able to wear backless dresses because of the scar in the back...I am not trying to scare you, but these are all things you should know beforehand, and if that is okay with you, then go ahead. i am sorry I did mine..It was on one side only, and the other side looks much better than the side with the LD. It is flatter and needs fat injections because of dents caused by this LD muscle....Think about it and ask questions...I wish you the best......
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I would never move my LD muscles unless there was a very good reason to do so....never would I do it to get a more natural look. I cannot go braless wearing something solid color...it has to be a pattern print. This is because my flaps show thru. I guess I could get some fat injections to smooth out around the flap edges but I do not want to go through another surgery. I have to be carefull with clothes...swimsuits etc. I had to have the LD because of prior rad treatments. My doc said it was to high a risk for infection etc going just to TE's. That scared me so I agreed to have the LD recon. I know there are different kinds of LD recon...some do not use any of your skin from the back but if this is what your PS intends to do...well the skin from the back is a different texture and color than the breast skin....the flaps will look different. I have seen some great looking LD recon where the flap of skin is round and it's placed where the areola was then you can just have the flap tattooed to be the color of a nipp/areola. I have the football shaped skin flaps.
Do you have access to the picture forum?....
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No, I didn't know there was a picture forum! How do I get access?
My PS told me my flap will be round where my areola will be tattooed on.0 -
My lat flap is that way, with just the round portion where the nipple was located. I needed the muscle flap to support the implant. The plan is to use this round portion to create the new nipple and then tattoo it. Yes, the skin is a different color than the breast skin but the scar around the circle of skin has faded a lot considering it's only be since October. I didn't go into this surgery without researching what was possible for my case due to prior breast augmentations, wanting to keep my UMX side the same size as my other side, etc. I trusted my PS since he worked directly with the breast cancer team. Honestly I haven't noticed much difference in my activities due to the missing muscle. The scar on my back is longer than I had expected but I've seen other's photos and they do vary. Just be sure you know what you are in for and expect from what ever procedure you decide. It's a tough decision but in the end it is your decision. Research your options and good luck with what ever you decide.
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Hi Everyone! New to this thread. Tried to read all the posts but there is way too much.
I had a lumpectomy on 8/30/2010 with 6 weeks of rads. I still have my nipple but everything under that is gone and I have been left with a huge dimple and a nipple that points down and to the left. I recently had an appt with a PS who is recommending LD flap. I have been doing research online but have not been able to find much on total recovery time, how long is the surgery? I read a few posing back - someone mentioned LD flap vs muscle sparing LD flap. Can someone explain this to me? I am looking for whatever information you ladies can give me. I am shooting for the end of April so I have lots of time to gather information. Thanks!!
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Hi Jo. I know you from the tammy thread - welcome! Can't tell you how long on surgery b/c mine was bilateral plus mastectomies. Also my doc tried a new technique using robotic surgery where they harvested the lat muscles and tissue through the front. It worked on one side, so I have no scar in back, but the other side he saw a blood vessel and wasn't sure he could get around it on that side so he did cut my back on the one side. So with all of that, the surgery was very long! I know I was one of the first that this surgrery has been performed on and the results are really good. I was off work for 4 weeks but the last two of those I was able to drive, go to the gym, etc. By week four I was walking four miles a day and feeling pretty good. First couple weeks were rough though. Good luck!!!
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Hi all~ Sorry if I have posted this question before . . .
I had BMX with direct full implants placed. Mastectomy was problematic (7 hours) with two tumors that were difficult to excise, plus one was shoved up again my skin and the other was shoved up against chest wall and the skin of my inframammary fold under my breast. Also had two positive lymph nodes. (This pathology for the lymph nodes done while in the operating room).
The plastic surgery recon was immediate and only took 2 hours making the surgery a total of 9 long hours.
So the day after my surgery I'm told I'm n/oing to need radiation. So couldn't that have been determined in the OR so the plastic surgeon wouldn't put in full-direct implants? Maybe instead just do TEs or suggest delayed until radiation done? I have been hearing from other docs over and over -- we don't do immediate direct full implants because of radiation . . .
Anyway! If a LD is necessary to fix radiation damage, what good is a golf ball sized round piece, or a mini-football sized piece of muscle going to do for an entire breast that was radiated? It sounds to me like a softball sized piece of skin/muscle is in order.
Also, does anyone know if an LD flap can be a free flap versus a ped flap that is tunneled under the armpit/axillary?
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bcisnofun - I do know you from the tammy thread. Thanks for the info. There are only 2 plastic surgeons in the area where I live. I have seen one and plan on making an appt with the other one and then compare notes. The one I have not seen is on my insurance provider network. They would cover surgery with either one of them - with the latter I get a 5% discount on my out of pocket expenses.
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apriljoy, You will need to send nowheregirl (use to be Timtam) a private message asking for permission to enter the picture forum. She protects our pictures with an ironclad fist. Since you are fairly new to this site you will need to do more postings so that she will know you are legit. She is strict about this and we are so thankful that she is a great protector. Noone would post pictures if they thought anyone to hack into her forum and get to our pictures. The picture forum is separate from BC.org. I don't know how many postings she requires but I am sure you do not have enough yet.0
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Hi Linda54,
I'm interested in "talking" with nowheregirl also. How do I go about sending her a message? I saw that I needed to go through her profile when I tried but don't know how to get to someone's profile unless I'm reading their post.
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nans - Go to the top of this page and click on member list. Then type in her name. You will be able to send a PM that way. Hope this helps.
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nans, jo1955 is right....top right corner of this page...click on member list....then type in "nowheregirl" and it will take you to her page. Look to the right and you will see "send member a private message".....0
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Pink Heart,
Usually when they don't know if you will need rads or not they don't put in the direct implant - just the TE.
There is no "ping-pong ball size" muscle taken. They take the whole muscle and a piece of skin on top of it the size they need it (the piece of skin not the muscle). I do not know what a "muscle sparing LD flap" looks like though. and no, the LD cannot be free flap as thre is too much tissue and it won't survive by itself, without the respective blood vessels.
this is how a LD flap looks like
Apriljoy.... your PS probably is like mine was, and wants to tuck in under his belt more LD flap surgeries under his belt. There is NO reason why to take a healthy muscle and put it in the place of a breast when you don't need that procedure. Also, IMO, TE+exchange always looks better than LD flap - and I say that from what I have seen on the pictures forum.If he says he cannot achieve a natural look with TE+exchange, change the PS.
You might be lucky with the LD flap, and not have many problems, except for the "iron bra" but then you might not be lucky, tbh, by what I have seen more than half of the women who have had the LD flap recon done are complaining of chronic back pain (and it's muscle pain not pain due to spine issues), weakness in arm, etc. Also, be aware that you start having problems way out of the surgery, about 3-4 months if not later, you do not realize right away what's wrong.
Also, you will have cuts on your back (not all PS's do the laparoscopic procedure through the areola cut) and also bulging under your arms, and your back will look weird, you will have a straight narrow back until right under the shoulder blades where the back will suddenly "expand".
Kind of like this:
http://www.youtube.com/watch?v=tw4lMwV3s-M
and here you can see a little bit of animation
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Day - Your post is most interesting. It is kind hard for me to really research this or any recon option since I did not have a masectomy. I had a lumpectomy and a big chunk was taken out. I don't think I could consider the DIEP as I have a good sized scar from an ectopic pregnancy many years ago.
From what my PS said, he will use the same incision as the lump, create a tunnel and bring the muscle around. He never mentioned an additional incision on my back. I have another appt with him on the 20th to ask just those kinds of questions.
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I would like to say that there are now a myriad of surgical techniques that are used by experienced PS and not all lat flap procedures are alike. The illustrations are good, but I have seen individuals that had the muscle relocation with no back incisions when no additional skin was needed. In addition, the actual flap size, shape and location on the chest wall vary greatly from surgeon to surgeon.
Because there are so many variations of the surgery, it is very important that you ask to see illustrations from your PS of his proposed surgery, also ask to view pictures of patients he has already operated on and ask for a full body marking of the proposed incisions so you can judge for yourself just how large those incisions will be.
It is a very serious surgery. You don't want to wake up from anesthesia and be surprised by things you didn't anticipate.
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any kind of free flap has to be done by a micro-surgeon...
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