Latissimus Dorsi Breast Reconstruction
Comments
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Beth - That is the kind of information I am looking for. When my PS told me he wanted to do a lat flap he did not say anything about a second incision on my back. I really won't need a whole lot to get the results I am looking for. I have an appt with him on the 20th to ask just these kinds of questions and the more I read on here the longer the list is getting. I will not be getting an implant - don't need one.
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Jo - Glad to hear the information was helpful. I have seen some truly amazing things where they use the muscle and are able to do it with microsurgery techniques and not make a large back incision. There usually is some sort of small laproscopic incision on the back depending on whether the procedure is done robotically. Sometimes no back incision is done at all. I needed maximum skin and muscle, so my incisions are scary looking. Hopefully they will fade with time.
Just make the surgeon spend the time necessary to go through it all. If your doctor publishes studies or is at a teaching facility, you will find that they have published surgical articles that explain the upgrades in technique. Be sure to ask for links to his articles so you can read them for yourself.
I really feel that this is a surgery that shouldn't be done by doctors that don't do the procedure frequently and keep up with the changes in equipment/approach/technique. You want an expert at this and it isn't the time to be taking "good enough".
Let us know how you are feeling about it all after your appointment.
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Beth - I have found out that he works with the only "breast center" in my area. I did not know there was one when my BC journey started. I loved my surgeon - he still will take care of anything I need. He did not mention any back scar which leads me to believe he will not use that much. I have probably a third of the boob that needs to be done. I will update everyone after the 20th.
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Oh I so wish I had had more information before having my surgery as this is one surgery that you cannot take back. I know a lot of people are very happy with their results but I wasn't told some many things that became unpleseant surprises. I wouldn't have chosen this type of surgery if I knew what I know now. Also I guess there are more options that were not available two years ago.
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I am scheduled for LD flap on March 7th. Getting very nervous, but thanks to all the posts, I have a long list of questions for my PS. I go in next week for preop labs, etc. Will get to see PS then. He did tell me I would have a small incision on my back. Will ask him how many inches is small to him.
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My small incision was an angry looking 7 inches across my back one month ago. Faded to almost nothing now (except weird skin flap at end to be corrected).
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I too have a "small" incision that is oh, maybe eight inches. I know it will most likely fade as my other scars have faded over the years. But I don't like the saggy skin that is no longer attached to a lat muscle. Don't get me wrong, there was some sagginess prior to my surgery, but now it's not the same on both sides. I see my PS this Friday. I'm hoping I can keep all the questions straight and remember them. I also hope he can move the "nipple" area over before he creates one. That is my number one gripe. For some reason I'm a little too far to the left. <sigh> I try my best to put all this in perspective. I've read other posts and I know I'm lucky.
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I had a lumpectomy and am lopsided. I saw a PS once who told me the best option for me would be the LD flap. After reading posts on here it appears that some are happy with the results and some would not do this again. I'm not sure what to think - getting a little freaked out here. I have another appt on the 20th and have a long list of questions. The one thing I am going to ask about is the incision on the back and just how long it will be. I have researched the DIEP flap and unfortunately that is not an option for me because of two previous surgeries in the stomach area. Always looking for feedback and advise.
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I just want to point out again....the length of the back incisions is greatly affected by the amount of skin you need for the flaps. My back incisions were over 12 inches long on both sides. Not everyone needs that much skin, so have your PS mark on your back what he expects he will take and you can tell how long the incisions will be.
Mine have faded with time, but because they are so long, my backless sundress days are long over. For me, the decision to have some type of breasts again overrode the vanity of the back scars.
I have documented my surgery and recovery on the pic forum. It is Latissimus Flap Recon - under my same screen name. If you have access, you can look and send me any questions you have.
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westieluv - How do I access the pictures??? I would very much be interested.
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Send a PM to MBJ or Whippetmom. If you have posted enough, they should offer you access. It is a separate forum that is guarded by TimTam for privacy reasons.
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westieluv - Thanks - I will do that.
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Jo ~ Thinking about you and your appointment on Monday. Hoping that it goes smoothly and that all your questions and concerns are answered. Be sure to let me know if you have other questions.
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Beth - Thanks so much for the info and support. I will post here Monday after my appt and let you know what my decision is and what I find out.
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westieluv - Sorry I did not post sooner but have had a busy few days.
The appt the my PS went great. He answered all my questions and also showed me exactly what he would be doing. In the course of the conversation, I did ask about mammos and he said no more on the recon side that I would probably need MRIs. Since I had my last mammo in June, he wants another one before the surgery for 2 reasons - to make sure it is clear and to have a current baseline. I had to call my MO and have him move my mammo up from June to Mar 20. That works perfect - that will be around the same time I will get my surgical clearance. Once the PS has everything, then I will get scheduled for sometime in late April.
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jo1955 ~ Glad that the appointment went so well for you! I have not had an MRI since my surgery, but it's now something that I plan for with my healthcare expenses. My PS recommends that I get scanned once every 3 years. I didn't enjoy the mammograms, but the MRIs are alot more expensive.
April will be here before you know it. Did the PS tell you how many drains you would have and the expected length of hospital stay?
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Glad that all your questions were answered - that is a huge relief!
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last summer as I was approaching my 3rd year with my implants I asked my PS (I had met my out-of-pocket because of a hyster) if I should have an MRI and he said that if I was not having any problems then No....I just thought it would be a good time money wise. So did not have one done. The manufacturers of silicone implants recommend an MRI every 3 years...not the doctors.
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I will be in the hospital 2 days and will have 2 drains. He said they will be in about 7 - 10 days. After that, if I want to go back to work that would not be a problem. I am fortunate in that I sit in front of a computer, answer phones and do paperwork. I don't have to lift anything - that is what I have staff for. Sometimes it is good being the boss. The other added plus is, I don't drive to work, I walk, I live on the resort property and if I get tired, I can go home.
Linda - I will not have an implant. The area is too small for one. I am just having a lumpectomy divot filled in.
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Hello Ladies,
I am a cancer survivor, I have had a double mastectomy..finished rads last July and I think its time for my reconstruction...PS suggested LD Flap, I will be going to a group session he offers, i would like to know what the surgery is like and the recovery time...also how big are the insicions and if is as hard as a mastectomy surgery...
thanks
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coni, will you be having lat flaps on both sides or just one?
I have bilateral lat flaps, but I had them done 2 months apart & took off 2 weeks from work for each surgery. Incision size varies depending on how much skin is needed.
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dll66 - i will have for one side only, the non- cancer breast will have implant only.. wow two weeks? that's fast recovery... how is the pain, do u feel any weakness on the muscle?
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The recovery time is very dependent on the size of the incisions, the size and placement of the skin flap and any contra lateral breast work being performed. Each of us is unique in the physical shape that we bring to the OR, so there are varied times in recovery. Plan for as much time as your body needs. A fast recovery would be good, but don't feel abnormal if you find yourself not bouncing back so quickly. After all, we had cancer and depending on what treatments you had, you may experience slower healing.
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thanks ladies..
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Hi all..I had the lap dorsi reconstruction with tissue expander back in 2002, finally had the expander removed in 2004 and replaced with a silicone gel implant after chemo, rads and herceptin...nearly 10 years on and I'm happy with my decision...some negatives but mainly positives.
Good luck to all Sharon
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UPDATE RE: Pictures forum....
Please contact only Lilah or nowheregirl [formerly Timtam] for entrance information. I am no longer a gatekeeper. But the requirements for entrance to this privacy protected forum mandate that the person requesting entrance be a bc.org member for some period of time and be an active posting member as well.
Thanks everyone!!
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Feels like I have done a ton of research online and I am finding out there is little to no information about LD flap surgery after having a lumpectomy. My PS has said that I will not need an implant and talked about having 2 drains after. What are the drains for and what if anything has to be done to them? He said I would have them about 7 - 10 days. Hoping someone will chime in and share their experience with the drains. I don't have a surgery date yet but am looking at the end of April. Just looking for some answers.
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Jo - Check your PM. I left you a message.
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Jo: I am having Lat surgery on Friday March 2. My surgeon said I will have 2 drains - one in the chest and one in my back. The drains remove excess fluid that would otherwise cause swelling at the surgical sites. He said the drains will likely be in 1 to 2 weeks. I had drains after my mastectomy and did not have a problem with them. You need to empty them a couple of times a day and will need to measure the amount of drainage. You can shower with them; I've got a lanyard that I wear around my neck and pin the drains to when I shower. Yes, they are a nuisance, but what in this cancer journey isn't?
My PS is very optimistic that I will be happy with the outcome and I'm looking forward to having this behind me. I plan on starting physical therapy as soon as the doctor says it's ok. I've seen some before and after photos of the Lat procedure and the results can be pretty amazing. I'll chime in after the surgery to share the post-op experience.
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Alex- That would be so great. My PS has also said I should be happy with the outcome. I will not need an implant which is good. I don't know how far back you read but my story is basically, I had a lumpectomy. The entire bottom half on my breast is gone - still have a nipple - and it just looks like a big dimple. My BC breast measures 2 cm smaller than the good side.
My biggest concern was the drains and how that worked. I am glad to hear you can shower with them. You said you use a lanyard and pin the drains to them? I am having a hard time picturing that in my mind. Is it so they are out of the way? I will have to write that down and ask my PS when I see him for my preadmit appt. This is exactly the kind of information I am looking for.
I will be in your pocket on Friday so have something with big pockets. Will be looking forward to hearing from you with the post op report. Best wishes for a speedy recovery.
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