Latissimus Dorsi Breast Reconstruction
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Hi Everyone,
I'm scheduled for my second surgery on 3/13. I had lat flap on left side with immediate implant, back in October. Over time as things have relaxed it just seems like the lat side is slightly larger and this is sort of moving the "nipple" area over too much to the left. So, I have my preop with the PS this Wednesday. The last time I saw him he said he would have to swap the lat side with a slightly smaller implant and reposition it a bit so the nipple area will be in a better spot. Then he's going to redo the "good" right side to match. I'm seeing him again just to be sure I have it all clear in my head what to expect.
My question to all of you is this. Has anyone had their implant on the lat side swapped for another? I'm sort of worried about how they do it with the lat flap there. Where will the incision be? I will also be asking the PS all this but I wanted to hear from anyone that actually had it done. Thanks!
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jwilco - I can't help you but wish you the very best. I am in the process of getting my surgical clearance and mammo for surgery sometime in April. I will not be getting an implant. I am just wanting to fix a "deformed looking" boob after lumpectomy. Rest assured I will be thinking about you and will be in your pocket on surgery day. Please keep us posted post surgery.
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jwilco, I have had 2 additional surgeries on a lat flap. My PS made an incision just very slightly above the original one. I had contracture of scar tissue & a small hole in my skin opened up, exposing the implant, so I had the scar tissue removed & the implant swapped out. About a month later, I had another hole in the same spot & had to have the implant removed. The healing issues were attributed to inflammation after rads. After waiting for 2 months to give my rads side more time to heal, I just recently had an adjustable saline implant placed & my PS moved the lat flap over slightly to give more coverage in the area that was previously not healing.
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DLL66 - How long after rads did you do the first lat flap surgery? I finished rads 15 months ago.
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2 months. I finished rads in May 2011.
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DLL66 - I hope you don't mind me asking but did you have an mx or lumpectomy? How was your recovery time? I am still gathering as much information as I can before mine. At least with this, I will be well informed.
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I had a BMX, followed by rads. I had a lat flap on my rads side in 7/11 & another lat flap on my non-rads side due to a skin failure with tissue expanders in 9/11. Everyone's recovery time is different, but I took 2 weeks off from work for each surgery. I work full time in retail management & was fine to go back to work in 2 weeks.
I don't mind--happy to help someone else whenever I can.
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jo, I believe the rule of thumb is to wait at least 6 months after radiation to give the skin ample time to heal. I waited a year and a half.
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HappyTrisha - Thanks so much for the info.
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My PS likes to wait 6-8 weeks after rads so he can work before fibrosis sets in.
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Hi all! I just had my Lat Flap on Friday, March 2. I came home last night. So far, so good! I feel really terrific and have very little pain although there is soreness which I stay on top of with percocet and advil. There is probably a "B" sized mound post-surgery which will be inflated to a "C" in the near future. The drains will probably be in for another week or so. This surgery was much easier than the mastectomy and I'm moving my arm with minimal discomfort. Whew. I'm so glad to be beyond this surgery and excited for the months to come!
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hi ladies
Im schedule to have my lat flap march 23
im excited yet nervous at the same time....for me the double mastectomy was hard, i just hope this wont be as bad, although i do think it might be..im preparing for the worst...Alex56 good to hear you are doing great! glad to hear it was not as bad as mastectomy which is great!!
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alex56 - Good to hear you are recovery well. Hopefully I won't have any problems. I had a lumpectomy with half of my breast being taken.
coni - Pocket party time come the 23rd. Best of luck to you and wishes for a speedy recovery.
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Jo, I used a bikini top to pin my drains to in the shower, just an FYI. I hated the drains (I had 5 of them), and I was happy to have them gone. I had a bunch of oversized button down shirts that I just pinned them into during the day. I was also lucky that the hospital gave me a mastectomy tank with a kangaroo pouch for the drains.
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Okay! Gotta ask a dumb question. Can you wear any kind of a bra with drains? I know I will have 2. One on the front and one on the back.
lele37 - Thanks for the tip but I don't wear bikinis. Any other suggestions? I guess I just can't picture the drains. Maybe I will get some tips from the doctor??
I'm sorry if I sound just plain stupid but this is all new and very confusing to me right now.
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I used a bathrobe belt around my waist and pinned my drains to that when I took a shower. You get very creative with the drains. I hated them more than anything. If there aren't any examples on this site just Google JP drains and you can see a picture. They aren't too hard to manage and don't hurt, they are just annoying.
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jo, you can wear a bra with drains. I went back to work with drains & managed to wear a bra with prosthetics with my partially-filled TEs.
Glad you are doing well, alex!
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I just wanted to chime in on the bra question Jo asked: I came out of surgery with a compression bra/vest on. The drains can be pinned to it and the compression helps squeeze the excess fluid out. I'll keep the compression garment on until the drains come out, then my PS said I could wear any sports-type bra. I am using a lanyard to pin the drains to when I take a shower. The over-size button down shirt is a must have. Best of luck to you ladies who are having your surgery in the next few weeks. For me, the recovery after mastectomy was long and painful. Happily, this procedure has been relatively easy. The only thing that seems really uncomfortable is bending over to pick something up off the floor. Weird, but I can live with that!
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DLL66 and alex56 - Thanks so much for the info. I do wear front hook bras and was so glad I did when I had my lumpectomy. My scar is on the bottom side of my breast and because I can not have any kind of tape of my chest, the bra helped to keep the bandage in place. My PS does not think I should consider going back to work until the drains come out - will wait and see. I had my lumpectomy on Monday and could have gone back to work on Wed. I have a great boss and will be able to take some time off but I know it will drive me crazy being home for that long.
Another question I have is - how much if any range of motion did you lose in the back muscles? I am right handed and will have the surgery on my left.
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I lost no noticeable ROM in my back. Others have, though.
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DLL66 - That is good to know. I am a golfer and really don't want to give up the game. It is the one thing that DH and I do together outdoors.
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Definitely ask your PS how it will affect your golf swing. My PS told me that unless I was a water-skier, I probably would not notice anything.
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You ladies have no idea how much I appreciate the time you are taking to answer my questions. I feel much less anxious about this and really kind of excited. It really helps to hear from those that have experienced this.
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Jo - I haven't noticed any range of motion or lack of strength with everyday stuff. I also work out and still do all my regular weight exercises with free weights. I do admit that for my lat side I feel like I have to get my arm raised differently to shave compared to the other side.
When is your surgery?
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jwilco - I do not have a surgery date yet. I am a manager in a 55+ Mobile Home/RV Resort. The majority of my residents spend the winter months in south Texas and then leave to go back home in the spring. By this time next month, we will be empty with the exception of our year round residents - about 50. I am in the process of getting my surgical clearance - that will be next week and then the following week will need to get a mammo - PS wants it for a baseline and to make sure it is clear. I am hoping I can call him around March 23 to schedule the surgery. He said he needed at least 4 weeks lead time so I am looking at late April.0
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I have no real issues with ROM in back however when I lift my arm over my head I do feel a slight stretch; PS said it should decrease over time and with PT. I wake up a little tight in the back, however it decreases throughout the day. For drains I used a shoelace to hold during showers (I had one drain for almost seven weeks!).
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Hi ladies, new here. I've been hanging out on the March chemo board. I will be having the lat flap procedure June 14, after completing chemo. There doesn't seem to be a lot of info on the internet about this procedure. I saw some pics where the scar is a small eye shape, and others that are larger and more away from the nipple. I told my PS I'd rather have a larger piece of skin taken, maybe in hopes that the scars won't be as noticeable. What are your thoughts on that? What do most people end up with? I have not had radiation, by the way. Sometimes do they just put a circle of skin where the areola will be? My desire for the lat flap is twofold. For one reason, I don't like the look of a breast with the straight scar all across the center, with the nipple in the center. Also, I feel like the muscle/tissue over top of the implant will look and feel more breast-like than just flat skin and chest muscle over the implant. Am I right in thinking that? Does anyone have any thoughts or advice for me? I want to make the right decision. Before my BMX I had saline implants under size A's (for a full C, small D). I want to go back to what I had. Thanks for any input! I look forward to getting breasts back after this nightmare of breast cancer!
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Welcome Amy - I really can't help you with your specific questions but I do know if you google Latissmus Dorsi flap breast reconstruction surgery you will get many hits. Some websites have pictures of before and after shots. I am also still gathering information and hope to have surgery next month. Best of luck to you.
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Hi Amy, I had implants years ago prior to BC. I think the main reason the lat procedure was recommended for me was to help support the implant so I would end up close to the same size as before. I had left side UMX skin sparring. Couldn't keep the nipple but I do have a round section of skin where my new one will go, but it's skin from the lat flap so it's slightly different from the breast skin. My PS used my scars from my original breast augmentation so there wasn't the incision line across.
I'm scheduled for revision next Tuesday. I am hoping to end up the same size I was, full C small D. Right now I'm full D on the lat side (the implant is going to be changed for slightly smaller).
Good luck with your surgery.
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Thanks for the welcome, ladies. It's a lot to think about, but it takes my mind off impending chemo. I'm concerned it won't look like I hope it will, and my PS said it is a 5 hour surgery, which is a long time under anesthesia. I will see what else I can find on the internet. Thanks!
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