Latissimus Dorsi Breast Reconstruction
Comments
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My surgery was about 8 hours total - UMX and lat dorsi. Only 'scar' in front is circle of skin (from my back) around where nipple and aerola were. No other scar in front as I had a skin sparing UMX. That same skin will be used to make the nipple later. Scar on back is long - going in a slight diagonal from middle of back to under my arm.
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Ditto. Teresa's description is just the same as mine. Husband measured the scar on the back and it was eight inches! Oh well. I wasn't ever going to be on the cover of Sports Illustrated anyway. I know the scar will fade with time. It's very thin, just long.
I'm having revision surgery next Tuesday on BOTH sides. It's weird. I'm feeling like I'm going through it all over again, even though this will be way easier than the original. I think it's just my wondering..."what will I look like this time". I've gotten used to my uneven boobs.
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jwilco - Hope the PS gets it right this time. Can't believe you are uneven - you would think someone would have noticed it and fixed it right away. I am so sorry you are having to do this again.
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Well, I'm one week past my Lat surgery and impatient to move on. I still have drains in, although probably not for much longer - they've really started slowing down. Oh what a pain they are. The good news is that I'm able to sleep in my own bed and am off the pain meds. The breast mound looks good and I think it will look awesome once it starts getting inflated. My range of motion is really good. The only thing that is painful is anything that is weight bearing like a pushup type of motion. Definately need to be careful about lifting for a few weeks, but I anticipate slowly working my strength level back. The scar on my back is pretty startling, but once it heals and fades, who cares?
I'm reading with interest the comments about symmetry and adding it to the "must have" list of things to go over with my PS. Oh please God I want this done right the first time!
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Thanks ladies. I knew going into this that it was a skin sparring UMX lat on the left first surgery and then a lift/redo of the right, to better go with the left. I knew that would be a second step. But originally the second step was to have a nipple created on the lat side and the lift/redo on the right. However, the way things settled with the lat side the implant needs to be resituated and it appears that the slightly larger size is making the skin/nipple circle end up slightly to far to the left. So we are skipping the nipple creating, that will be done later in office.
I do wish it was all done the first time, but I've come to realize that sometimes there needs to be revisions. I'm trying to stay positive but am realizing that this surgery is making me think of the original UMX.
Spending this weekend getting my stuff in order. I know the recovery will be better than the original lat surgery. Just hoping my two weeks off work will be enough.
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alex56 - I am so glad to hear your recovery is coming along and things are working out. I find it very encouraging to hear about the good range of motion in the arm and back. I know my PS told me recovery time - no heavy lifting - would be 2 - 4 weeks. I am not too worried about the scar that will be on my back. I can't see it anyway so who cares???
I will begin my preop stuff next week. Surgical clearance - labs & EKG, then the following week will have my mammo. Hopefully 2 weeks from today I will have a surgery date. Will keep everyone posted.
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Revision / symmetry - I new going in that there might be an issue with symmetry and not the PS getting it wrong. As the muscle settles into its new position it can change and move. (and as it gets used to it new position and function) Met with PS and she wants to wait another few months before adding to the breast - giving even more time for swelling to go down and the muscle to settle - then onto making the breasts even. Then adding the nipple. A long process, but still feel good about everything.
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Good that you are feeling positive. That helps alot. I'm having my revision surgery on Tuesday and today I'm feeling anxious a little. Wondering what to expect now. You are right about the muscle relaxing. I've noticed on my lat side that the lat muscle part relaxed quite a bit. Which is good because on the underneath part, closer to my arm pit area, you could really feel the lat muscle, now not nearly as much. However, it did drop the implant down due to it relaxing which is something that will be redone. It is a long process but I'm still very greatful to have gotten this far. What's weird is that I've actually started to forget that the left side is totally fake. So it's almost like just as I've gotten used to the way things are, they will change. Of course it should be for the better.
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I am so relieved to find this thread! I have been searching for women who had lat- flap reconstruction for seven weeks): My issue is constant back pain resulting from the relocation of the lat muscles.
My original dx was stage III IDC with mets to lymph nodes. An MRI revealed Lobular carcinoma in situ. My surgeon said breast cancer was considered a turtle, but I had a fast turtle. I completed 21 grueling rounds of chemo on December 22. An ultrasound following treatment did not show any signs of cancer, so we were very positive regarding the success of my chemo regimen.
I wanted to have everything (double mastectomies, skin sparing breast reconstruction, and nipple reconstruction) done in one surgery and my surgeon and ps were very positive about doing all the work in one procedure. The surgery was on January 20th and took 12 hours and four days later I was discharged with six JP drains. They were as horrible as everyone has described. Three were removed at two weeks out and the remaining drains three weeks out. The cosmetic result of my procedure could not be better. When I get the tats the only breast scarring I have will be minimal.
Unfortunately the back pain I have is excruciating at times. I have scoliosis and wonder if that could be contributing, although my PS says it shouldn't. My breasts contract and flex upon any body movement. Obviously they think they are still in my back. In the beginning pain accompanied this phenomenon, but that has improved greatly. My back has been tapped for the last three weeks. The fluid they have removed looks like a unit of blood. Oddly, the fluid collection is on my right side, while the left side is where most of the pain is concentrated.
Whew! I am typed out! If anyone has similar outcomes please let me know. Btw, I take Advil every four hours and Flexaril tid.0 -
One more very important factoid! The path report from my breast tissue and 12 removed lymph nodes revealed no signs of cancer. The grueling chemo payed off!
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I just read your comment on the lat dorsi reconstruction. I believe we are in similar boats): I just posted on the thread. So discouraged!
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Donna - Congrats on the clean path report. I have not had my surgery yet and at first I got very scared reading your story but then I told myself that everyone is different and I will get through this okay.
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Donna - A relief to have your surgery over with, I hope your back pain subsides with time. My surgery was the same as yours, BMX, skin sparing, with new nipples - I think I was in surgery for 8 hours. Mine was Dec. 2010. It takes time for our bodies to heal and I still have and may always have numbness on the sides and near the scars on my back. That is about my only complaint and that's not such a big deal to me. The cosmetic results with this surgery were awesome. The scars on the back have faded over the past year. Jo - You will do fine with your surgery. If you ladies have any questions, feel free to ask. I hadn't been on the site in quite some time because I feel so cured from cancer and life is back to normal (except for Tamoxifen issues).
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Florida, thanks for your reply. Did (or do) you experience the muscles in your breast flexing and contracting? Also, have you had back pain, or range of motion loss? Did you have PT at any point?
Jo, PLEASE dont let my experience scare you. I am the exception, not the rule. More and more I believe my scoliosis is causing back pain, exacerbated by the relocation of the lat muscles. Read back on this thread and you will meet countless women who are doing great! They are pleased with their recontructed breasts, as am I. My breasts look like the ones I had when I was 20.
Regroup from my post and regain your bravado!0 -
hello, I started to read the posts from the beginning but there are too many. I am having my recon next Monday (March 19). I am having a mx on the good side with an implant. The radiated side will have a TE with an LD flap. I was not a candiate for the DIEP. I have been doing some strength training the past few weeks as well as some cardio trying to get in good shape for the surgery. I took 4 weeks of off work. What can I exptect pain wise? How should I plan on sleeping? In my bed or on the couch? I believe my PS has me in hospital overnight. I am nervous and excited to be whoel again. I had a friend who had suregery the last week in January,she had DMX and 2 TE's, she still has her drains in!! Is that normal? My PS office said to expect at least 2.
Any help is appreciated.....
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CK - My pain immediately after the surgery was well controlled with a morphine pump. On the second day my vein collapsed and the pump was removed. They began oral dalodid and Lortab, alternating every two hours. That regimen was very successful also. The second day I showered and sat in a chair for four hours.
The JP drains are a nuisance, but a necessity. It's like having a baby. You will forget the irritation shortly down the road.0 -
I forgot to mention sleeping experience. I slept in the bed propped up on pillows to a sitting position. It wasn't nearly as difficult as I expected.
Regarding your friend's drains, I haven't heard of anyone who had them that long. My PS' practice is to remove the drains when the output is no more than 20 cc's two days in a row. With that being said, the last three weeks the PS has had to "tap" my back because of fluid build up. If it continues I will have surgery to reinsert a drain.0 -
Donna - Oh! I am not that much of a chicken. It was good to hear that you can shower with the drains and sleeping propped up helps. I have an adjustable bed and all I have to do is press a button to get into the position I need. On the drains, I never had babies so can't relate to that but reading it did make me laugh.0
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Ckgrayoh: Good luck on the 19th!! I had my Lat flap w/TE last week. The surgery went well and I opted for 2 nights in the hospital. Pain was not nearly as bad as I thought it would be. While I was inpatient it was controlled with Percocet and Toradol. I was up and walking around (to the bathroom!) very shortly after they brought me to my room. They let me shower the next day. Range of motion was excellent; very little discomfort in my back. Yes, you'll be sore and that side of your body will feel weak for sure. When I got home I slept in the recliner for the first couple of nights, but then moved back to my bed. I can now sleep on the non-surgical side, even with drains in. One drain will come out this week, the other next week. I'm taking this whole month off from work. The breast "mound" looks awesome and I haven't even had a fill yet! The scar on my back looks scary but will fade in time. The "patch" on the breast has a "franken-boob" look to it, but it makes me laugh! All in all, not a horrible experience. Keep up with your workout and you'll do great. My PS encouraged me to massage the area a couple of times a day for the weeks leading up to surgery. Hang in there!
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Sleeping - I was able to sleep in bed, on my back, with lots of pillow support once home (3 nights in hospital - surgery Thursday, home Sumday morning). Even now, I like to have an extra pillow to help with side sleeping.
Drains - came home with 3 (one for UMX and 2 for Lat Dorsi) and had 1 for seven weeks. It was a pain, but got used to it. The issue is that I walk a lot and the more I walked the more output. But I did not want to be immobile, have the drain removed, then have a fluid backup. 7 weeks was long and I was so glad to get it out.
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I know I am jumping in late here, but I had another good tip for managing the drains in the shower. I tied a pair of panty hose around my waist and safety pinned the drains to the pantyhose. This was the tip I received from my BS, and it worked pretty well.
I will probably be on board for a lat flap later this year. Waiting for my skin to heal after rads now and will consult with the PS in June.
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bethcw - As far as I am concerned, you can never be too late with information since I am still waiting to have surgery. Hopeing to get a date by end of next week. I finished rads 15 months ago - that is not what is causing the delay.- it is my job -waiting for it to slow down a bit
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Hi ladies.. I just got lat flap reconstruction two weeks ago and experiencing excruciating painsvin my lower pelvic area. Did anyone else have this problem? If so, how long did it last and what did you do to relieve pain? Thanks
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Donna - I no longer have back pain, only if I over-exert myself in the yard trimming bushes, raking, etc. Pulling forward while raking wears me out. I don't have quite the stamina I used to have. It does bother me to scrub the shower. As far as range of motion, it is not bad at all. I'm not as strong as I used to be. I don't work the pecs on the weight machine anymore - which is maybe why I don't have the pecs flexing and contracting. I know many women do have this symptom. I don't do as much arm exercises as I used to. After getting home from surgery, sleeping in the recliner was the easiest for me because I had trouble getting in and out of bed. When I did start sleeping in bed, I used pillows and found I couldn't sleep on my side for the first couple months. It was so tender where the drains had been. I really didn't feel good after surgery until those drains were out (about 2 weeks after). I showered with the drains, using tubing around my neck and then safety clipping the drains to the tubing. They gave me the tubing in the hospital. It was wonderful to take a shower! TrustMary - I don't recall pain in the pelvic area.
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For sleeping I went from the recliner, to the couch, to finally the bed. I just couldn't get comfortable in bed at first. Plus I kept waking up and didn't want to bother my husband's sleep with me fussing around all night. Eventually it was a lot easier and nice to be back in bed with hubby. Although I still had a drain on my side (from the lat part) and I worried he would lay on and then what if he did and I rolled over and it came out. So even though I was in the bed I placed a small pillow between us. LOL
As for the drains. I'm one of those that had it in forever! But that is probably just me and the way my body works. So it can happen, or it will be done draining in only a couple weeks and you will free!
As far as pain, I was in the hospital for three days. The pain was well controlled and I think I had more of an issue with sleeping due to the hospital bed. I can never get comfortable in them. Plus dealing with the IV, etc. The whole experience was annoying more than anything. But I'm glad I was there for a few nights so they could make sure I was healing ok.
Once I was home the pain was easily managed with the meds they gave me. I was off work for longer than I expected but that was due to the drain hanging around for so long. Also, I think I was extra stressed out over the whole cancer issue. Dealing with decisions, doctors, tests, etc. Mentally I needed the time to feel ok in my head too.
For those awaiting surgery, you will be fine. It seems so overwhelming now but it's amazing how the body recovers. I have my revision surgery tomorrow morning so I'm trying to repeat that last sentence to myself too.
Good Luck!
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Thanks to everyone for the information. I am anxiously awaiting the 19th. I know my PS has me in the hospital for one night, depending on how I feel may stay another night. I just got a nice comfy recliner so I think I will get my books and kindle and phone charger and tv remote all set up this weekend. I bought a button up the front silk like night shirt so I think I am all set. Thanks again everyone!!
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Bethcw - I am having the lat flap surgery June 14, which will be a month after chemo ends. Maybe you'll be having yours around the same time. I will get tissue expanders at first. Sounds like a long process to get breasts back, but I am ready! Good luck to you and all the others with upcoming surgeries!
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CK~
You mentioned you were not a candidate for DIEP flap, and I'm curious why. I have been turned down, too, for DIEP.
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Hi Pink- I did not have enough belly fat to make a new breast. Plus I wanted to go bigger, just a cup size and there just was not enough to make two. The PS I saw said "get fat", um no thanks.
So I went to another surgeon and found out about the LD procedure. I also did not want to be under for that long. It was like an 8 or 9 hour procedure. When I spoke with my BS she said since I am young and pretty active ( horseback riding) she said my trunk would be weak from the surgery and I should consider something else. It sounds like a good surgery and makes natural feeling breasts, I am not looking forward to having the implants in my body but nothing else I can really do.
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CK - Please let me know how your surgery goes. I am hoping to have a surgery date by this time next week for April. I am excited but scared at the same time.
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