Latissimus Dorsi Breast Reconstruction
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I also was not a candidate for DIEP due to previous ab surgery. My PS looked at my belly and said there was enough fat but due to the previous surgery did not know how much 'work' had been done in/on/around the belly so did not want to risk it. Plus the DIEP leaves a horizontal scar - add that to my scar from breast bone to pelvic area...PS said a no-go.
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I'm home from my revision surgery (Tues) and doing ok. Hoping to get to shower today. I'm really sore but not only in my chest area, which of course I expected, but also my muscles feel sore in my abs, thighs, arms. Sometimes I wonder what they do to us when we are knocked out.
I have one drain that should be out by next Wednesday. I hope! I haven't looked too closely at the results yet. Sort of scared to do it.
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jwilco - Glad to hear you are home and doing well. With the extra muscle aches, one does have to wonder what goes on when we are not awake.
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Thanks Jo. Do you have a surgery date yet?
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jwilco - Not yet. I go tomorrow for lab results and EKG. Nurse is supposed to fax everything to the PS. Tues I go for my mammo and then will call on Thurs to get scheduled.
How are you feeling? Hope you are getting lots of rest.
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Labs and EKG are done. Had my routine scripts rewritten for another 3 months. Now waiting to have my mammo on Tues and then I can schedule surgery. Will keep everyone posted.
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This section has been pretty quiet all weekend so I thought I would check in. I had my revision surgery on Tuesday, went home from hospital on Wednesday and today I'm feeling pretty good. Haven't had a pain pill since before I went to bed last night and I just finished getting dressed after a shower, so I guess I'm done with the pain pills.
I still have a drain that should be removed on Wednesday. My original surgery was UMX (left) with skin sparring, lat flap, immediate implant. The implant just seemed too large and the nipple area too far to the left. So this revision the PS exchanged the lat implant to a smaller size, somehow skootched over the nipple area and tightened up the pocket for the implant. On my righ, non BC side, I had an old implant from previous lift and he swapped it out with the same size and I think lifted it a bit. He also did fat grafting on the lat side with the lipo area being my back. I look like I've been beat with a baseball bat. I've only taken a few peeks at the boobs. Still feeling nervous about it but know it's hasn't even been a week yet.
I hope everyone is doing well. It's been a rainy weekend in CA so I haven't been missing much by being stuck inside.
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I had the LD flap on the left, right nipple sparing mastectomy (prophylactic) and bilateral TE's with Alloderm on March 7th. Initially had 6 drains. Have 3 left now. Got my first expansion this past Monday. Not fun. Can't believe how heavy my chest felt after the expansion. I have a constant feeling of a rack or something heavy sitting on my chest. Hope the implants don't feel like this. Pleased with results so far. Pleasantly surprised that I have had minimal pain from the back incision.
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jwilco. So glad you are feeling so good. Sounds like you are in for a speedy recovery. Sure hope I do after mine. Hope to have a date by the end of this week. Where is CA are you? I am orginally from Riverside.
nurseronda10 - Also glad you are doing well.
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Jo1955 - Good luck with your surgery. I'm sure you will do just fine. I was really dreading it but so glad I am on the uphill side.
Got the rest of my drains out today. Now, I feel free! Get my next expansion Monday.
Does anyone have any advice or input about the nipple on the LD flap side? The PS nurse explained that he would take a graft from my inner thigh to make the nipple and the areola. I don't want to take any chances of messing up the LD flap by sticking a nipple on it, if there is any possibility of that happening. I have had complications with every surgery I have ever had so don't want to make it that far and then something go wrong over a nipple. Has anyone had just a nipple tattoo on the LD flap side?
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nurseronda - Great news on the drains coming out. Sounds like you are doing very well. That is inspiring. Thanks for your support and encouragement - I amm going to need it.
Have my surgical clearance done, mammo done today. Now waiting for mammo results to get to MO so he can fax to PS. Hope to have a surgery date by the Friday or first part of next week. I really hate this waiting game.
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Nurseronda10 ~ I am a bilateral lat flap gal and will be doing 3D tattoos with Vinnie Myers in May. I just couldn't justify the risk. I suffered lots of complications and my skin on one side will probably never recover rom the trauma.
I plan to post pics on the pic forum when I get them done. Waiting until late May to give the skin maximum time to recover before doing the tattoos.0 -
I will be having my nipple done soon. PS plan is to use the skin that she used on the breast to make the nipple; that is to say the skin that was taken from my back. I had a skin sparing MX, so there is no other incision on the breast. I was a bit surprised about that as thought the skin would be from my thigh. And then the tattoo for the aerola.
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Fay, I am now 5 wks & 2 days post BM & lat flap with silicone implants, all in one surgery. Was in the hospital for 2 nights, home 1 then back in another for a blood transfusion. Overall things are great! Had 4 drains, removed at 2 weeks. Still a little sore all over but yesterday started having pretty bad pain under right arm & going to the back. DH says I probably pulled something.?. Anyone else have a new pain 5 weeks out?
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Had my followup with the PS and got my drain out. Yahoo. That was nice. Overall he likes the way my revisions went. I think it's better too. So, now we wait for me to heal and see if I need any additional fat grafting. Then it's on to the nipple! He will be creating it using the circle patch of skin from my lat flap (I also had skin sparring). I do feel sore and tired after my outing today. We did a few more errands than just the dr appt. My advice to those who have drains, try to take it easy when you get the final one out. It's really easy to get a feeling of freedom and then over do it.
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jwilco - Great news! I bet you are feeling so much better. Will take the advice about not overdoing it once the drains are out.
Had my mammo yesterday and hoping my MO has the results tomorrow so they can be faxed to the PS. Crossing my fingers that I finally have a surgery date by Friday for sometime in April. Will keep everyone posted.
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I am going to try and read this thread throughout the day. Would someone explain the pros/cons of LD flap in case I need one to supplement my fat grafting?
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Pluses and minuses of latissimus dorsi
- Plus: Many breast surgeons like this procedure because the flap is easily slipped around front, through a short tunnel in the skin, and put into position. Generally this procedure produces excellent results with few complications.
- Minus: The skin on your back has a different color and texture than breast skin.
- Minus: Latissimus dorsi also results in some back asymmetry (unevenness in the appearance of your back). Usually, though, back function and strength aren't affected.
The above from the RECONSTRUCTION Section. You will find those here who are pleased with the result and those that aren't. With any option, there are pros and cons.
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lizdehart, I think one of the main things for a positive outcome is make sure you choose a PS that has done a lot of the LD flap procedures. The PS I chose has done over 2,000 and I felt very comfortable with him. So far, knock on wood, everything has gone well. I am 16 days postop and am pleased with results. Thanks to this site and whippetmom, I found a great PS. My problems started with going to a general surgeon for a mastectomy. I knew to ask for a skin sparing mastectomy but the morning of surgery the permit did not read that way and the nurse talked to him and he said that is how his permit reads which basically said left mastectomy. For all I know, I had a radical mastectomy. Then my drains were left in too long and I got an infection and had to have a second surgery and a wound vac, so I ended up a huge thin scar. I really dreaded having my back cut on, but so far cannot tell it has affected my strength doing simple things (not allowed to lift over 10 pounds yet).
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Ha. I have a really good skin match from the front to back. My PS even commented on how good a match it is. Despite living in FL, I am NOT a sun worshipper.
When I had a lat flap on one side, the side with the lat flap had a much more natural shape & slope (with TEs) than the non-flap side. I have since gone on to have lat flaps on both sides.
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I finally got my surgery date - April 18th! I have to see the PS on April 11th to sign all the consent forms and get my hosp pre op stuff. Seems like it has taken forever to get to this point.
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Hi all. So had LD surgery on Monday, got out of hosptial on weds. The PS did not use any TE's so that is good. BUT, I am very uncomfortable!! My chest is tight, but the worst is my back. It fees like a constant muscle pull. OMG so uncomfy!! Stopped taking the pain pills due to lack of a BM since SUnday. Finally went today and figured I could take a tylenol for pain. I am sure this will get better with time but for now the implants feel so hard and out of place. YUCK!!! Have 3 drains, the come out next Tuesday. The back skin is a lot lighter than the chest but oh well. All in all if I have not had to get new boobs, if I never got bc I would not elect to get implants just becuz I want big boobs. IT's not worth the discomfort. I am not trying to scare anyone, but it is very umcomfortable. GOod luck to anyone else
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I think there are pros and cons with all the reconstruction surgery types, you just have to really do your research and talk with an experienced PS to come up with the best choice for your situation.
For my, my skin sparing w/implant UMX lat flap was done on Oct, 2011. It was a three days in the hospital and a few weeks at home. I did have drains, one for the back was in the longest. As far as pain, it was completely manageable with pain meds. I had to remind myself after a week or two to remember to NOT lift things with my left side. My scar on my back, measured by my husband, is a thin 8 inch line. I did return to my normal workout routine but went slow with my weight lifting portion. But I haven't noticed a huge difference in NOT being able to do anything due to the moved lat muscle. It's weird that the muscle could and has been moved. Sometimes it boggles my mind that they can do that. It is used to support my implant on that side. My back skin circle is different than my breast skin. But eventually that will become a nipple with a tattoo.
I had revisions and fat grafting done on March 13 and so far so good. Revisions are more the norm than the exception so be prepared for the possibility of revisions no matter what procedure you have.
Good luck in making your tough decision. I wish you the best.
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Jo - How exciting you got your date! Your preop is my bday so that's a lucky day. LOL You have such a positive attitude I'm sure you will do well. Make sure you have yourself all set up for when you come home. You know the drill, button front shirts, easy pull on pants, move things around in your bathroom and kitchen so you won't have to reach for anything. I wasn't comfortable sleeping in the bed right away, slept on recliner then couch. I had trouble lying flat. But that's just me. But just in case try to be prepared for that too. Extra pillows, even when sitting in a chair to prop your arm up will help your back. Oh, since you will most likely have a drain or two, before you leave the hospital ask your favorite nurse for some drain gauze, tape, what ever they will give you. They usually offer anyway. The drains are an annoyance more than anything.
I wish you the best outcome and speedy recovery.
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Jo1955-Congratulations on finally getting a date. The 18th is my tentative date to return to work.
ckgrayoh-it will get better. I had LD flap on the left, right nipple sparing mastectomy and bilateral TE's. My chest was horribly tight too. 5 days after my surgery he expanded on both sides. I felt like I couldn't even take a deep breath, so I worried about my asthma flaring, etc. I got tearful and at that point was wishing I had not had the surgery, but It only lasted a couple of days. I am now glad I had it done. I had to take Miralax to help with constipation while on pain pills. I have not had much tightness or pain in my back incision.
jwilco-I enjoy weightlifting too, so it is good to know that it is possible to do the things we did before. About how much time did you give yourself before you started lifting weight again? I am all for taking it slow.
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nursronda10 - Once the dr said I could start my exercise program I started back with the elliptical and then slowly did the free weights. I think it was about eight weeks or so. I have free weights and a Nautilus rack at home (my husband had the Nautilus - I'm not what you would consider "buff" lol). I started the weights lighter and just sort of tried to see what I could do, each week I did a little more. I haven't gone back to taking a weight training class so I haven't used gym weight machines. I did ask my PS about lat exercices being ok and he said no problem, if I can do them then fine. I think it's just up to seeing what you can do and then wait a day or two to see if it hurts too much. I did try a push up, just to see if I could do one. I could! But really just one and it was tough. I didn't usually do them so I don't worry about not being able to do them now.
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jwilco - I was starting to get really frustrated with this whole process. Seemed like doctors were dragging their feet. But now that I do have a date I can focus on other things. I am hoping to be home by Friday. My bday is on Sat the 21st - will be 57. I am getting so quilting projects together to work on while I am at home. I am trying to figure out how I will sleep. The surgery is going to be on my left side and I sleep on my left side. I do have one of those adjustable beds so I can put the head up if I have to.
This thread has been a wealth of information and I am so glad I found it. I have learned so many things which lead me to ask my PS the right questions. I am so excited about this and I don't think I could have felt this good without all the support and encouragement I found here. I will keep everyone updated. Even though some of you ladies are recouping I hope you stick around for awhile. I would like to share my progess with you. (((HUGS)))
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Jo - Yes, keep us updated on how things go. I'm sure you will do fine and having the adjustable bed will help a lot. I promise you that each day you will feel better and better. I'll be thinking of you on the 18th.
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jwilco - Will do!
edited to add: I see my PS on the 11th to sign the consent forms, ask more questions and to get the hosp preadmit paperwork. I hope when I do the hosp stuff, they let me know what time to be there. Then it is back to the dreaded waiting game.
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ckgrayoh, I just replied to your post on another thread and after I did, I thought your name sounded familiar and see that I basically said the same thing here. Lol.
Jo1955, I feel the same way. So glad to see others that have had the LD flap and are happy with it. I will keep coming to this thread to check your progress. My PS said it would be more comfortable to sleep in a recliner for the first couple of weeks. Oh, how right he was. I tried lying down and just wasn't comfortable at all and then trying to get back up to get out of bed was hard.
jwilco, I have always liked toned arms, but as I have gotten older there is way more flab than muscle, sorry to say. That is fantastic that you were able to do a pushup. I have found since I have been on Arimidex it is murder for me to get down on the floor and try to get back up so I was doing wall pushups. I will be anxious to see if I can still do them whenever the PS clears me to start exercising again. I had gotten into great shape in 2010....started doing P90X, lost weight, ran in a 5K, was feeling so good and then find out I had breast cancer. I'm sure there are many others that could share the same story. Now I feel old and out of shape.
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