Latissimus Dorsi Breast Reconstruction
Comments
-
Hoping for some insight here-my PS advised against a Lat Flap. I asked if it would help w/appearance as i'm really thin and implants show ripples etc. She said it doesn't help w/appearance as you're left w/2 flap scars that some people have likened to little footballs. It certainly doesn't sound appealing as appearance is the main reason for me to have this procedure vs implant alone. Any advice?
0 -
Hi Undercoverebel, You may want to get a second opinion about your options. Does this surgeon do a lot of lat flaps? Maybe not. I'll end up with an implant on the right side, and a lat flap on the left side. The right side did well with the TE and exchange. I lost 2 implants on the right side due to infections. Right now I have a TE with 100cc's under the lat flap on the left side. I can envision how it will look. The fold matches the fold on the right, and the outside contour of the flap matches the outside contour on the right. It just needs projection. My scars will be mismatched, but I just wanted a normal appearance in clothes. I'm 60, so my needs are probably differen than yours. Good Luck!
0 -
Jen 78: That sucks! I had a nipple sparing mx and my nipple got cut around, moved up, and reattached. Luckily, I have never had any problems with the incisions surrounding the nipple. I can relate to the open wound though. When I had capsular contracture, the TE pushed its way outwards and out through my skin. In about 2 days flat, I ended up with a hole about 8 square inches where instead of skin, there was just TE, because the skin had dissolved away. It was the scariest, nastiest thing ever. I'm glad your problem seems like it will be easy to fix(?). All these complications are depressing though!
0 -
OMG, Sunny. That's awful! My hole is just shy of dime sized and I thought that was bad. Our surgeries sound similar. Out of curiosity, how did they deal with your lack of skin? I hope that everything ended up working out well!!
0 -
Jen78: One of the reasons I will be getting the lat dorsi flap operation is because I need more skin on the breast now and the skin I do have is too thin. Hopefully it will work out.
0 -
undercoverbel - one of the main reasons I have heard/read about not doing the lat flap is the use of muscle instead of tissue only or implants alone. But this is a personal decision. My lat flap scar is not football shaped, but a somewhat angled scar across my back. The only scarring on my breast is from the SNB and around where my nipple was, but this will be covered up with grafting.0
-
0
0 -
thanks Day! I had a skin sparing MX so don't have the' little football' scar.
0 -
jo1955... my last drain seems to get busier when I sit around too. But, at last I am seeing some slowing down. Not enough though. I actually called my PS's nurse today and whined a bit. I need to reschedule my spine surgery and now my PS says I have to wait until July. Uggh!
Recovery time? Not sure what to say. I am feeling pretty darn good nearly 4 weeks from surgery, but still being very careful about lifting, etc. That could take a while. Traveling? Well, just try going through TSA at the airport with drains on board.
But once they are gone, I am out of here!0 -
joan888 - The last drain seems to be going down every time I empty it but is not close to coming out yet. I am so hoping Friday is the day. I went back to work last week and it feels great. We only work half days so I do have the chance to relax in the afternoon. Like you, I am still very careful about lifting. I could milk that one for quite a while with DH - LOL! I will be 3 weeks out from surgery on Wed.0
-
Oh my - can't imagine trying to travel with drains and the TSA! Wow, what a thought! I know the drains are tough but wow does it ever feel fabulous when they are gone and a distant memory. I just kept trying to think about how they are doing their job as I had one drain get clogged early one and fluid built up in my back which was terribly painful. Hang in there it will be easier.
Finally say the link Day posted a few pages back. Wondering why some get the oval flap and others like myself had the surgery through the nipple area? Are those nipple sparing surgeries? I wish I had had that but at the time my Doc didn't recommend it. I hate the way mine have turned out which might have made a difference in how I feel about it all. Anyway, hope the drains come out soon for you all
0 -
Hey Ladies - in regards to my last post regarding massage. Note I am 2 years out from main surgery so my massaging has been going on for awhile and I was making light of one of my unconscious habits..
On an individual basis ask your PS when you can start massaging. I know they wanted me to do it pretty early to keep the fat replacement from balling up {necrosis}. Hope everyone had a great Cinco de Mayo holiday.
Cindy
from Sunny Seattle0 -
undercoverebel: I had the lat flap with an implant in Dec. '10. Because of radiation I was not a good candidate for just implants. The main reason for the lat flap is to bring in a new blood supply that the radiation destroys, and the football of skin if more skin is needed. The implant gives some bulk. (mine is a small one) I have had issues with my lat muscle spasming across my chest and into my armpit. It has thrown my shoulders out of whack. I'm going to have to do something different cause I can't hack this. If I had it to do over again I would have done the DIEP or nothing! I blogged thru the whole cancer experience. I have pics on my blog of my "football" on my breast, as well as the incision across my back. You can see those at: mamahilton.blogspot.com
Just jump down to I think the first post of 2011 to see those pics. I think it's really true that PS's tend to recommend what they are most comfortable doing themselves. But many are not that trained in the micro-surgery stuff like DIEP. But if you have a surgeon who is and has a good reputation for that, I think going the "own tissue" route might be the best way to go! Good luck!
0 -
lalove55 - My PS cut the nerve to the lat flap muscle to avoid the spasms. So far so good. I do believe each PS has their own method to doing this particular surgery.
0 -
Stanzie - regarding the football shape. I too had my surgery through the nipple, the nipple was removed. I have a round section of skin from my back lat area that is in place of the muscle. I think everyone else is correct. It depends on your situation and your surgeon. I didn't have radiation but I had prior breast augmentation so that is why I couldn't keep my nipple.
I haven't really noticed my lat muscle having a spazm. I do sometimes get a "puffy" feeling on that side where your bra strap is under the arm. It's weird but it comes and goes. I feel it and I think it's swollen, but when I touch it there is no swelling. Strange....
Speaking of strange...I know change is hard, but I'm not sold on this new website design.
0 -
jwilco - I also get that puffy feeling under my arm and think it is swollen but it really is not and mine does come and go. I am 3 weeks post op tomorrow and so far my PS has not let me go back to wearing a bra. Not rushing back into it since it is so darn hot here. Found several tops with the built in bra that are so comfy.
0 -
Jo1955 - Sounds like you are doing well. My PS said he cut the nerve too, but I never asked him what the purpose was and now I know.
Not too crazy about the new format, but I have never liked change any way.
0 -
nurseronda - I would hate to have a muscle spasm in the boob if you know what I mean.
I still have one drain left and from the looks of it, the damn thing wiill not be coming out this Friday AGAIN! Sheesh! It is really starting to hurt and at times it is difficult to sit for long periods of time. I am 3 weeks post op tomorrow. I am trying to tell myself I just better get ready for another week of hell. This is all going to be worth it in the end. Sorry to whine but don't know where else to do it.
0 -
Jo - I'm glad I'm not the only one to get the weird swollen feeling only to have it not be swollen. It will happen at strange times too. When I'm not really doing anything but walking around, other times I'm doing something so it makes sense. Weird.
I'm sorry you still have the drain. Not to worry you, but I actually had my last drain in for over a month. The only reason it was removed was because it had gotten clogged twice, once the PS got it unclogged, but not the second time. The area where it entered was getting irritated, and to top it off, the last time it clogged was on a Friday night and it drained out the hole. I had to use a maxi pad as a bandage. Talk about making you feel like crap. Trying to get back to my life with a maxi pad taped over my drain hole. Sheesh! Surgery was 10/11, drain out week before Thanksgiving. It was annoying and made me really grumpy too. It was hard because I was trying to get through all this cancer crap (dr appts, decisions on treatment, etc.) and I had to go to see other dr's with the drain in and it just made the whole thing more difficult. I have no problems reading your whining because I totally understand. Hang in there!
0 -
I'd like to join in the whining tonight. Tomorrow is one month post surgery and the two remaining drains are still producing 50 and 70 cc, respectively, in 24 hours with no sign of decline. Will they ever be ready to come out? I wonder what the record time for back drains from a LD surgery would be.
Jen78 - I am sorry to hear about what you've been dealing with since the drains were removed. I can see how that would be disheartening to have a setback just when you expect a turn for the better.0 -
Allow me to join in the whining about drains. I will be 4 weeks post-op tomorrow and this one remaining drain will likely be with me for at least another week. Yesterday was the first day it drained less than 60cc. My PS wants it down to 25cc before it comes out. He is being pretty conservative with me because of the cellulitis infections I had prior to surgery. I am so ready to bury this drain!
0 -
With my first lat flap, I had a drain for 6 weeks. Having it in for so long caused me to crash & become dehydrated. With my second lat flap, my PS pulled my drain when I got down to 60ccs a day to avoid that happening again. Both times I returned to work full-time 2 weeks after surgery.
I learned the hard way that if I have drains in, I have to up my protein & fluid intake.
0 -
Hang in there with your drains, ladies. My back ones came out at 5 weeks and toward the end, you all know I was cursing them on an hourly basis. I had my back drained manually for the first time on Monday and she got about 70 cc's from one side and 55 cc's from the other. I guess she'll do that weekly until there isn't anything left to drain.
I have the swollen feeling under my arms, too. It comes and goes and it's more on one side than the other. The PS had told me that I'd feel that for awhile but that ultimately, the muscle there would atrophy from lack of use and I wouldn't feel it as much. Fingers crossed that it happens that way!
I'm still dealing with my wound issues. I'm using something called Hydrogel with my gauze now to pack the hole and dress the wound. Seems to be helping some (keeps it moist), which is good. But, it's got a long way to go before it's healed.
I took 4 weeks off work for my surgery and then worked from home for 2 weeks. Today is my first day back in the office. I've only been here a couple hours and I'm already tired. I'm thinking it's just the stimulation - so many people to talk to and catch up with after being away so long!
Happy Wednesday - hope everyone is feeling good.
0 -
I went back to work 10 days after surgery but only have to work 1/2 days so it wasn't that bad. In fact, it felt good just being out of the house for awhile.
I swear this last drain is never going to come out. Just when I think the fluid is down to the level it needs to be for removal the level goes back up and I am starting all over again. I can't see the end in sight. Have a follow up Friday with my PS and I can already here him saying - another 5 - 7 days and will reassess then. Sorry to be whining about this. This is just getting me so down. Thanks for listening.
0 -
jo1955 - I am definitely going to check with my doc about the nerve to the muscle. Others have mentioned that to me. After a year and a half of spasms, my reconstructed breast is very distorted, high, and tight. It has pulled the nipple that was saved almost up to my armpit! Geez! Has anyone out there had any bad issues with having the nerve cut? I'd get this puppy cut in a minute if I thought it would help!
0 -
lalove55 - I would definitely ask your PS. My specifically said he cut that the muscle so that I would not have spasms. The only thing I am dealing right now is swelling in my armpit that I don't think is swelling and that tends to come and go.
0 -
So sorry for all of you that have had your drains in for weeks. Makes me feel so lucky to have all 6 out by day 10. Wonder why mine didn't drain that much. I never had more than 30 ml in 12 hours. Just watch, I will have the drains in forever with the exchange surgery.
PS said my LE would improve with the LD flap surgery. Didn't really believe him. I really expected it to get worse but surprisingly, it has improved. The back of my arm rarely ever aches any more and I have been able to go without the compression sleeve and glove more.
0 -
jo1955 - I still have a puffy spot in my armpit, and it gets these creepy prickly feelings like a giant metallic spider crawling across my armpit. Weird, all of the dumb things we get to experience! (By the way, I assume you were born in 1955? I was born in May of 1955, so I'm thinking we might be the same age!)
0 -
lalove55 - And you would be correct. My birthday is April 21st. Just turned 57. Was in the hospital of all places.
I am 3 weeks post op today and still have the puffiness. Not too bad and it seems to be going down.
0 -
I don't think there is any rhyme or reason to why drains drain as much as they do and have to stay in as long as they do.
When I had my double mastectomy with immediate reconstruction I had 6 drains and was in hospital for 10 days until the morning they pulled the last drain. Went home and the following week the PS used a needle to drain about 75cc from the base of my lat scar and she repeated that the following week and pulled about 50 cc out. My PS didn't believe in sending patients home with drains due to the risk of infection and also the body had to and could, at some point, learn to absorb some of the fluid.
Six months later I needed the implant replaced for a larger one one the lat dorsi side (only had one flap on the radiation side) and was supposed to be in the hospital with the one drain overnight and was there four nights and that one drain put out more than 3! So much, I became anemic and they wanted to do a blood transfusion (no thank you).......so each drain follows it's own path just as each Plastic Surgeon is different. It doesn't mean one is good and one is bad - plus our bodies are different.
And hey, you 1955'ers, you are making me feel old as I was born in 1952!
0
