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Latissimus Dorsi Breast Reconstruction

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  • kaiote
    kaiote Member Posts: 6
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    Hello, Can anyone tell me please if I will need to keep taking Tamoxifen after surgery? Thanks

  • FACECRAFTER
    FACECRAFTER Member Posts: 433
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    Yes, kaiote, you will.  Tamoxifen is to stop any future cancers from forming.  JUDY

  • kaiote
    kaiote Member Posts: 6
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    Thank you Judy. I have brca1 and therefore predisposed to Ovarian and breast cancer but will have neither ovaries or breast tissue after this op. I can't find any evidence to say that Tamoxifen will prevents other cancers. I will speak to my Dr though. Thanks

  • Faythnme
    Faythnme Member Posts: 92
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    Hi Alicia - I know what cellulitis is but not around the breast area.  So I am not sure what to say.  Back in August when my first attempt at reconstruction (the typical type done) failed due to the TE popping out of the muscle and tissue on the left side I told the PS to stop and I wanted to heal physicaly, emotionally and mentally.  I had had 5 surgeries on starting May with a lumpectomy and then 7/21 the mx; 8/4 necrosis removed; 8/19 the reconstruction; 9/1 the TE's removed.  After both TE's were removed I had an infection on the right side.  After the PS (who didn't know what was causing it and hadn't seen anything like it before) remove the fluid it took a month for it to heal.  On 5/4 I had my 2nd attempt at reconstruction (new PS) and so far everything is going well.  I had the LD Flap (latissimus dorsi).  I am glad I took a break and let my body heal for 6-7 months.  I was convinced I needed that time in order for the 2nd attempt to work.  I also want to mention that I DID NOT have any radiation or chemotherapy as I caught my disease very early.  So, so far so good everything is working out well. I have had 1 fill so far and 5 of 6 drains removed.  My last drain will come out this Wednesday (thank goodness) and I will get another fill.  The end result should be a full "D".  I have 550cc TE's in right now.  I'm thinking of Wednesdays fill to be 60cc (L) and 70cc(R), that will give them 120cc's in each TE.  The PS said if all goes well (and it will) I should be able to have my exchange in late Sept/early Oct. Smile

    Alicia, I think you need to decide for yourself what would be best for you.  What are the chances that if you are not given the proper time to heal from the infection and the lat flap is done the way the PS wants to do it that the infection and cellulitis will or will not reoccur?  You might want to ask your PS that. I'm not a doctor but in my case I listened to my body.  I will say that right now I am so glad that I had the lat flap surgery and my new PS knew immediately that was the way for me to go.  Mine was a 6 hour surgery (both breasts).  If it had not worked I told her my decision was to be breastless for the rest of my life as I would not do the one with the muscle from the stomach.

    Sorry for being so winded, can't sleep because I took a nap this afternoon.  I hope I have made some sense at least.

    I drove for the first time since the 4th!!!

    Have a fab day!  Cindy

  • Faythnme
    Faythnme Member Posts: 92
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    Hi Alicia - I know what cellulitis is but not around the breast area.  So I am not sure what to say.  Back in August when my first attempt at reconstruction (the typical type done) failed due to the TE popping out of the muscle and tissue on the left side I told the PS to stop and I wanted to heal physicaly, emotionally and mentally.  I had had 5 surgeries on starting May with a lumpectomy and then 7/21 the mx; 8/4 necrosis removed; 8/19 the reconstruction; 9/1 the TE's removed.  After both TE's were removed I had an infection on the right side.  After the PS (who didn't know what was causing it and hadn't seen anything like it before) remove the fluid it took a month for it to heal.  On 5/4 I had my 2nd attempt at reconstruction (new PS) and so far everything is going well.  I had the LD Flap (latissimus dorsi).  I am glad I took a break and let my body heal for 6-7 months.  I was convinced I needed that time in order for the 2nd attempt to work.  I also want to mention that I DID NOT have any radiation or chemotherapy as I caught my disease very early.  So, so far so good everything is working out well. I have had 1 fill so far and 5 of 6 drains removed.  My last drain will come out this Wednesday (thank goodness) and I will get another fill.  The end result should be a full "D".  I have 550cc TE's in right now.  I'm thinking of Wednesdays fill to be 60cc (L) and 70cc(R), that will give them 120cc's in each TE.  The PS said if all goes well (and it will) I should be able to have my exchange in late Sept/early Oct. Smile

    Alicia, I think you need to decide for yourself what would be best for you.  What are the chances that if you are not given the proper time to heal from the infection and the lat flap is done the way the PS wants to do it that the infection and cellulitis will or will not reoccur?  You might want to ask your PS that. I'm not a doctor but in my case I listened to my body.  I will say that right now I am so glad that I had the lat flap surgery and my new PS knew immediately that was the way for me to go.  Mine was a 6 hour surgery (both breasts).  If it had not worked I told her my decision was to be breastless for the rest of my life as I would not do the one with the muscle from the stomach.

    Sorry for being so winded, can't sleep because I took a nap this afternoon.  I hope I have made some sense at least.

    I drove for the first time since the 4th!!!

    Have a fab day!  Cindy

  • Alicia
    Alicia Member Posts: 17
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    Cindy, Thank you so much for sharing your story. That's awesome that you can drive already after just 3 weeks. Cellulitis is redness and inflammation usually caused by a staff infection. In my case, the fact that I had radiation complicates things considerably. You are very lucky to have avoided it. You're absolutely right about listening to your body. Thank you for that reminder!

  • Faythnme
    Faythnme Member Posts: 92
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    Good Morning Ladies -

    Well I had my 2nd fill Wednesday!  120cc on each side so now I have 180 (R) and 170 (L).  Everything is healing quite well.  It also turns out that Flexeril does nothing for me.  So going forward I only take a 1/2 of Percoset if needed.  I finally get to take a real shower too.  I had 1 drain left in until this past Wednesday as we thought there might be an infection.  Turns out everything is okay so I am off of the antibiotics as well.  I'm just making sure I take deep breaths and do lots of stretching through out the day.  So far that is what's working. So to the showers I go.  It'll be so nice.  Next fill Tuesday.

    Alicia - I wish you the best!  All I can say is that I am glad I took the time to let my body heal and I honestly believe that is why everything is going as planned.  Everything I have planned to happen so far is working.  You will figure out what's best for you!  My thoughts and prayers are with you!! Smile

    Have a wonderful Memorial Weekend Ladies!!

    Cindy

  • Stanzie
    Stanzie Member Posts: 1,611
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    Oh I so remember that first shower....... Enjoy!!! Boy it has been long and I know you must be tired of sponge baths.... Glad everything is going so well!

  • Diane509
    Diane509 Member Posts: 42
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    Has anyone else had the Lat Flap done without an inscision on the back?

  • Faythnme
    Faythnme Member Posts: 92
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     Hi Diane - I have not.  Even through research I have not heard of that. If you have a good PS the line should be well hidden when wearing tank tops and even some low back outfits.  However if you wear bikinis (not me..lol) I don't think you can hide it but you should be able to diminish the appearance of it a little with the right approach.

    Well I am on my 3rd fill today.  So total now I have 300cc in the left and 290 in the right.  So far so good.  Still no pain pills.  After this fill I also do not have the linebacker feeling under my arms.  The PA told me that as I get further along the discomfort may be more prevelant.  We shall see and take it 1 day at a time.  I have noticed however that after each fill I get really tired and sleep most of the rest of the day and most of th next day.  That's alright by me.

    Has anyone had any issues with their legs after surgery?

    Cindy @--{--{--

  • Stanzie
    Stanzie Member Posts: 1,611
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    What is going on with your legs? Glad the fills aren't so bad so far.

  • Faythnme
    Faythnme Member Posts: 92
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    Stanzie  - Its just kind of weird.  My plantar fasciti started up again in my left foot.  Its been years since it hurt.  My left knee is just painful.  I'm not sure what is going on.  I don't see anything weird on them.  I think maybe if I walk more it might help.  I know it's  not blood clots though.  maybe I need to make a better attempt at sleeping in my bed rather than on the couch.

  • Alicia
    Alicia Member Posts: 17
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    My feet started hurting between chemo and tamoxifen. I think it's hormone-related. They hurt the most after inactivity, like sleeping. 

  • Faythnme
    Faythnme Member Posts: 92
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    I think you may be right Alicia.  However I did not have any rads or chemo.  I think it's more of inactiviy.  It may also be because when I do my deep breathing I do semi squats before bringing my arms up over my head. 

    C

  • Diane509
    Diane509 Member Posts: 42
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    I am having feet issues too... swelling in the feet, ankles, calves, thighs and abdoman... not upper body,..isn't that strange?  Still touting 20 exra lbs since I checked in for surgery.  Mostly fluid I imagine but in addition I am eating regular meals and not excercising much....hmmmm could there be a coralation? 

    Anyway Cindy I have my first post op today with PS (he has been on vacation since I got out of the hospital so his nurse has been checking me and pulling drains until now) I have 2 drains left and I hope they will be pulled today.  

    Not looking forward to the fill.... I think I actually left the hospital with them pumped up to 200 or something... (maybe that's why I have so much tightness already).

    I have been unable to find anyone who had the same type surgery I did.  My lat flap was done without any cutting into my back.  The scar on the boob goes all the way horizontally across to just under my arm, but there is no incision on the back whatsoever.  My PS was explaining to me how it's normally done and how he wasn't satisfied that women had to have the additional back scar (even if it could be covered by a bra or bathing suit).  A friend of mine had the identical surgery and the PS tells me only 1 other doctor west of the Mississippi does it that way.....he said it takes longer and it's more intricate microsurgery but he felt it was worth it for the results.

    I searched the internet high and low and couldn't find any info on it.... I even asked him ...he said I wouldn't find it out there because it's not that common.  So the breast surgeon spares all the tissue she can (except the nipple and areaola in my case with the DCIS and makes the long cut as drawn by the PS during a preop visit.  He said...he likes working with her because she follows his cutting instructions and leaves him great flaps....   Anyway, that's how it's done.... somehow they go in through the breast incision....reach back to the back and harvest one end of the lat muscle and pull it through that tunnel and around to the front....

    I have to remind myself of al my body has been through when I start complaining of the pains of recovery.....we have been hit with a double whammy on both sides of the body.... 4 quadrants really.  No wonder it's slow....

    Happy Wednesday to you all..............................

    diane

  • Linda54
    Linda54 Member Posts: 509
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    Diane....With my brain getting older it is harder to remember things but I do remember someone on these boards having LD flap recon and it was done through the MX incision and no incisions on her back.  Just can't remember who that was right now.  I will let you know IF I remember...LOL...or maybe she will read this and respond.

    edited to add:  abbadoodles had a free LD flap recon.  The muscle was lifted and reattached so this is microsurgery.

  • 2Xsenough
    2Xsenough Member Posts: 48
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    Hey, Linda, great avatar!!! It's me, I'm the one with no back scars. So Diane, I must have found the PS that does this type of surgery. He's in Reno. I don't have time to chat today cause we are leaving tomorrow for a two week trip. If anyone needs info on this procedure please PM me and I'll check in when I get home. 

    Bobbi 

  • Linda54
    Linda54 Member Posts: 509
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    Bobbi

    Good to hear from you.  I was thinking it was you but was not sure and did not want to say until I knew for sure.....2 week trip!!!!  have a great time and be safe.....

  • Faythnme
    Faythnme Member Posts: 92
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    Diane/Bobby - That is absolutely wonderful for you guys.  I'll  have to ask my PS when I see her in a couple of weeks.  My Lat Flap is actually a delayed reconstruction so maybe I would not have qualified for it anyways.  It also turns out that the last PS did something strange.  I keep forgetting to ask the new one what that was  again.

    Man I am sneezing like crazy over here.  Not sure what that is all about.  10 times in a row. Maybe I should check the pollen count.  I don't typically have allergies this time of the year.  Thank goodness it's not effecting my chest.

    Have a great week all.  Haven't felt to good today so I'm going to go relax,

    Cindy

  • Faythnme
    Faythnme Member Posts: 92
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    Question to everyone - how soon were you able to start working out and where you allowed to do?  Right  now my PS just wants me to walk everyday (rain or shine and I live in Seattle with liquid sunshine... Cool).  I believe she said I could try yoga in a couple of weeks.  I would like to hear back on what everyone else has done.

    Thanks again!!

    Cindy

  • tamgam
    tamgam Member Posts: 83
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    Faythnme-  I did not feel energetic enough to exercise for almost 6 weeks after LD surgery.  I just was so tired and even a little walking was a challenge.  But I also packed on about 15-20 lbs so I really wish I had pushed myself just a little.  Everyone heals at a diff rate so you have to do what feels good for your body.  I am in no way saying to overdo it, setbacks are emotionally devastating, but challenge your strength a little more each day.  I had bmx about 10 weeks ago and feel like myself again but just in the past month.  I am done my fills and waiting for exchange.  I am having a tough time losing the extra fat but one day at a time, right?

    I must say I my back muscles feel great.  I worked up some strength cleaning windows and such.  It was actually a challenge at first but more and more I felt stronger.  I found serious housecleaning to be a great mental and physical strength training!  Good luck to you on the yoga.  I have only ventured to use the yoga program on Wii Fit but so far so good.

  • SusanZ1961
    SusanZ1961 Member Posts: 8
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    Hi Ladies,

    I am having Left LD flap with immediate implants on both sides tomorrow morning.  I am a little nervous but yet excited to finally have my reconstruction.  I will be in the hospital 4 or 5 days.  Any suggestions on what to take or not take to the hospital?

    Susan 

  • Faythnme
    Faythnme Member Posts: 92
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    Hi Susan - take very comfortable clothes, the loser the better because you will probably have some drains. Don't worry about what you look like in it either because your comfort is # 1.  While you are in the hospital you will probably sleep more than anything.  I was in for 3 days and barely remember it.  I had a small pillow in the car as well so that the seatbelt didn't go directly on my chest.  Don't take anything valuable.  Only your drivers license, medical card and if you wear glasses bring them.  If it would be hard to replace it don't bring it.  Hopefully that helps some.

    Hi Tamgam - thanks for the information. I just finished a walk down to the coffee shop.  I live in a great area with lots of small little shops. It's just that when I get down there I just want to sit down close my eyes and rest.  I wear my shape ups so hopefully that helps a little.  I've been trying to do things around the house.  I make jewerly so I've been dabbelling in that.  I just dont' want to do anything that will set me back as this is my 2nd attempt at recon and it's working so far.  I do a lot of deep breathing.  Last night I couldn't sleep so I was up listening to my IPOD and can you believe I was up at 2am in the morning trying to dance?? OMGoodness....you would not have imagined how you used that Lat muscle.  What a sight that was.  I think I got 4 hours of sleep after that.  I'll just keep working around the house and hopefull that will help.  Next adventure?  Trying to figure out how to get my reading glasses from beind a couch that is too heavy to move.  I think I have a long stick somewhere!!! LOL Wink

    Everyone have a fab day!!

    Cindy

  • lamuso
    lamuso Member Posts: 7
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    Hi Linda54.  I too have the tight bra feeling on my radiated side.  I had an LD flap with tissue expander and then saline implant put in.  It is a strange feeling and sometimes it does bug me.  On my Non cancerous side I just had the tissue expanders/implant put in.  There is no tight bra feeling on that side.  I believe it comes from the radiation and all the scar tissue.  I am pretty lumpy on that side.  Also the LD flap further irritated it.  I've been stretching to try and help with this but I don't get great results.  If you discover something that helps, please let me know.

  • Linda54
    Linda54 Member Posts: 509
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    Leslie

    My tightness is on both my rad and my prophylactic side.  I think it has to do with the LD muscle not wanting to stay stretched.  I know 2 ladies that had this same surgery and same PS as me and they do not have the tightness...guess I was just lucky  LOL....I tried PT with no success..I am thinking that in time it will become just a normal feeling and it will not bother me as much.  If I do find a "cure" I will be shouting from the rooftop...

     Susan, I remember my surgery like it was yesterday (2 years Bi-lat MX with Bi-lat LD flaps)...Do take some silky PJ bottoms so that you can slide easily in and out of bed.  Also, I am short and had a hard time getting in and out of bed...wishing I had a step stool to make it easier...don't know if the hospital would have allowed one..LOL......I had a friend to come by the hospital the next morning on her way to work and she applied my makeup for me.  If you wear makeup, having this done can help you feel tons better.  Having a drain apron would help but if you do not have one already I guess it is a little late.  Get the nurses to show you how to clean your drains.  I did not know about this and when a friend came to see me when I got home she showed me how. 

    I will pray for a successful surgery for you and infection free. 

    Check in when you feel up to it and let us know if you need info when you get home.

    take care

    Linda

  • Linda54
    Linda54 Member Posts: 509
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    Cindy

    I started walking as soon as all the drains were out and that was at day 17 and started my range of motion exercises.

    Back to work at 4 wks.  Week 5,  I started adding a little jogging with my walks and at 6 wks I was walking 1 min and running 1 min for 4 miles. At 12 weeks I had worked up to 10 miles of running 9 min/walking 1 min.  also at 12 weeks I started strength training.

    Now after 2 years and 4 surgeries I am feeling like my "old" self and doing everything that I did before.

  • Faythnme
    Faythnme Member Posts: 92
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    Linda - thats  awesome. I mentioned running but they told me not to do any.  I go back to work on the 14th part time and then full time on the 22th.  I think that will make world of difference.  I was doing range of motion exercise almost as soon as got home day 7 I think. Trying to walk but I don't like to walk in the rain when it's cold outside too.  I keep thinking about getting back in the gym with my headphones and go to secluded room and dance.  I love to dance.  Now last night this morning that was a site to be seen....long story.

    Thanks for all of the information.  Much appreciated.

  • Faythnme
    Faythnme Member Posts: 92
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    Well I finally slept in my own bed last night.  Slept for 8 hours, most sleep I've gotten since surgery. 

    Question for implants:  Saline or Silicone and why?

    Thanks!

  • tamgam
    tamgam Member Posts: 83
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    Faythnme- I would love to dance to if I had any rythm.  I swear I had a different body when I was younger.  I would go to clubs and dance until they closed for years.  Now it is like I have two left feet made of wood!  Go figure!

    Anyway, I am going with the silicone.  Hoping my exchange is a little more than a month away if scheduling permits.  An overwhelming number of ladies on BCO go with silicone. My PS swears they feel the most natural and are the best choice.  But I have had no rads so I do not know if that makes a difference. I do know that even though I have had good results so far with the TEs I am foaming at the mouth thinking of getting softer implants!.  I feel as if my PS is so capable and I can not wait to see the results.  I will def keep you posted.

    HUGS♥

  • Faythnme
    Faythnme Member Posts: 92
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    Thanks Tamgam - My sister was questioning why silicone and not saline.  I think she was concerned with the safety portion of it.  I am definitely going with silicone as I've done a lot of research and my PS uses Silicone as well.  I have to wait until October I think for my exchange.  Even though at this point I am not having any difficulties with the TE's I certainly look forward to that date.

    Anyone - Does anyone sleep on their side with the TE's?  I've heard stories on the site where women say that their TE's have slipped to under their armpits.  My PS says that won't happen with me.  Could it be the difference between the Lat Flap and typical reconstruction?

    Thanks!! CindyCool It's going to be sunny in beautiful Seattle today!!!