Latissimus Dorsi Breast Reconstruction
Comments
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Julee - I had a left LD flap on March 7th and would do it over again in a heartbeat. Make sure your PS has done hundreds of them and also make sure he cuts the nerve. Mine PS had done over 2,000 so I felt very comfortable that he knew what he was doing. Good luck!
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Going in tomorrow for another revision. PS thought he had cut all the nerves and didn't so he is going to fix it. The muscle contractions are a pain in the butt. While he is at it, he is also going to do an aerola lift. Scheduled for 7:30 and should be home by noon. I would still do this again in a heartbeat.
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I too had a UMX with LD on my left. Skin sparing so straight to implant, no TE. Would I do it again, yes. I do not regret the decision I made to go with this type of immediate reconstruction. I haven't had any problems with my lat side and the muscle relocaton. I did have the first implant swapped for slightly smaller. Now it's a pretty close match to the right side.
I did second guess myself after the first surgery. Did I do the right thing? bla bla bla. But that's just me. I do that with a lot of things in life.
But I also didn't tell more than three people at my work that I had BC. I was out "on leave". No one can tell I had anything done, with my clothes on of course. I have no idea about the muscle nerve that others mention. I haven't noticed any totally off the wall muscle movements on the lat side. Yes it feels different when I do certain things like working out with weights or mopping the floor. I wasn't a candidate for DIEP or other types of flaps so this was the best option for me. No regrets! 0 -
Hi Julee -
I had a large lumpectomy (well, that's the best way I can think of to describe it) and then a LD flap 8 years ago. For me, the surgery wasn't particularly painful and the drain was only in for a week or 10 days, not too bad. I used arnica prior to the surgery, that helped one heckuva lot with bruising, pain and healing quickly.
Doing fine today. Had some loss of range of motion at first but persistent yoga and deep tissue massage has gotten me through all of that. I still have massage and do yoga 5 x weekly. I also write a blog to help others through this journey so if you'd like the web address, let me know.
Sending hugs!
xoxox
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has anyone had this surgery at Sunnybrook in Toronto? I am looking for a surgeon with experience. Please let me know. thanks, Nicole
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Nicole4 ~ send a private message to Whippetmom. She has a list of doctors that do this surgery and she can research that for you. Not sure what she has on Toronto.
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I had a BMX and latissimus dorsi reconstruction done 4 weeks ago with TE and I've been expanded twice so far. I just had the last 2 (out of 4) drains removed yesterday. I saw online where you can expect to go back to work 2-3 weeks after the surgery. I have two more weeks on my short term disability (6 weeks total) and even though some days I feel like I could go back sooner, today I do not. I was wondering how long were you all out from work? Do you continue to how bouts of exhaustion? What about back discomfort?
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I think this all depends on whether your job is physical or not. I'm at my desk, but sitting for prolonged periods was uncomfortable, so I was out the entire 6 weeks. I had been through a lot, so I felt my body needed the extra time to recover. We are all so different.
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I have been MIA for a few months, but I have a good excuse. I had some very extensive spine surgery a month ago and that has taken priority over my reconstruction project for now. I had lat flap surgery on one side in April and will be going back to visit my PS next month to see what revisions he recommends now that things have had a chance to settle. Overall, I am very happy with the outcome except that my lat flap side is smaller and flatter than the other side where I have just an implant. I mentioned it to my PS at 2 months post surgery, but he wanted to wait and see where things landed later down the road, after my spine surgery. For now, I feel like I have to wear a little filler on that side when I wear a bra. Nuisance! I am guessing that he may recommend putting in a slightly larger implant on that side. Think that side has a 220cc implant right now.
For now, I need to concentrate on recovering from spine surgery. The first two weeks post op was the most painful period I have experienced in my life.... Just as my surgeon warned. But I am now suddenly starting to feel much, much better and have just 2 more months left in my back brace. So, I actually willing to get back to thinking about finishing this reconstruction process once and for all.
Jo... Sounds like things are going very well for you. I think we had our lat flap surgery done about the same week, if I recall correctly.
Good luck to those going through surgery. I am glad I did it, but then, I didn't have much choice either.0 -
joan888 - So glad to hear your spine surgery went well and you are recovering. I think I am done with my revisions. I go back next Wednesday - the 22nd. I won't say this is my last appt because the last time I said that, I walked out of my PS office with a surgery date. It has been one week today since I had the surgery and I am so very pleased with everything. So glad I decided to do this. And yes, I think our surgeries in April were about the same time. Mine was on the 18th.
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I hope someone can help me. I had revision surgery on Aug 7th. PS had to go back in and cut the nerves to the muscle - he said he did it at the first surgery but I could still contract the muscle. Anyway, I discovered yesterday that my back on the lat side is full of fluid. Why did I not call my PS? He is on vacation and I am not scheduled to see him again until the 22nd. I am thinking this is a huge seroma. What do I do? Any advice/suggestions would be greatly appreciated.
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Jo- there should be someone on call while your PS is out of town. There should be an answering service. Give them a call and find out if they want to see you this weekend or Monday. Seromas are a bummer, but usually they can be drained easily.
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Jo, Uffda is right. The PS office should either have another dr covering for him so at least you can see someone to get piece of mind. Seromas are a pain but want to be sure that's all it is. Of course, this advice also sucks since it's Friday night.
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Hi Jo, i also had this problem with fluid to my back re LD. You need to have fluid drained off, so contact breast nurses. This is not painfull it may take a few times for build up of fluid to stop. Then you will be fine. Please keepus updated. best wishesx
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kaza - I kinda thought it was fluid buildup/seroma. I had that a couple of times after my lumpectomy. I would assume it would be the same procedure. My PS is the only one in the office - he owns his own practice so I have to wait until he comes back from vacation. I know it is no big deal to wait until my Wed followup appt. This is just an inconvenience. I am leaving on the 30th for a well deserved cruise and if I have to go a second time to have more fluid drained off, I hope it can wait until I get back on Sept 11th. I will keep everyone updated.
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Jo, the waiting is the worst part hope all goes well for you on Wednesday.
Get that over with, and you can look forward to your holiday.
Thinking of you x
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Jo- if it gets bad you call him anyway! Have fun on your trip!
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Uffda - I sure will. It doesn't hurt - it is just irritating. I sleep on that side and I can feel the squishy when I am trying to go to sleep.
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Jo I hope it goes ok and then you can have a great worry free vacation! No big vacation for me this year, but tomorrow I get a nipple! LOL!
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jwilco - Hope you get good results with the nipple. Let us know how it goes please.
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Thanks. I'm trying to stay busy so I don't start thinking about yet another surgery. This will make number four in this last year. I hope I don't lose my marbles from all the anesthesia. :-) Good news is that this surgery should be shorter (fat grafting, minor skin revision and nipple) and I get to go home the same day! I will have to update all my pictures on the picture website.
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jwilco - I know the feeling with multiiple surgeries this year. Had the revision in April with a 4 day hospital stay, end of June another hysteroscopy - 3 cm polyp - if I had been thinking I should of had my GYN do a complete hysterectomy and the third surgery was the recon revision. On this last one, guess my PS did not cut enough of the nerves. I could still move the muscle and the boob would flop all over the place. The nipple lift I had done at the same time looks great.
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Here we go...I am very new, just registered today. I am in the process of getting recon surgery scheduled, skin saving mastectomy on the right breast with Latissimus Dorsi for the left. The left has been through radiation almost a year ago. I have been reading this topic, it seems like the skin on my breasts will feel different because one will be my actual breast skin and the other will come from my back? Of course I will have tissue expanders on both sides...just kind of rambling here, you guys are kind of intimidating because you seem to know so much, lol. I had a pretty active year last year with all my treatment and surgeries....not really looking forward to another surgery but am sure tired of wearing a prostetec breast.
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hswhranch - This is my opinion only but I believe the most important thing is to find a PS that has done several hundred latissimus flaps. Don't be afraid to ask and if you get a bad feeling from one PS make an appt with another. I messaged whippetmom after I went to a PS that acted like he didn't have a clueless and he was recommended by my breast surgeon which in itself was kind of scary. She gave me a couple of plastic surgeon's names fairlly close to where I live and I made appointments with both and after seeing the first one, I knew he was the right one, so cancelled the second one. The experience I had between the two I saw was like night and day. I found out later the first one I went to did not have that much experience in delayed reconstruction of a messed up mastectomy. It would have been nice if he had told me that, but instead he was going to try to place a tissue expander first and "if the skin won't stretch out I can take some stuff off your back later." These were his exact words. He only spent 5 minutes with me. Never asked if I had had radiation either. Good luck!!
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I am scheduled to have an LD flap in 3 days. I am nervous about the long term back pain/numbness. did any of you have trouble laying on your back? how did you sleep? If there are any tips, please share! its bad enough to have surgery on the front, but to have it on my back too is very scary.
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My PS' office recommended sleeping on my back with a wedge pillow or in a recliner. I had (& still have) no issues lying on my back or with pain or numbness.
Good luck, lea321!
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lea321 - I never had any trouble putting weight on my back. I slept in a recliner for a little over a week, but that was because it was uncomfortable getting up and down and the recliner made it easier. When I moved back into bed, I found the hardest part was positioning myself - we use our arms for that more than we realize and I couldn't put much weight on them. But, you work around it.
I'm 4 months out now and I don't have any numbness or pain in my back. My scars are thin pink lines. My only annoyance is a dog ear at the bottom of each incision (where my drains were). They look like small "love handles" but I'm assured that when I have my 2nd surgery, those will be removed.
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you guys are a world of information. I had somebody tell me that the surgical oncologist that she works for said that LD's were outdated. I don't see how they can be when there are limited reconstruction options for certian types of mastectomy's. Can you feel that muscle running under your arm or is it just something that you get used to. Heck I'm still numb from having the lymph nodes removed.
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hwhranch, I don't feel the muscle. Others' experiences may differ, but I am happy with my decision to have bilateral lat flaps. I had one done in July 2011 & the other in Sept 2011. For a couple of months I could feel the muscle tightening up in my chest randomly, but it was not painful & rarely happens now.
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hwhranch - I don't feel the muscle under my arms anymore. In the weeks following the surgery, sometimes it felt like I had a tennis ball under there...but it goes away. I had the same spasms DLL66 mentioned, but those have subsided, as well. I do think that I started feeling better once I started physical therapy. So, if you can find someone locally that has some experience with mastectomy patients, I'd recommend it.
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