Latissimus Dorsi Breast Reconstruction
Comments
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hwhranch - I don't know how much help I could be to you. I had a lumpectomy and a significant amount of my breast was taken hence the LD flap. I slept in a recliner for 5 weeks until the last drain came out - I had 2. The scar on my back is thin and not noticeable. I do not feel the muscle under my arm anymore. I had my LD flap done in April and my PS had to go back in 2 weeks ago and cut more nerves so the muscle could not contract. I am very pleased with my decision.
DLL66 - I just noticed you are coming up on your 2 year cancerversary. Mine is 3 days after yours and will also be 2 years. Yeah! For us.
Just an update. I did manage to get in to see my PS today about the seroma in my back. He aspirated 80ccs and I now have to wear a compression wrap for the next 24 hours - longer if I feel the need. Have another follow up next week. He thinks he may have to aspirate one more time. Told him that would be fine - I kinda expected it since I went through this same scenario with my lumpectomy - I had several seromas with that as well so this was not a big surprise. I knew what it was right away.
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What made you sleep in the recliner? Is it awkward in the bed because of the tubes or the surgery site. Nobody has talked about much pain? I have a pretty high tolerance anyway.
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hwhranch - I was not in much pain. I had very little pain medication in the hospital and the nurses could not believe it. They told me that many women who have the LD flap done are like babies - crying all the time about the pain. My PS gave me Vicodin for home and I took very few of them. I slept in the recliner for a couple of reasons - it was much more comfortable and I did not rollover on the drains. Also, my PS told me the more upright you can sleep the better drainage you will get. He said if you lay flat, the blood/fluid has a tendency to pool and you may get a lot more drainage at night vs during the day. Before the drains are removed you have to be at 30 ccs or less for a 24 hour period and that is not much in the drain. I had one removed at 2 1/2 weeks and the last one at 5 weeks - 2 drains total.
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Jo I was the same way after my mastectomy. The morning after I was raising my arm over my head. They could not believe that I could do that, lol. Said most women could not/would not do it for weeks, lol. So it sounds like being off work and recovery is more about the drain tubes, it was the same with my mastectomy.
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hwhranch - I went to work with my drains still in. I was able to find some tops that I could go braless and also full enough I would hide the drains. Actually I could put them in my pocket. I pinned them to the waistband of my shorts and tucked the tubes in my pockets or waistband depending on what shorts I was wearing. I work at a 55+ mobile home/rv/ resort and this time of year my job is mostly computer and telephone. I would have my assistant manager take care of the residents. It would have driven me crazy to stay home until the drains were out. I felt so good and wanted to be out of the house. Okay! Call me crazy - I'm sure some would but I have a tendency to bounce back rather quickly.
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Yay, jo1955! It's a good milestone
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I have had 2 lumpectonies that left my right breast smaller than my left breast. My last lumpectomy was last August. In December I had surgery to get implants. I was a b and the implants made me a c+. I felt they were too big and in January I had surgery to get smaller implants, and breast lifts. Because of radiation and other factors this surgery left my right breast an inch higher then my left. Then 3 weeks after this surgery I developed an implant infection and the implant had to come out. That was in Febuary. Now I require a latissimus flap surgery which I am having September 12. After getting several opinions it was decided that I would not get an implant this time. My surgeons think I will have enough breast tissue without it. If it turns out that my breast is smaller than the breast that still has an implant I would require another surgery to get an implant 4 to 6 months later. I would love to hear from women who are satisfied with the results of the latissimus flap. Does your breast look natural? Is their much discoloration from the two different skin tones? What was the surgery like? Was their much pain? How many days were you hospitalized? How long did you have to wear drains? Any information or advice you can give me would be greatly appreciated.
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I often heard that the LD surgery was outdated and there were 'newer and better alternatives' and that I was crazy for selecting that option. People tired to talk me into an ab flap even after I explained that prior ab surgery created more difficulties. For me the LD was one of the only options as I did not want only implants.
1. I am satisfied with the results and my breast looks and feels (the flap allows for bounce and movement) natural, or as natural can be without the nipple (that is coming later). My surgeon thought she could create the same size without an implant, however went back 6 months after LD to insert a small implant, fix the dog ear on my side, and reshape the breast. It looks good and excited about finishing up this process in November. Prior to surgery I wore a 36b/c, after first surgery I was a 36c, and now I am at 38d. So, I might have to at some stage have a lift/implant on the 'good' side to even out again. Or lose some of the excess weight I have gained during the past 7 months. (Went to Nordstroms for fitting and it was excellent!!!)
2. There is not much discoloration as the only skin that was removed was the nipple and the aerole. So there is a small patch that is darker (from the skin on my back). That skin will be used to create the nipple. My back scar is noticable, but continues to fade. The PS did a good job and there are no bumps or jags. My concern is that the location where the nipple should be isn't 100% 'front and center' - it is a bit to the side. But I have trust in my PS to do what needs to be done.
3. I don't really remember the surgery - it was both a MX and the LD surgery. I know it was long (7 or 8 hours). Stayed in hospital 3 days. Not a lot of pain and I was on tylenol by day 2. At home I took pain meds during the day and stronger ones at night to help me sleep. I slept on my back which was not painful. I put a pillow under my legs and that helped. Getting up and moving was difficult however. Sitting was much more comfortable than being in bed. The worst pain came when I forgot about the surgery and tried to stretch (this seemed to be a natural movement in the morning and on day 7 at home I woke, stretched left then right - OMG!!!!! lesson learned.
4. This is the doozy. I have 4 drains and had the last ones for 6 and 7 weeks. But after a mild panic attack, a trip to the ER for an infection, and the desire to yank those out myself.... it worked out. No extra fluid build-up.
5. I now have almost complete range of motion. I would say 98%. What helped was going to a physical therapist during the first 2 months after surgery. It helped so much and I recommend it. I can lift my arm, but still feel a pull (not a pain) in the breast. No big noticable issues with loss of back strength however the skin is still tight - very tight.
6. There are woman who have had no major issues with this surgery and women who have had loads of issues. The surgery depends so much on you, your doctor, your body, etc. I was worried right after the surgery when I could not lift my arm (also had SNB during surgery) and thought I had made a huge mistake. I remember the doubt and the frustration. But, for me it is working out. If I had to do it again, I think this is the way I would go.
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Thank you for all the info fitzdc. Do those in the know think itis a good idea to see how the latissimus flap surgery settle and then put in a small implant if I need it or should I get a small implant now?
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katehudson - I also had a lumpectomy. If you look, our stats are almost identical. I waited almost a year and a half to do this procedure. My PS said there would not be enough room for an implant so I don't have one. He used enough muscle to give my nice symmetry. BTW! I am a 36C. I have my own nipple and he moved that back to its original place - mine was pointing to the left and down. I recently had to have another revision and while he had me under, I had a nipple lift since it was still pointing down a bit. I am very happy with my results and would do it again. I am loving the fact that I do not have any artificial parts - implants. I am 4 months post op and I think I am going to settle as much as it is going to.
I did not have much pain. In fact, I had very little pain meds in the hospital and took very little once I got home. The nurses were so surprised I wasn't a crying mess and in a lot of pain. I was up walking to the bathroom within a few hours of getting to my room. I had to have assistance the first couple of times and that was because the nurse said so - LOL!
Had 2 drains - one came out at 2 1/2 weeks and the other at 5 weeks. The worst part of all of this was not being able to sleep in my bed and the drains. Had to sleep in the recliner until the last drain came out.
I returned to work within a week and yes, with the drains. I would have gone crazy if I had to stay at home for 5 weeks. I felt great.
Hope this helps you and good luck with your decision.
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Hi Jo Thanks for letting me know I too have my own nipple. Since I had lifts I don't think I will have a problem with anything pionting down. How many days were you in the hospital
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katehudson2...My story is similar to ftizdc in that I had the UMX and LD surgery at the same time but with implant from the start (I had them prior to BC). I had a revision in March to swap it to a smaller size and replace the right side implant with fat grafting on the UMX side too. Most recent is just yesterday I had surgery to get the nipple. I also thought my circle of skin from the LD flap was too far to the left. He moved it a little at first revision and again this time. I think it's pretty good. Took a peak at the nipple this morning when I changed the gauze and was surprised to see it. It's larger than the original but I've read on this site that they will shrink down a bit. It's only day two of recovery but once the nausea from the surgery was gone I've been doing ok.
When I had my original UMX/LD surgery I was in the hospital for three days with three drains. The one for my back was in for about 7 weeks. That was a major annoyance. As far as the recovery, it didn't hurt to lay on my back, but it was sore in the breast area, and if I used my arms too much, etc. Nothing that was too hard to handle. Yes, the circle of back skin where my nipple was is different than the rest. I had skin sparring MX so most of my LD side is my original breast skin.
This was the best choice for me given my prior abdominal surgeries and breast augmentation. I'm happy with the results.
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Hi there ladies! I notice that more than a few who have had this surgery are having problems with pain and discomfort, so today I shot a video entitled "Great Massage Technique After Latissimus Flap Reconstruction" and below is the link. I'm a massage therapist, I've had the surgery myself, and this is what helped me through it. Hope it helps you too.
Sending lots of love and hugs!
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katehudson - The original plan was to do the surgery first thing in the morning - 7:30 and stay overnight - go home the next afternoon. NOT! I had a lot of drainage, so much so that I developed a hematoma and had to go back to surgery the next afternoon. I ended up staying in the hospital for 4 days. PLEASE! Do not let this scare you. This rarely happens. My PS told me I was the second person in his 23 years of doing these that this happened. Nothing throughout this entire BC journey has been easy for me. Bottom line - it is an overnight stay if you are correcting a lumpectomy defect like I did. I was up and moving about not long after I was in my room.0
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Marnie - I watched your video. It was really good except when you show how to do the skin rolling technique the sound is really low. I had my volume turned up all the way and could hardly hear you. Just some feedback for you.
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Thank you for letting me know Jwico and Jo
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katehudson - I may have missed it but do you have surgery scheduled yet?
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Jo- how is your seroma?
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Hi Jo, My surgery is scheduled for Sept. 12
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Okay! We will just be getting back from our cruise. Good luck to you.
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I'm glad you guys are posting your experiences again here. I am having surgery done 7 days from now and am excited/nervous. I can't wait to not have an empty right side, and I am hoping the LD flap will also make the right side feel sort of natural so that it responds sort of similar to my normal left side. I'm not too nervous about the surgery itself, but just about how my 16 month old will deal with Mommy not being with her.
Thanks for the video link Marnie - I will be sure to do it.
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Sunny, I am supposed to have one scheduled in September....somebody dropped the ball at the PS office though. Met with them end of June and they said it would be September before they could get it done...no problem. I called last week and they just then started trying to get scheduled with the breast surgeon. I am anxious and nerveous also. Tired of looking at one boob and one "nothing", lol.
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Yes, the one boob look is just depressing!
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I have a question. On the first night at the hospital after surgery did you have to wear a catheter and have an IV? I was at my surgeon's office yesterday and she told me I would have these things my first night after surgery. I was surprised about the catheter.
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Hi,
I don't post often but I do keep up with the reading. I am so glad most of you have had good results and are happy with the procedure and results. I just thought I'd throw in some on the other side. I did not get so lucky with my surgery. I do think it was the PS and now realize he was not very good and quite sloppy.
I have total numbness on my back which no one mentioned and I just hate, Also I am over 2 1/2 years out and still have a great deal of pain on my back and have to take a pillow with me everywhere. I also have a lot of issues with the muscle going under my arm- on one side it is ok, the other side it is awful - amazing painful. I cannot wear any type of bra other than a sports bra which are Not flattering and most of my clothes look horrible. I've been terribly depressed about the whole thing. I have talked to my PS, BS and other PS's and no one wants to say anything bad about the first PS so they tell me I just have to live with it and how they don't recommend doing anything because of the chance of lymphadema. If I could just take the whole reconstrution away I would. I just hate it. I honestly think on the one side, the muscle is twisted or rolled up on itself or something as it like carring a book under my arm. The other issue from this PS is that the scars on my back are not on an even level nor are the a thin line they vary from thick to think and back to thick. I did ask him why they were not even and he actually said "Oh I guess I wasn't paying attention when I drew the lines".
Not all is horrible though, the shape of the breasts are fine and just looking at them they are Ok, nipples not good as he assured with with back skin they would be perky and robust but now they flattened immediately.
Anyway, I hope one day to find someone who could help me but so far I haven't found anyone willing to touch me. Also the breasts are not even where they start in front- I kept thinking were they like that before? But no I took pictures and they were not. Also something to take into consideration. I was small between an a -b and I was fine with that but he talked me into going bigger I said ok but just to a fill out a b. Well I have at least a C or larger which I don't like. I don't know as I can't wear "real" bras. He said the muscle also takes up room which I never thought about but you would have thought he would have.
Anyway, I'm not trying to discourage anyone but for those trying to decide maybe it will at least give you some other questions to ask beforehand. Also one question after the surgery I had these 4 brusies - very small at the top of my back and the lower part of my back in the center, they have now become dents. Any clue what caused these- the PS says he has no idea. Wondering if anyone else has these? Thanks and again I think I just had a very poor surgeon.
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Kate, I was in the hospital for 3 days. My surgery was over 11 hours long. I had the BMX with LD/TE reconstruction. I think the catheter is placed because it is such a long surgery. It came out the next morning because they wanted me up and walking. It was not that bad.
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Kerrberlady thank you for letting me know.
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I too had the catheter - it came out the next morning also.
Stanzie - I too have a small bruise/dent in the center of my back. I know it wasn't there before and it is not painful, but it I wonder if it will fade.
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I had a catheter, as well. My surgery took nearly 15 hours and I ended up keeping the catheter until my 3rd day in the hospital. It was supposed to come out the day after surgery, but I ended up needing a couple of blood transfusions and it was just easier to keep it a bit longer so that I could relax in bed. BTW, the transfusions were a precaution and the need was likely due to being just 6 weeks pfc combined with the lengthy surgery.
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kerberrady and jen78: wow, you had super long surgeries! I was told my surgery would just be about 3 and a half hours. Perhaps because I already had the mx done, and I'm not getting tissue expanders, and it's just the one side. I am hoping the long surgery is why you guys had the catheter in so long?? I remember when I had my uni mastectomy, the catheter was gone by the time I woke up, and I was hoping this surgery would be the same.
Stanzie: Sorry you are still going through so much! I can only hope it doesn't happen to me.
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http://www.youtube.com/watch?v=rYcc8kshQR4