Latissimus Dorsi Breast Reconstruction
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sweetcaroline2 - PS removed right breast (prophylactic) at the same time as left LD flap and because of having surgery on both sides I had difficulty getting in and out of bed without help. I did not have a LD flap on the right but PS did not want me using my arms. I was miserable for first two weeks even with pain meds and at one point wishing I had never had it done, but I am so happy with results and would do it again. The first fill four days postop was the most painful for me. Actually it was the second fill because he filled during surgery. You should ask your PS if he can remove the other. Mine made a small incision under the breast and removed the breast tissue, but he used to be a general surgeon prior to becoming a PS. Initially, I thought I had to get a breast surgeon to remove the good breast. So glad I told my PS I wanted the other removed. I kept my nipple on that side, so actually doesn't look like anything was done because the incision is under the breast.
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jo1955 - Hope you have a wonderful time on the cruise!!
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katehudson25- Good luck to you too! That your BS thinks you will be fine at home without someone to stay with you is encouraging . I won't be in the hospital as long- my BS says 3-4 days. I wish I could stay longer, even though I know nurses will be in to wake me at all hours for vital signs, etc. I am bringing an eye mask so the overhead light doesn't blind me and taking advantage of all of the suggestions from the kind ladies who have already been through this and share their experiences. I moved my recliner to the bedroom (easier to get out of than a bed) and moved an end table and lamp next to it. I bought a grabber to reach things with and loaded some light reading and audio books on my Kindle to occupy me when I am recuperate enough to be bored. I have someone to do my housework- is there anything else you have heard of that I can do to make things easier?
sunny321- Glad to hear that the nausea has gone away. I hope that your recovery is swift and easy. My PS says I will not have a dressing after my UMX and LD flap- just a soft bra that they will put on me in surgery and I will wear it 24/7 until he tells me otherwise.
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nurseronda10- If you don't mind my asking, why did you choose to have a different type of reconstruction on the prophylactic side? Do the two sides look alike ? I am a DD and after surgery will be smaller on the LD flap side even with the implant, so my PS is doing a lift/reduction incision. The plan is to later (after I recover from radiation) do a lift/reduction on the other side. I will be happy to be smaller busted. Since I must have surgery on both breasts for symmetry and will lose sensation in both breasts anyway, I thought I might as well have a BMX. Then I wouldn't have to worry about bc on the prophylactic side, but I had not considered having two different types of reconstruction.
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Thnk you Sweetcaroline, and of course all the best to you. I will have my doctor write an order not to wake me for vital signs. Why don't you do the same
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We made it to Florida and am only about 45 minutes from the Carnival cruise terminal. Will be meeting with BIL & SIL later for dinner. I am so excited - can't wait to get on the ship tomorrow morning. Promise to take lots of pictures. Hugs & Kisses
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sweetcaroline2 - My skin was adhered to my chest wall from having a wound vac which is the reason for the LD flap on the left. At first I was going to do a lift on the right and then I decided to go ahead and have that breast removed for peace of mind. He never mentioned doing a LD flap on the prophylactic side. I have wondered why women have them on both sides. I am so glad I had both removed because he let me choose the implants. I told him I liked round breasts better than tear drop shaped so he used high profile round implants. If I had opted to keep right breast, he would have had to use tear drop shaped. If I had a nipple on the left, they would look just alike. If I wear a tight shirt and look in the mirror at my back side, I can tell the latissimus muscle is gone from that side, but my daughter and husband say it is not noticeable to them. I guess this could be one of the reasons for doing the LD flap on both sides.
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I'm now 3 days post surgery and am enjoying being at home. I never would have suspected pre-surgery that the worst thing about recovering would be the nausea. Usually after general anesthesia, I am coherent within minutes, but this time the nausea left me out of it for hours. I'm not bothered by it now unless I walk around for too long, but I still get a little nauseous. The pain after the LD flap surgery is so much LESS than after the mastectomy. I have been really surprised by that. I wonder if it is because I don't have a TE in, whereas I did have a TE after the mx. I thought when I first got home that I would be fine with ibuprofin, but I learned quickly that I needed my roxicet, but have been taking only small doses of it.
I can't imagine being in the hospital for several nights. Being at home, I have been able to get 8+ hour stretches of sleep in the recliner with no one coming in to check on me or my roommate patient, and it feels like sleep is what my body needs most now, not nurse interruptions.
For me the most heartbreaking part about my recovery has been my 16 month old daughter who bursts into tears when she sees my drains or if she sees me walking awkwardly. It's hard to read a toddler's mind, but I think she was really scared at first. Yesterday we started practicing her sitting on the couch on my good side, so I can sort of cuddle her and interact with her, with my mom or husband there to keep her from hurting me. I am just grateful to know she won't remember this, but I know it is hard on a little person who doesn't understand about owies.
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Thank you for sharing your experience. Even though this experience is a lot different then the mx there is still a lot of recovery to be done. I can see how it would be difficult to go to work too early in the nursing field. I work in a hospital but it is a desk job and they are really strict about time off - so I am kind of forced to get back to work quickly. I hope the next 2 post ops do not need a lot of recovery time. I'm hoping the other 2 drains will come out next week. One of them is draining bright red fluid but not a lot of it. Since it is a holiday everyone is out but first thing Tuesday morning I will be calling my PS.
I hope everyone is doing well. It's nice to interact with people that are on the same journey. Everyone have a wonderful holiday. My wish is that everyone heals quickly and completely.
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Just checking in and it sounds like everyone that just had surgery is doing well. That's good to hear. From my experience, I felt good after a week or two at home but the drain kept me from going back to work. I didn't want to go with the drain, but I felt like I could have physically. Mentally I was glad to not be in the office and dealing with everyone. Take the time you do have to relax and let your body fully heal.
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Hi Jwllcio. You mentioned that the drains kept you from going back to work. Can't the drains be hidden under large tops?
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In my opinion the drains can definitely be hidden. I went out yesterday with a loose button-up shirt and bra and I can't imagine that anyone noticed anything strange. For me, the loose bra was sort of uncomfortable, but I wouldn't have been able to make my chest look normal otherwise.
Also, you might get lucky and get the drains removed after just a week:-) I am hoping that will happen to me anyway.0 -
Hi Sunny, My doctor said 2 weeks for drain removal
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I guess different doctors have such different drain removal standards. My PS said the output had to be below 20, so there was no specific timeline. I remember I got my mx drain removed after 5 days. I know that some ladies on here have had to wait up to 6 weeks to get rid of dangling friends:-(
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Hope everyone is having a great Labor Day weekend. It has rained off and on all day here in south central Kentucky.
Most PS will not remove drains until output is below a certain number. Mine wanted the output to be less than 20 ml for 2 days straight before he would consider removal. I was one of the lucky ones and had the 6th drain removed by day 10. I really feel for the ones that have had to keep them in for weeks.
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I had one of my drains in for a very long time. Not the norm, but it can happen. I didn't feel comfortable going to work with the drain so I was lucky and was able to begin working from home part time first.
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When did you all start doing stretches to regain complete range of motion? I'm 6 days post-surgery and haven't started yet, but am wondering if I should? I don't see my PS for 2 more days.
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jwilco,
I know what you mean about not wanting to go to work with drains. I am 2 weeks post-op and I just got the 2nd of 3 drains taken out. I've tried to hide them but they are bulky and hard to hide. I have to go back to work next Monday and I'm hoping to get the final drain out this coming Thursday. Now I am worried about being able to wear a bra to work. My PS has drummed in my head that you have to wear loose clothing because you don't want to kill the muscle flap. I've brought some camisoles but the inner bra is still a little tight. I don't know what I'm going to do!!
I also start getting my "fill-ups" on Monday. How does that feel? I ask how much they would fill and the nurse told me that it on what I can handle. She said we could do this slow or do it quickly. I want quickly but I'm not sure what to expect. Right now the extender is uncomfortable at times - it feels like it is sticking into my breast bone. Thank goodness it's not often. Even though I know this takes time I am ready to move on and get it done so I can start the recovery process.
I hope everyone had a wonderful and restful holiday. It seems like the rain is everywhere and I heard from a friend today that the almanac says that the South will be cool and wet for the winter, so I guess it's not going to stop anytime soon.
Have a wonderful day everyone.
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Hi Debbiemm1 -
I've had 1 fill and it was 100cc's on each side. I didn't have any pain other than the initial needle puncture - that was kind of uncomfortable, but only for a second. After that, there was no pain at all. I wasn't sore in the following days except for the one time I laid on my stomach for PT. That turned out to be a bad idea and it caused some pain for a couple of days. Overall, it was a really easy procedure. I think that because the TE's are in front of the pec muscle there really isn't a ton of stretching going on. In my case, the fills are simply to help us decide how big I want to be. That's something I'm still struggling with right now and I'm planning on having my exchange next month.
I also remember that pain where it felt like the expander was digging into my sternum. After I got the fill, it stopped completely. My PS thought it was the rough edge of the TE being thick and flat - once it was expanded, it was less invasive.
Good luck!
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Hi Jen78,
Ouch!! That sounds painful. My PS told me ahead of time no lieing on my stomach. It's hard enough lieing on my side!
Your post has made me less anxious about the fill. Good luck with your exchange. I'm sure you are looking forward to that, I know I am and I'm not as far along as you.
It'll be a relief if the fill takes away the digging filling. Last night it seemed to be at its worse. I couldn't get comfortable no matter which way I moved. I went yesterday and got the 2nd drain removed. It feels like they are pulling your insides out! But thankfully it only last for a little bit. I am suppose to get the last one out tomorrow but now it's draining more than before so I don't know if they'll take it out.
Is anyone doing any exercises and if so when did you start? I also saw where someone said they were given a soft bra to wear. Where would you get one of those? My PS said that the bottom of the bra sitting on the muscle flap could cut off the blood supply so whatever I wore had to be really loose. I haven't found a really loose bra yet. My PS is really persistant about not doing anything to cut off that blood supply, but I'm glad he is. It's just a little awkward not wearing anything and having your nipple on the other side harden and poke out of your clothes while you are out. I guess I'm a little self conscious. How do you guys handle that sort of thing?
I hope everyone is doing well today. Good luck to all of you.
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PS are so different. I had to wear a tight binder for two weeks, then went to a soft bra (Coobie bra) that the PS office gave me. I needed a second one so purchased a Barely There bra.
I made the mistake of lying on my stomach 17 days after surgery which slightly messed up the breast pocket. PS was not too pleased with me.
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debbiemm1: I'm 8 days post surgery and when I leave the house, I currently wear the post-surgical bra I got shortly after my mx surgery last year. My PS said that was fine and also gave me a huge padded piece of gauze to place under the bra to keep my surgical site from being squished. I forgot to ask my PS about exercises/stretches at my appt today though. I was so excited to get both of my drains out, that it slipped my mind to ask. I am planning on starting stretches today anyway though. I feel like a new person without the drains, suddenly able to move my body again. I think I will just work on being able to lift my arm straight over my head first.
What exercises did you or anyone else do post surgery?
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sunny321: Wow...I'm 17 days post surgery and I just got my last drain out yesterday. I know what you mean about the excitement of getting the drains all out. It's like a "hurt so good" thing. I felt really good yesterday thinking I could do anything again. I soon found out I was wrong. A simple task such as changing the bed sheets on the bed put me in tears. I was done for the rest of the evening. I was determined to complete the task though. It made me realize just how limited I am now.
I haven't started exercising. My PS told me to take moving around slow. He had given me a book before I made my decision and the book says that when you have a LD flap that you should wait 6-8 weeks before you start exercising. I know it's different with everyone though. I go back to work on Monday and I think I will drop by the PT and see what they recommend. I'll let you know.
My PS didn't give me any type of bra to wear. I ask about a sports bra and the only thing he told me was to wear something that was really loose. Even the camisoles that I've found are tight so I'm lost as to what to wear. Surely they make something special for this.
Good luck with your stretches.
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I"m having a mastectomy with a LAT flap and TE on sept 20th. I have so many questions the doctors say one thing and the web says something different. I would like someone that has been through this to aswer my questions and I have quiet a few of them. Do I just leave all of the questions here? I'm new to this. Thank you for any help.
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Hi, my surgery is also on the 20th...Everybody is different, just like with the SE from chemo.
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Ask your questions. We have all had the LD flap with various differences. Some with TE, some straight to implant, some to regain shape after lumpectomy.
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When do you start feeling normal? and when does your back stop hurting? I'm not very far out but I'm anxious to be back to a near normal state.
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how long does the surgery take? How much pain? How long before all pain goes away and complete range of motion comes back? How much blood loss? How long usaually in hospital? Has anyone had complications if so what? I know there is more but cant think. Thanks for any info
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Roberson, My surgery was last year on October 21 of last year. The surgery took 11 hours, slight complications with my previous lumpectomy and radiated side. I was in the hospital 3 days. Range of motion took for me about 2 months to gain back. We have a great breast cancer support team at Forsyth Hospital in Winston Salem and I was sent home with a stick for exercising with as well as a DVD with exercises on it. I didn't have much blood loss, I don't really know the norm for that. I have, knock on wood, had no complications. I didn't sleep in a recliner, I actually went to bed and slept, I am single so stretching out and being comfortable after 3 days in a hospital bed were a relief to me. I was just a turtle getting up and down until i built up strength. Worst part is the drains, you will hear that from most of us. My back still is tight, but not miserably so. I notice that the longer I am up and sitting after work, the more I feel it, so I am usually in bed at 8 or 9pm, to just lay down and relax. I can read or watch TV in my room. I live about 3 minutes from the school I teach at, and I had several visitors check on me throughout the day while they were in planning periods or lunch. I had my daughter with me for a week and a friend stayed with me for about 3 weeks. My friends had a DDDD, Danielle's designated doctor driver, system worked out on who would drive me to doctors the first few weeks. Just make sure you have alot of support around you afterward, you will definitely need that!
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My surgery was also last October, on October 11. I had UMX on the left side, straight to implant, no TE. I think it was about 8 hours. I was in the hospital for three days. At first it was hard just getting up from the hospital bed but I just learned to use the right side and I was ok. Everything on the left felt tight. Once I was home I slept either in the recliner or the couch so I could sit upright a little. It was easier to get up from than the bed. As I was home and moving around more things started feeling ok. I did have two drains and they were a real pain. Not painful, just a pain to deal with. After a week or so I would venture out with my husband to the store, with the drains tucked away, and of course there were the follow ups to the dr. I took longer off from work but that was partially due to my one drain remining in for a long time. It didn't come out until the second week of November! I was luckily able to work from home. There was also alot of emotional stuff to deal with that I'm glad I didn't rush back into work. But if I had to I would have been able to and been ok.
Once I was allowed to start exercising again I started out slowly, only walking and short stints on the elipticle. Eventually I worked back into my usual routine with weights. I haven't noticed any real difference in what I can do since the lat surgery. I did stretching on the left side as soon as I was allowed because it would feel stiff. I would lift my arm up and stretch it against the wall.
It's been almost a year and I've had two other surgeries. One to swap out the UMX implant to a smaller size and also lift and swap the implant on the non BC side (I had implants prior to BC). So now they match better. The UMX implant is larger but that is because I have only skin, no breast tissue. I also had a lot of fat grafting. It's pretty close when you look at them. The third and most recent surgery was to create a nipple, remove some extra skin and a little more fat grafting. I'm now just waiting to be able to get the nipple tattoo.
I knew because of my prior PS reconstruction (it was following massive weight loss) that there is always the possibility for the need for revision sugeries. That has been hard because I'm really tired of surgeries.
I'm lucky that my husband is retired and able to be with me during the day and drove me to appts. But as far as doing things around the house, I did most of everything on my own. But I did need help the first week or so.
Good luck with your surgery.
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