Latissimus Dorsi Breast Reconstruction
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Have an appt with my PS this afternoon. I have a little "dog ear" at the front end of my back scar he is going to flatten out for me so my bra does not rest on it and make it sore and irritated. It will be done in the office and should go quickly. Don't know if I will have to have a followup or if this is really good bye. Been trying to close this chapter for about a month now. I really love my PS and will miss him and his wonderful staff. Will post how it went later today.
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Got my "walking papers" today! I have been released to go back to work on next Tuesday! So excited!!! I actually miss going to work!
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Hi Jo1955 -
I'm new to this site, having just finished over 33 radiation treatments in early October. I had early stage IDC with a wide margin lumpectomy and 0 / 6 nodes, so no chemo (thank god!) for me. I'm small chested, so the lumpectomy made me even flatter (urghh!), and I'll be visiting with a Pl.Surgeon next month to discuss a corrective enhancement. I've heard that radiation toughens the breast tissue and makes breast augmentation difficult. As you had a lumpectomy followed by radiation, what was your experience? I work full-time, so am curious about how much time I'll realistically need to take off for recovery. I'm also a golfer, eager to get back in the game next season! ! - Kay-in-NH
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Kay-in-NH,
First welcome to this site. These ladies have such a wealth of information and are so very supportive.
I had my lumpectomy in Aug 2010 and did not have the reconstruction until April this year. My PS was amazed at how well my skin help up during radiation and said there would not be a problem doing the lat flap.
I had the surgery done on April 18th. Had a few problems so did not get out of the hospital the next day. Spent a total of 4 days and then went home. Had very little pain meds. Went home with 2 drains that were placed close together on my left side. The drains were the worst part - anyone will tell you that. I had to sleep in a recliner until the drains came out. I did go back to work after my one week followup and yes, with the drains in. I had a couple of baggy shirts I could wear and pin the drains to the shirts. I tend to bounce back fairly quickly. I think a lot of it is because I want to be able to return to my daily routine as soon as possible. My PS did not have a problem with me going back to work so quickly. I could do a lot of my work sitting in front of the computer. But I also had the option of going home and resting if I needed to. I have a terrific boss and since I am on salary and the summer months are slow for me , he knows I will more than make up for it in the winter months when we can be crazy busy.
I also play golf. I was not allowed to even swing a golf club for 2 months. I did some small stretches and worked my way up from there. I started out playing 9 holes for a couple of rounds and then did 18. I found I was tired after 9 at first and did not want to push it. I have about 98% range of motion and can play golf with no problems.
I love my results - no regrets. I would do it again in a heartbeat. This part of the BC journey was actually the easiest - if there is any such thing.
Please, please ask me any and all questions. I would be more than happy to follow you in your journey through this surgery. You can also send me a PM anytime.
Let me know how your PS appt goes next month.
Hugs & Kisses.
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I have been having some of the worse pulling in the donor site from the surgery. The pulling is extremely uncomfortable and at times painful. I saw my PS on Monday and he said I was at the toughest point when horizontal scars were forming in the muscle from the donor site and that what I'm experiencing is normal. He said to take ibuprofen for the discomfort. It does help.
Is anyone else having this kind of discomfort?0 -
hm.... i don't understand the 'horizontal scars forming in the muscle from the donor site'. MY PS never mentioned scars forming however I did experience some pain under my arm.
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I watched a vid on the internet of the surgery and based off of that, there is remaining muscle in the back that has to heal since he made horizontal cut to get the muscle out I assume that's where the horizontal scarring is. I guess!!
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Momluke - I am 2 years out from my Lat Flap recon, and the discomfort in my back seems to be increasing. I am just one of those people who's bodies go into overdrive building scar tissue. When I had my surgery to take out the expander and do the LF, my doctor and his Fellow both came in at different times and commented that the capsule around my expander was the thickness of an orange peel. And there I lay with a new implant in my chest! I think I knew right then I was in trouble! Having been radiated makes getting implants so much more "iffy". I'll be going in for surgery in January to get scar tissue removed and released from my back and breast, have the Thoracodorsal nerve cut to stop the spasming, have the implant removed, and have some fat grafting done to fill some of the void left by the implant. Geez! I'll be back to incisions, drain tubes, and the whole bit.
Kay - welcome! When you go talk to your PS, learn about all of the options, & asked a ton of questions. I wish I had come to these sites first like you are. I have learned the hard way. Since you have been radiated, I'd be wary of anything that involves an implant. Sure, many women do fine, but you'd be surprised how many have pain & issues from implants because of capsular contracture, particularly those radiated women. The radiated women seem to have fewer issues with just their own tissue, i.e., DIEP or fatgrafting. Fatgrafting will totally be the way of the future since it doesn't involve big surgeries that move chunks of flesh, plus blood vessels & nerves from one place to another. They just lipo your own fat from your thighs, belly, buttocks, wherever, and graft that fat into your breasts. Unfortunately a lot of insurance Co.'s still consider it too new, and won't cover it. Some do, like BC/BS, Aetna, and others. I think women need to get really noisy about how these "slice&dice" options can eventually get approved for breast reconstruction, yet they are as slow as usual to approve Lipo & fatgrafting for breast reconstruction, even though these have been used for a while to reconstruct faces, hands, anything else! OK - I'll get off my soapbox. You can tell I'm a frustrated, sliced & diced woman!
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I'm having this surgery after a mx on November 15. I'm just wondering how the recovery compares to Tram flap surgery, not so bad? Worse? I just don't know what to expect.
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I have not had a TRAM reconstruction but the lat dorsi is challenging at times. My PS put it this way: the muscle they move from your back wants to continue to act like its still in your back so it takes awhile for it to "forget" what it used to do.
My recovery time was about 6 weeks. My PS is very conservative. I've seen where some ladies went back to work in a week or 2 after surgery.0 -
cat24 - I also have not had TRAM reconstruction. Like momluke said - it can be challenging at times. The worst part was the drains. I was in the hospital for 4 days instead of an overnight stay as is the case with most. I developed a hematoma and had to be taken back to surgery the next day. Was not discharged until my blood levels and numbers were back to normal. As far as pain meds go, hardly any. With that said, I went back to work after my one week followup and yes, with the drains. At 5 weeks, I was swinging a golf club again - must to the surprise of my PS. I had this surgery on Apr 18 this year and have 98% range of motion. I do still feel some tightness in my back with the weather changes but it is doable. I did have a couple of revisions done but no big deal. Good luck to you and hope you have a speedy recovery.
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Thanks momluke and jo1955 - the Tram had it's challenges too and I am way too familiar with the drains - had four of the little darlings. My PS said 3-4 days in the hospital - I was in three with the Tram which he said was a little early. He said if I was feeling good, he might let me go at 2, guess we will see. He estimated four weeks off work - I was off six with the Tram and this is 10 months later and I still have some stiffness and numbness in abdomen and where the flap was pulled through. Just trying to get a feel for what this is going to be like. Thanks for sharing your stories.
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Cat24, I had 2 lat flaps done during separate surgeries over a year ago. Both times I was in the hospital for 2 nights & was able to return to work in 2 weeks. Range of motion is excellent. I have no discomfort in my back at all.
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DLL, I love it!
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Hello all,
I just thought I would jump in here. I have been to one PS for reconstruction consultation. He does not do microsurgery therefore, DIEP was not an option. I will need to see someone else if I choose to go that route. The PS I did see gave me the option of TRAM or LD. I am wondering if any of you chose not to go DIEP over LD and why....So many posts on the advantages of DIEP since it takes no muscle...I would appreciate any feedback.
Blessings!
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Recovery time was a big factor in my not choosing DIEP. I just could not afford to take that much time off from work. Also, my BS recommended a team that is in another city if I was interested in DIEP. I travel 45 minutes or so each way to my dr appts as it is, and to see this team would be more like 2 hours each way. I also planned to lose weight, which I am now working on. As I understand it, DIEP breasts will shrink as you lose weight since they are your own tissue.
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Sunny2 - I think the biggest factor in choosing a reconstruction option is whether or not you have been radiated. If so, I would advise you to steer clear of Lat Flap if an implant is needed, because radiated breasts have a lot higher instance of capsular contracture. I would search out a doctor who does DIEP, even though there is a longer recovery time. If you haven't been radiated, then either way can be OK.
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Lat flap is actually a recommended recon method for those who have had radiation, like myself. The blood flow from the lat muscle helps with the circulation impairment on the radiated side.
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Lat dorci is also recommended for older, heavier women like me, because of the shorter time of surgery. They don't want us under general anesthesia for 10-12 hours at a time.
Blessings
Paula0 -
I had bilateral mastectomy with lat flap recon on 9/11...i was in the hosptial for 5 days due to nausea and vomiting. I feel like my revovery has been slow. Although all of my incusions have healed nicely, i feel like a
I cannot get any stamina back. I have a desk job but it seems i cant work much more than 4 hours. I have alot of tightness through my back around the incision sites as well as the front of my breasts. My boobs...if thats what we still call them..lol..still seem ti be very swollen . Does all seem normal you gals who have had this procedure? I have aldo been extremely emotional and crying at the drop if hat.. i just want to feel better again
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I would take going back to work slowly.
At home you can rest if you get tired. At work, well, it's usually frowned upon.
This is your recovery and it's important. Rest is important. About 6 weeks after your surgery physio is important. Go gentle.
I was in hospital 10 days after my double mastectomy with one LD flap and 6 drains. Around home, as I quit working as a nurse, it took me about three weeks to even be able to stay awake all day and not need a nap - but I was 59 at the time, but did marathons and triathlons up until my initial diagnosis.
Now I train for me when I feel up to it. No pressure. That's what you want - no pressure. Set your own goals and adjust as needed (sounds like a cooking recipe).
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Thanks for the encourgement...i have been feeling so down latetly. When my ps told me i could go back to work after 3 weeks i assumed i would feel alright. Instead i felt more like i had been run over by a train. My mastectomy was somewhat propholactic. My first bout of bc was in 2001 at the age of 37. Since that time i have had numerous biopsies with atypia and lcis so after 10 years it just seemed like the girls needed to go. Since my recovery had been so much harder than i had anticipated i have really second guessed my decision consequenty giving me bouts of anxiety. I just wonder if i will ever feel like myself again.
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ltlemiss, I am sure one of these days you will feel like yourself. After I had a complete hysterectomy in December 2010 and went into surgical menopause, those were the darkest days of my life. I had horrific insomnia, nausea, anxiety and depression, I was just about at the end of my rope. I didn't think I would ever feel like myself again. Do you want to know what helped me and broke the cycle? I went to my chiropractor and had my back adjusted. I could just feel the tension leaving my body and I started to feel like myself again. Now of course, you can't do this right after surgery. But after my mastectomy earlier this year, probably at about six weeks I returned to my chiropractor and he started me off with some gentle stretches and massage. And I was off work six weeks with my tram flap and it was not easy going back, I was so tired.
Don't worry about how much time your recovery is taking, everyone is different. Just try to be good to yourself. Don't put great expectations on yourself. I don't know what your family situation is, but my rule was if everyone has something to eat and something clean to wear and that's all I could do, that is good enough.
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ltlemiss - I was off work for about 6 weeks. Sure I could do things earlier, go to the store, etc. But work was more demanding. You can't just take a nap when you get tired. LOL Give yourself plenty of time to heal, rest and recover. It takes time for the mental part too. Everyone is different and if you need some time then take it.
I feel anxiety too about things. It's been a year sine my UMX but I know that I pondered every decision I made over and over. I'm trying to find a way to ease my mind with all this and I will say that the questioning of my decisions had gotten better with time.
Remember everyone is different. If there is one thing I've learned through this whole rotten BC thing is that there are so many options, situations, etc., and you have to just do what is best for you.
I wish you the best.
jen
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Thank you do much for all your support. It does make me feel better knowing im not alone.
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Hello Friends,
I have not posted in over a year now when I had my bilateral. My friends here were invaluable as they walked with me through surgery, an infection and recovery. I am back because I am scheduled for the lat flap thursday Oct 25th. I am very anxious and having trouble sleeping as I agonize over whether or not I am making the right decision. I have been without breasts for over a year now and delayed the recon due to having had the infection with the bilat and work requirements. I was diagnosed the first time with DCIS 9 years ago and underwent radiation. Cancer returned last summer (2011). I am now 49. Just need a little encouragement and thots of those who are ahead of me. Thank you.
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Good luck to you, jleemac. I have no regrets or second thoughts about opting for lat flaps. I hope you find a solution that you feel comfortable with.
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jleemac. Best of luck to you. I had the lat flap done on just one side and I have no regrets and would do it again with no reservations or second thoughts. For me, recovery was much easier than I thought it would be. Have had a few revisions done and just loving the results.
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Lalove55: I have undergone radiation...but through all my searching (mostly my hubby's searching) we have found that the risk for contracture is no greater for LD following radiation than it is for implant without radiation.
DLL66: I have thought about the whole weight loss thing. By the way, from your picture you look a perfect size...you are quite lovely. I've never had a weight issue and actually thought I'd best gain some if I wanted to be a canidate for DIEP which I plan on loosing...about 10 pounds. I was wondering if I went DIEP if weight loss would effect the new breast. Decisions, decisions...I'm leaning towards the LD. I just cringe at the thought of how much cutting is involved in the DIEP. I finished up with Herceptin 2 weeks ago...YAY!!! I'm so ready to do recon and get this ride over.
Blessings!
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sunny2 - I started my lat flap recon in April this year and just about ready to say good bye to my PS. I had enough fat for the DIEP but felt LD was a better way to go. I did not want to go through the healing process with the stomach. My back scar is just a thin line and range of motion is very close to what I have prior to surgery. No regrets and loving the results. Good luck to you and hope you have a speedy recovery.
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