Latissimus Dorsi Breast Reconstruction
Comments
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I know my ps said he would remove any scar tissue when he removed the TE's at exchange. I feel so comfortable with my PS and his staff that I am not really having to hammer him with a lot of questions. Also, I'm not concerned with perfection in my breasts. I just feel lucky to have gotten through all my other treatments and know that I kicked Cancer's butt, lol.
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That is so true!
As for the scar tissue, unfortunately, the insurance doesn't cover removal of the scar tissue on the back (what is on the harvested site) so....
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My back has healed up great! Don't think I will have any problems at all from there.
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Hello Ladies! My first post here. I feel like I've found a home! I had the lat flap with immediate nipple fabrication done with my R mx; an 8 hour surgery. I have found tremendous relief from pain and discomfort with an OT who does myofacsial tissue release and massage. I still have some problems with my scapula and back scar area but it is getting a lot better. It has also improved my mobility. I am currently healing from TE with scar revision, breast revision and fat graft. I never would have made it through those two surgeries without my OT!
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hwhranch, that is great that you don't have scar tissue on the harvesting area. I think that only forms if you get seromas in that area.
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hwhranch: i feel the same way. i went in to this knowing they wouldn't look like they did before......so just being able to have my figure back and know that i made it this far......is a huge blessing to me. Praise God!
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Hi Everyone~ haven't been on in a while, my computer crashed and the holidays, work ect... So, i have a ??? for you. I am flying for work on Saturday and i am nervous about going thru the security scanner with my expander. My PS says they will not see it in the XRay machine, has anyone flown with the Expander & did it show up on the body scanner??? I'M SO NERVOUS!!!
So, i think i have had 6 or 7 fills and it looks like a softball and then my own droopy boob on the other side. I am worried about filling too much and then when i get my lift on the "real" side that my "new boob" will be too big. talked to my PS about it and he said he will do my "real" side first because he only has so much to work with. The other side he said he can make smaller if he needs to. He said better to over expand than under expand. WHAT ARE YOUR THOUGHTS AND EXPERIENCES??? I am going in for a fill on Friday and not sure if i should get the full 50cc's we have been doing. Maybe half??? THANKS, I VALUE YOUR OPINIONS!!!
My surgery is planned for March 5th for the lift, March 19th for the New Boob.
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I flew just fine with an expander. Went through security twice and it was just a week before my exchange that was on 12\06\12. I also have a real boob and a "new" boob. I did not choose to have a lift on the real size. I did not want to lose any feeling in the real one. I told my PS to match them up as a much as he could. I think he was able to match them pretty well. I am still a bit swollen on the "new" side but it is much more droopy than the TS was. I don't think 50ccs is too much. My expansions were between 80 and 110cc for a total of 410cc and my implant was 340cc.
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Had to see my PS today for a steriod injection. Seems I have a spot just above my back scar that tends to get inflammed. Last time this happened was in early Nov. The cold weather is not helping matters either. He wants me to continue doing the stretches I am doing and also to massage that area on my back. He also wants me to take Aleve but I am not going to do that everyday. NSAIDs can be hard on the tummy. Got instant relief with the shot. The cold weather makes the remaining back muscle tighten up like no tomorrow. Has anyone else experienced this? This is the first winter after surgery - had no idea this would happen.
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Hello everyone,
It has been a while since I've been on here. I've been following everyone's progress though and you have all been a tremendous help to me in my recovery. I am going for my switch tomorrow and my ps is doing a reduction on the real side, zplasty on a bad scar and liposuction on the area under my arm that still looks swollen. Can anyone tell me how they felt after they had the switch and if they had the other side done at the same time? I want to go out of town to see my children and grandchildren and wanted to know if I would even feel like doing that.
I really feel privileged to be a part of this group and share in the aches and pains and recovery suggestions. I hope everyone continues to do well. You are all like a family to me.
Debi Seagroves
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debbiemm1 -- On Dec 6, I had my exchange with scar revision and fat graft with abdominal lipo and he also did a little lipo to the swollen underarm. The lipo sites were quite sore until recently and just yesterday I was a able to watch my 2yo great-nephew. I was exhausted and sore after a couple hours! I do still have some tightness and zinging type pain. At this point, I would not want to travel too far or do to much. My only grandchild was born on Oct 19th in Japan! I have not seen her yet and can't wait to be strong enough for that trip!
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jo - yes the cold is HELL on the remaining back muscles
i use a heating pad all the time now because i am just so sore
don't get me started on how no one ever told me this either!
i had a blow-out with my PS and his fellow today. Not that it makes a bit of difference in my outcome but if i can help other ladies then i will speak out. He said he has NEVER had anyone complain of these many back issues after surgery - hmmmm i wish i had a lie detector with me. I told them this surgery should never be done on active women, or any women for that matter - too risky, too many long term complications. I also blasted them about not having proper PT's who know how to handle women after this surgery
sorry - todays rant
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rozem - Rant all you want - that is what we are here for.
Glad it is just not me. I had to see my PS today the back pain was just too much. He said once again, the nerve that runs along the rib bones is inflammed. I had this happen 2 months ago. He gave me a steroid/lidocaine shot and all is well again. He wants me to continue doing my stretches and add massages. He also suggested lidocaine patches. I hope this shot lasts longer than the last one. These shots are instant relief and I now feel great. Now to get rid of the cold weather we are having - LOL!
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jo - what do the shots do? can they do this on my lower back? i need some relief
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rozem - It helps with the inflammation. I get instant relief from it. I would think you could also benefit from one of these. My PS injects the medication in 3 different spots - all close together but related. For me the injections are painless. I have no feeling in that area. I know when it is time to go for an injection when what is left of the back muscle gets super tight and I can't get it stretched out. Wouldn't hurt to ask your doctor about this.
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Are you sure that is what is left of the back muscle and not scar tissue?
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With some experimentation, I discovered that I had one area in my back that would begin to ache and hurt if I did not wear the correct supportive bra. I spent some $$ on finding a few great ones that have wide side bands and are wider in the back to help support the weight of the implant/lat flap. They help improve my posture while I am wearing them. When I go without wearing the bra, the back pain starts and can get quite bad. Just a suggestion. I see that many of you have already done the therapy and all the exercises without relief.
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I completed my (hopefully) last revision surgery and I have the green light to get my 3D tattoos in about 1 month. I plan to go see Vinnie Myers for the tattoos.
I am so relieved not to be facing more surgery. I have had 7 surgeries since Dec. 2010. I think my PS was a miracle worker because the before and after pics of my outcome are pretty dramatic, but it took dedication and commitment from both of us to get me to this point. They aren't perfect, but neither were my real ones.
I hate to hear that so many of you are having pain issues. The new sensations and tightness after this surgery took some adjustment. For me, my body adjusted pretty well but I was an avid swimmer and tennis player before the surgery. I no longer do either of those things because getting the muscle to atrophy is my number 1 priority.
I do weight lifting but avoid upper body moves that engage the pectoral muscles or engage the lats. This has been the best thing for me along with YOGA. I modify my yoga moves to also not engage those muscles. I posted previously about how I believe a good supportive bra is so essential to the recovery on this surgery along with exercise and physical therapy to get you going in the right direction.
Hoping for the best outcome possible to all of you that have just went through the initial surgery.
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I am not allowed to wear a bra for more than 2 hours at a time as per my PS recommendations. I have an Alloderm "internal bra" that makes wearing bras obsolete.
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We all get different recommendations from our P.S., surgeons about bras or no bras.
For me, I know that the weight of the implants is supported by the latissimus relocation, but in my case, it is NOT sufficient in supporting the entire weight of the upper pole of the implants. There is a definite downward movement when I am braless. I also had Alloderm, but in my case it isn't enough to support the entire weight of the implant and keep them up. Gravity is not my friend.
This all may depend on the size of implants you get in your recon. I am small framed and the implants are very wide.
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I'm in the same boat you are, Westie. My PS had me in an underwire bra pretty quickly after my exchange hoping to counteract gravity. I rarely go without one.
I'm 10 months out from the big surgery and 3 months out from my exchange. I don't have much pain or discomfort anymore. My back muscles feel tired sometimes, but I know that once I get better about doing my PT exercises again, that'll get better again, too.
Hope you're all doing well...I'm still very happy with my results.0 -
I am about 4 1/2 months from surgery. Never had an exchange surgery...went straight to implants. So far things are going well. Like Jo, I am finding the getting cold is not a good thing. The intensity of the whole area, front and back sucks. I will be glad when atrophy finally settles in. I'm tired of seeing my foob jump when I sneeze, cough or laugh.
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wesiteluv, in my case, the PS has put the implant under three muscles and the Alloderm sling - the bottom third of the implant is under the serratus anterior, the top thirid under the pectoral, and the LD comes on top of all of this. Not sure exactly where is the Alloderm sling in this layered cake thing. But, if on one hand it makes it so my foobs do not move downward, on the other hand it makes it practically impossible for me to workout any of these muscles. The serratus anterior especially I have to be careful about working out, as it hurts like I got broken ribs (that's the muscle that gives pain if you cough too much). I have 400 cc Mentor smooth high profile implants.
Momluke, I had the same - direct implant. It took a while for them to "drop and fluff" and I had to wear an Ace bandage above the foob for a couple months. Not to discourage you, my muscle did not really atrophy within a year. The PS went in and cut not just the thoracodorsal nerve (that is what gets rid of the animation) but also most of the pedicle, leaving only the blood supply. You should ask your PS if he is planning on cutting at least the thoraco-dorsal nerve. Even after that, you will still have some animation, as normally the top third of the implant is under the pectoralis major muscle. And never, ever expect your foobs to act the same as your old boobs when you bend forward. The implant will pretty much jump out from under the LD and come forward (gives me the feeling it's under my chin) and you will have a small pouch of LD muscle under the skin left behind. Looks quite weird.
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hi lat ladies
im just curious - did your PS ever mention using part of the LD muscle and not the entire thing? i didnt even know this was a possibility until a new PT yesterday asked me, i thought all LD surgeries were the same
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rozem - That is interesting - so did I.
Momluke - I so know about th foob going all over the place. During the first surgey in April, my PS said he cut the nerves - well, I don't think so. I could get that puppy to move all the time and I showed him this. By August, I had outpatient surgery to cut more of the nerves. I still have some movement but not as bad. PS said that is the pectoral nerves.
Does the jumping around and moving ever stop?
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rozem, yes it is done, but rarely. The part of the LD used does not atrophy very well.
jo, pretty much you will always have movement of the breast due to the pectoral muscle. A way to know which is which - if your breast moves when you pull up blinds, it's the latissimus dorsi. If your breast moves when you lift a heavy bag, that's the pectoral muscle.
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Rozem ~ All Lat flap surgeries are NOT the same. There are several subcategory variations depending on the amount of skin, muscle and chest wall work you need. Day's surgery and mine were not the same.
Some only use partial lat, some use full or advanced lat. (uses the entire muscle excised far down the back). Basically, the PS looks at your situation, your physical anatomy and how much bulk tissue you have with the lats on your back to make a judgement call on how much they will use.
I've seen pictures of women with little flaps, large flaps and in between that are football shaped. I've also seen pictures of women with round and oval small flaps. This is a highly individualized surgery technique. I know alot about it because I spent time researching it in detail and I met with several specialists in this field.
The PS that did my case invented an operating room equipment contraption that suspends and rotates the patient so that a team can do both sides simultaneously. It is a procedure specific type of operating equipment. It cuts the surgery time down to 4 hours for a bilateral full advanced lat flap procedure. There have been many changes in surgery technique and operating equipment on this procedure and your outcome could be affected if you go to someone that has not kept up with it. There are several good PS out there that specialize in lat flap, but it is getting harder to find them because the trend has been to go DIEP if possible.
Because I am not a big gal, I was not a candidate for the other procedures. I only had 1 shot to get this right. Knowing that, I wasn't going to take the risk on someone that wasn't a bonafide expert in the field just because they happened to be closer to where I lived.
Long story short ......this surgery has changed over time and the procedures are no longer the same for every patient.
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My foob jumps only on exertion like a sneeze. I can also flex it like a body builder flexes his pecs.
I believe westieluv is right on point with the different types of lat dorsi surgeries. My PS took a large segment of muscle and use the entire thing to cover my 550cc implant, then attached the muscle to my chestwall. My pectoral muscle wasn't used for the implant at all.0 -
Day - That is what my PS told me. It moves like it did before the revision to but more nerves. Mine tends to move when I used my arm in a front to back motion. I can also flex that muscle and I get foob movement. Knowing that, I can make the necessary adjustments in the way I do things. Thanks.
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Just as a piece of advice: when you get intimate do NOT be on top, propping yourself on your arms. That is NOT a nice sight that you are offering.
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