Latissimus Dorsi Breast Reconstruction
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Faythnme,
Sorry to hear that the "iron bra" is still bothering you. What have you tried to get relief? Have you spoken to your dr. about it? I hope new women who come to this site get honest, compassionate info too. Pain Management Specialists say that knowing about potential side effects/complications as a result of any surgery goes a LONG way towards helping patients heal/cope.
You're right. Today is a new beginning!!
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Hey ScaredS -
If I am up and moving around then the tightness doesn't really bother me. I do stretching and such and should be going back to the gym after the 1st. So hopefully that will help some. I'm not in any pain only discomfort and I find if I take any ibuprofen or tylenol it helps at night time so I can sleep. I'm not much of a pill popper at all, even after my worst experience last year when my first reconstruction failed. I cried that whole week the expanders were in. This go around is nearly a 360. I don't let it get in the way and I see a PT and she is a miracle worker. I'm so glad I listened to my body and started seeing her again. Maybe when I have my exchange in November it will subside a little.
All I can say is I have definitely saved some bucks on bras for now.
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Hi All,
I just curious, has anyone had the Latissimus Dorsi reconstruction on just one side? I had a left side mastectomy and met with PS who recommended I do this, but I'm curious, what happens with the other breast. How will they be symetric, I'm sure there is something on here about this, but too lazy to read through the posts...lol
I am finishing up rads before I will have the reconstruction, but just curious as to what others have done and the end result.
Mo
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Faythnme,
There's a book by Dr. Carolyn Kaelin, chief breast cancer surgeon and Josie Gadiner, a Reebok trainer about fitness after breast cancer surgery. The booK provides great exercises to do after each type of bc surgery. (There are specific exercises to do after lat flap operation.) It also gives some good "after-care tips. I have found it to be helpful. Dr. Kaelin is not only a bc surgeon--she is also a bc survivor.
For your info--
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Living Through Breast Cancer by Dr Carolyn Kaelin
you can order a used one in great shape for $3.39 plus shipping of $3.99 from
edited: This is not the book scared was talking about but still a great book....
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I will ignore the previous snipe at me (again.)
"Living through Breast Cancer" is not the book that discusses fitness after bc surgery. The book I was referring to is called "Breast Cancer Survivor's Fitness Plan" by Dr. Carolyn Kaelin, Josie Gardiner, and Francesca Coltera. It provides specific exercises to do after each of the different kinds of bc surgery (including lat flaps.)
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LD sisters, I am removing this topic from my favorites. I will no longer be checking this topic out. If you need me for anything please PM me. I will continue to be on this discussion board but not here. I have lots more postings to add to my 2,164 I have done in the 2+ years I have been here.
You have my utmost compassion.
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For me, the iron bra has gotten better but is still with me. I can remember those first weeks right after surgery it was so bad I would sometimes panic cause I didn't think I could get enough air in. So comparitively it is a tremendous difference.
Linda, I think you said streaches really helped is there a way to describe the type of straches that you used. I know writing vs pictures are difficult but I would be curious.
For me the most pain I still have are my back scars. I'm still driving with my pillow and have never noticed before how many people hug or pat you on the back as a greeting... I guess since it neve hurt before I didn't notice. I'm now coming up on 6 mos in Sept! Wow, can't believe it. Thanks and Cindy a lovely way to say how important each thread is and how we all just need to be here for each other and support. I for one am glad to hear about all the different experiences as we are all individuals.
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For LadyM13, I had the lat flap on only one side. I did have a double mast, (2Nd cancer on same breast, so no choice on Mast, and I chose to do double). Since I had previous rads, doc felt I couldn't just do implant alone. I found the lat flap surgery very painful for recovery. I'm usually a pretty pain tolerant person, but it was a hard, hard recovery... That said, the lat flap results are so much better then my other side where I had only an implant. The lat flap side looks more like a real breast, my implant side looks like a hamburger bun in my eyes. I went in for a revision on the hamburger side , but it still isn't a great match. My view might be very different to a doctor however. When doctors see them, they say "Great Job" I did ask my surgeon why he didn't do lat flap on both sides , his response was, it is much bigger surgery, why would I put you through that, if not needed? ... I do have major nerve damage in my arm, and a touch of lymphedema, but I think it was from my mast, not the reconstruction. I'm 2.5 years out of surgery, and I still have iron bra, random pains (on rib cartlidge), and severe itching, on both foobs. I asked my doc about this, and asked if this was normal... He said it is, even this far out of surgery, but that many patients have said it does eventually subside, but it can take many years. I'm still happy I had the surgery, no matter what, as I'm thankful that there are ways to "fix us", as I',m someone who could not have adjusted to life walking around with out reconstruction after mast. It is a personal choice, but for me it had to be done. I try to tell people, yes there will be pain, and other issues, but like having a baby, the pain goes away, and normal starts to return.
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Hello, I am new to the forum. I am actively searching to find a PS in the Phoenix area. I have been told that the Lat flap is the best solution for me. After TE with delayed healing, infections and several surgeries later, i am ready to do this. Does anyone have any suggestions for a good PS in Arizona? Does anyone know if there is somewhere you can call or look to see how many of these procedures any particular Surgeon does? I called my insurance company but they do not keep track of these things. I just keep thinking that PS must have to record this data somewhere. I am very nervous about this because I keep thinking if this does not work then what options do I have after that. I am also very nervous about the scars. I am feeling guilty about putting my family through more surgeries. I have family members and even my current PS who are telling me that sometimes you just need to say enough is enough and be glad I am alive. I do feel very blessed to be alive, but I also know that the 6 years that my implants were in, I felt much better about myself. I am only 43 years old and I am not ready to give up on having breasts yet.
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Stanzie,
If your back scars hurt a lot, or if it hurts when someone hugs you, you could see a physiatrist. My physiatrist prescribed a compounded cream to apply 3 - 5x per day to the painful areas on the back. (PM me if you want to now what's in the cream.) Anyhow, it has helped quite a bit. She also told me that some women get relief with a nerve blocK on certain parts of their back.) I drove with a pillow behind my back for a long time too. The compounded cream has helped.
Mittmott,
Didn't you get treated at Memorial Sloane Kettering? Great doctors there. I actually envy you in just getting a unilateral lat flap on the radiated side and just an implant on the other. I wish I had done that, even if the cosmetic results weren't as good as the bilateral lat flap. I think the "iron bra" might be worse with bilateral lat flaps. However, I am working with a Pain Management dr. now who is really trying to help me get rid of it. I'll keep you posted...
SS
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Nancy - I PM'd you a highly recommened PS in Arizona. I hope you check him out. Do keep an open mind as you interview PS.
Just to give you a brief run down on my new adventure...
Diagnosed: March 24, 2009 - Lumpectomy May 26, 2009 - BiMX July 21st, 2009 - Necrosis removed (dead skin in case you didn't know what it meant??
) August 4, 2009 - Breast reconstruction (pectoral muscle) August 19, 2009 - Failed Recon/Implant exposed and removed Sept 1, 2009 - RBrst infection 2 weeks later (took a month to heal). After the removal of the implants in September I told my then PS that I needed to stop and take time to heal emotionally, physically and mentally. I took 8 months off and in those eight months I saw a physical therapist nearly every week until February of 2010. She worked my breast scars and broke up scar tissue so that hopefully my next surgery would go well. In April I scheduled an appt with a new PS (Wandra Miles), highly recommended and works at a top notch hospital (Swedish Medical Center-Seattle). When she looked at my chest she knew right away the Lat Flap was the way to go for me. My skin had gotten tight from the last several surgeries (and I had had a skin sparing mx) and concaved. I was not a candidate for the DIEP (stomach muscle) as I had 5 surgeries in the same spot from c-sections and other surgeries, plus I had already made the decision to not go that way no matter what, I would remain breastless if LatFlap was not an option. My Lat Flap reconstruction was done 5/4 - 1 day before my birthday (I celebrated with Dilatin 
). Today I am 3 months from exchange (expanders to implants). I have the iron bra effect, it's tolerable for me, hopefully it will change some after the exchange. The way the PS did my Lat Flap was to put the expander under both the pectoral and lat flap. For some reason it is working. When the first PS did the reconstruction using only the pectoral and it was only in for 1 week, I cried every day. So this turned out to be a much better avenue for me.All I can suggest is that you listen to your body and your mind. There are several women on here who have had different experiences with their Lat Flap and hopefully you can find some answers to your questions with them as well.
Oh about the scars. I did a speech on my 1 year of being cancer free (7/21) and at the end of my speech I wrote: "I will not be ashamed of my scars as they are the brushstrokes in the masterpiece that is my life". You go through many things in your life and even though this is not one you asked for it is one you were dealt. Please, please stay positive and look forward. It will all fall into place.
As always you can PM me as well if you'd like.
We are all here for you!! You are not alone and you are loved!
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Bobbi, was your PS Doc Kiener in Reno? I was telling my PS about you and I remembered you said Reno... and he said...that's right, Doctor Kiener is the only other doctor he knows west of the Mississippi doing our "brand" of lat flap.
I finally have my exchange scheduled for December 9...yea
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Hi Ladies!
I haven't been on for awhile. I get kind of overwhelmed with all the different forums and where everyone posts...anyway I digress,
Could some of you LD flap ladies share your experiences a year or so out? I have some tighness/soreness in my back incision and puffiness under my arm (I call it a rolled towel feeling)
What has your experinece been like? Do these feelings go away?
Thanks so much!
Candi
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Hello, everyone.
I've not posted here before, but I have been reading the boards for several months. I had ovarian cancer last summer and because of this and having the BRCA gene, I had a prophylactic bilateral lat flap mastectomy with TE's on June 28. Since then I've had 2 fills and I'm hoping that's all I need. I go back to the PS on Tuesday and I'll find out.
I've been going to physical therapy and feel like I've gotten most of my range of motion back. I'm hoping I don't revert back after the exchange surgery.
Do any of you have a bulge under your arm? I have a huge bulge under my right arm, but not one under the left arm. It actually hinders some of the things that I try to do. I've talked to the PS about it, but he doesn't seen too concerned.
I really have no problems with my left side at all, but my right side will hurt at times and the TE seems to move around. I'm a school librarian and when I try to straighten the books on the shelf by pushing them to the left with my right hand, I have a lot of trouble.
Any help or suggestions would be appreciated.
Thanks,
Ann
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Oh Linda, I just love you. This is hilarious. We get so serious sometimes and a little levity is what we need on these boards. Go, girl.
For the record, I have always thought you are a compassionate, truthful, brave lady who is ready, willing and helpful to any and all in need. You are just great.
So are you, scared straight and thanks for the thanks. We are in this together, all of us, and I think that any experience is good to share. It helps the "bank of knowledge" for us all.
xox
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Gosh, I am sorry about this ladies, I was responding to Linda several pages back! It got posted here.
Let me see what I can help with tonight for anybody; I still have a "pooch" at the base of the incision that will swell up with too much activity. I can get "iron bra" back if I pull or push too hard without stretching before or after. If you are left handed (I am, and it's the side affected w the lat flap) consider ambidextry. I am being serious.
Moving muscles around does affect you, yes, but not all that much for me anymore. The rolled towel feeling oddly just was gone one day about 1 1/2 years out.
Hm, straightening the books. I think with the TE in you may want to really slow it down to one book at a time. Time enough to get strong with that arm after the exchange. The TE is doing a very important job for you and you don't want to pull too hard, tho honestly, it won't hurt it.
TE's do shift about. If you notice pain or misplacement, of course, call the PS and have him/her take a look. the bulges come and go, they seem to be worse for me after too much activity with the affected arm. They generally go away, but if they hurt you, again, a call is in order. Same for if you think things are swelling like lymphedema. Oddly, I mean.
Lat flaps can regenerate just fine, but they do take some work. I was with hubby last night and oh dear lord, I felt sensation in my boob! It hurts like crazy off and on and I just now realized this must mean more sensation coming back, and sure enough, it certainly did.
Goes to show you just how amazing our bodies can heal themselves, given time and prayer.
Sorry, Linda, you had posted yourself in a bandaged mouth a few pages back and it cracked me up.
love you guys
annie
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Holy cow, mittmott, we had the same experience. You are ahead of me, as I have not done the prophy yet, but I'll be catching up in the fall.
I feel the same way, about it all, everything.
....2 1/2 years and most of the feeling is back. The iron bra is gone most of the time, but oh what hard work to get rid of that it was!!
Glad you are good! Great to hear that someone besides me made the exact same choices made on the exact same reasoning. (two primary cancers, same boob, prior rads and lumpectomy, then went to lat flap and mastectomy recon.)
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Ok ladies I have my surgery in January. I still have the tight bra feeling but I also have like a skin bridge in between my breasts. Is this normal? The area between my breast is not flat against me breast bone. I'm wondering if I should go back to the surgeon. Thanks
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Asr51- yes I have a bulge under one arm but only a tiny one under the other arm and yes my PS wasn't concerned either. He said it was the muscle and that I just have to wait for it to atrophy. So?? It really bothers me a lot but haven't gotten much info either.
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Stanzie, I just went to the PS today and talked to him again about the bulge. He said he will probably liposuction it, but not until the nipple reconstruction. I just got my exchange date today. I have to wait 6 more weeks until Oct. 27. One of my foobs is larger than the other, so I got another fill today on only one side. This is the last one, though!
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LaceyK- I have a skin bridge too between my TE's. The PS said she will take care of that probably with the liposuction. I have my exchange scheduled for 11/17. I can't wait. I've also taken the class at the YMCA in combination with Fred Hutchison Cancer Society. It's for cancer survivors of all types. So far so good. PS put a halt to some of the exercises though that involve my pecs. Things are progressing. Just wishing it were over with....
Cindy
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Cindy, Im just the opposite.... I have a VALLEY ,,,, they are too far apart. But PS says he can fix it on the exchange. Going for mine on 12/9. Excercise is good, just don't over do it.
This time next year.... we'll all be sitting up straight and proud.
Diane
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Anyone have experience with sensation coming back to the lat flap breasts? Did you get any weird hypersensitivity? electrical feeling while the sensation came back? How long did it take for things to settle down? If ever? (Just when I was getting use to it feeling numb---here we go....)
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I just get prickly tingly sensations with very occassionally a semi-sharp pain. Funny seems like I get them more at night reading in bed but may be cause it is quiet then and I'm not running in 24 different directions. I just tell myself this is good as feelings and sensations would be nice to have back.
When I went in a 6 mos. for nips and areola he said patients are usually numb for 6-9 mos. I was starting to get feeling back so he said all that was really great and I should get lots of sensation back. I asked then about my lower back and he said that takes much longer usually about 2 years for sensation to come back. Hope that helps.
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Has anyone had a lat flap with no implants? I had a lumpectomy in May of 2009 with a reexcision following shortly after and then 6 weeks of radiation which ended August 2009. I saw a PS regarding reconstruction because I have a sizable crease where all the tissue was removed and I have gone from a C cup to an A. so I am very lopsided. I opted to not have the lat flap because I was concerned about the amount of time I would lose from work and how it would affect my back strength in the long run. My PS suggested that I try the fat grafting surgery, I could do perhaps 3-4 rounds and fill in that way. I had the first fat grafting done in July, developed cellulitis and lots of scar tissue and an even more a pronounced indentation . Fat grafting is now not an option, he would have to remove such a large amount of scar tissue for the next grafting there would be too much space to fill in. So I am on the fence deciding if a lat flap,which the PS recommends, is worth going through. I will not have an implant, it will strictly be the lat flap. Appreciate any feedback from those who have had the lat flap without implants and their results. Thanks!
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Why would you not want to have implants, just curious? I'm gathering you don't want to be totally flat, correct? I guess it would be just like muscle, but now sure how they would "shape it" but perhaps they can if it is an option.
It seems like an awfully big surgery if you don't want to put in implants. My understanding is that the muscle holds up the implants and covers them so they look and feel more "real". I know the fat grafting is a very long horrendous process and full of complications like the one you ran into. I have not found the loss of back strenght to be a problem, I don't swim as fast but I'm hopeing by next summer I will so for me that isn't an issue. Won't they have to remove the scar tissue anyway? Are there any other options given?
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Stanzie-
It seems most of the posts I have read were women who were getting the lat flap and tissue expanders, I was wondering if any others had the lat flap without getting TE and then implants. The bottom half of my breast is fine, the lat flap would be filling in the large concave area of my breast where all the tissue was removed from the lumpectomies, at the top side of my breast. Sorry if I wasn't clear in my post, hope that clears it up. Thanks for your response.
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Sorry I just missed that. I had the lat surgery but had immediate implants so now TE. So I guess I can't help but if you like your PS and he says it will work then that sounds great. You could see if your PS has any other patients who he/she has done this on. I hope it works for you!
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