Latissimus Dorsi Breast Reconstruction
Comments
-
Thanks Jeepster! I'll get the biotene. I've used that a few other times and it did work great. I'm going on a cruise 6 weeks after surgery and my PS said I shouldn't have any problems. We'll see. Gee, lying around on deck to recover doesn't sound too bad:). I've been trying since May to get this surgery done but with insurance then scheduling nothing has really gone in my favor. I'm just trying to stay positive. Thanks again:)!
0 -
MmadRigal05 A cruise sounds amazing! Perfect for recovery, no cooking, no cleaning! I will make sure pray for a speedy recovery. Pretty terrible that insurance is dictating too much of our health pathway these days.
0 -
I'm going on a cruise also in December and was wondering if I would be ok. Doctor said yes!
0 -
shorfi-depends on what your definition of ok is and who's going with you. i will have plenty of help lifting things like luggage and i'll have something to fill in my bathing suit so for me that's ok. i can rarely leave my house without my bra on (victoria's secret bombshell bra so i don't look like an old man with a beer belly, although they probably have bigger boobs than I do right now;) ) so that was most important for me. my cruise is 6 weeks post surgery and my doc has given me to go ahead. i think i need this cruise more for my mental/emotional healing than anything so i'm going no matter what. i hope you have a fantastic time on yours!
0 -
Congrats on such great plans after surgery. I was 6 Wks out and drove to visit family in Kansas! A cruise would have been soooo much better! LOL Best wishes to both of you for your upcoming surgeries, and cruises!
0 -
Mamasixtaz, just wanted to reply about your under arm issues, I had my surgery four weeks after you, what a journey! I have a fullness under my left arm where the lymph node was removed, my PS did not want me to start physical therapy too soon due to seromas. It does bother me too, I'm hoping that when I can stretch like I want to it will resolve. Just started sleeping on my side, what a relief! Am still wearing spanks and ace wrap. (UGH). September I will be due for exchange.
Do you fatigued easily? I'm pretty disappointed in my total body de-conditioning.0 -
Jeep-I have had trouble with seromas too but most have resolved. I still feel some fluid build up periodically but not enough to have removed. I think more is in the underarm boob now. I just wear a sports bra to support the underarm boob, the foobs are so tight they aren't going anywhere! LOL As far as fatique it has been a battle. I don't know whether to blame the surgeries, TEs, Tamoxifen??? I have had issues all year with my energy level. Never have had an issue till now. Looks like we will be exchanging about the same time. My surgery date is September 25th.
0 -
It is so good to have found this forum with all the wonderful information and support everyone provides. I will have my last chemo treatment next week and have chosen double mx instead of lumpectomy and radiation. I may still have to undergo radiation if my lymph nodes are positive, but none of my doctors expect that, although the pathology will be the final decision. I met with a PS today to discuss options for double mx. Having two friends that had TEs and implants, I was prepared to undergo the same surgery, only to learn that he feels lat flap with implants is the best option for my anatomy and will provide the best result (with TEs first). I have to say it took me quite by surprise and I am feverishly researching all the pros and cons. Reading all your comments has provided me with much comfort in knowing I can recover nicely from this type of surgery without much limitation. I have always been concerned that removing muscle from my back would cause some sort of body imbalance, but it sounds as if most have done very well. Still trying to wrap my head around it.
0 -
ZENFUL - in my opinion - if you can go the TE-implant route and skip the lat flaps then thats what i would do. Just my opinion, some on this thread may disagree. There is no need to have lat flaps if you are having implants, it is a MUCH MUCH bigger surgery/recovery. If he/she tells you that the result will look more natural, i would disagree aswell. I have one implant and one lat and the implant one looks way nicer. Most of us have had a lat flap due to rads damage, not for cosmetic reasons
I am one who has had on-going issues, pain, strength etc. and I only had one side done. Some, as you have been reading have adjusted very well.
Just giving you another perspective that may help in your decision making
0 -
Rosemary - thanks for your honest input. I notice that you had radiation. Was the flap side the side that was radiated? If so, might that be part of the reason for a lesser result than the implant side?
0 -
Rozem - autocorrect changed your name to Rosemary! Sorry.
0 -
yes the lat side was radiated (first it was radiated then i had the lat reconstruction), there are skin issues as always with radiated tissue but thats what the lat is supposed to help with. It looks ok but i have this elliptical skin area (skin from my back) that does not look nice and it kind of looks flatter, I think thats because the lat is pushing it down (my theory). If you dont have rads you wont need that extra skin
my biggest issue is not how it looks -quite honestly with all my pain issues that is the last thing i care about! the biggest issue and one that i think yoiu should strongly think about is comprimising your lat muscles - this is not to be done lightly. I thought, hey im young i can overcome it if i work hard enough - and trust me i have tried everything (yoga, massage, P/T, strength training, accupunture etc) to no avail. I realize i am the minority here and some women truly have no other choice but to use the lat due to thin, radiated skin etc. and come out of it just fine. Taking both lats is big -dont let the PS's tell you otherwise. Also you will feel that tightness under the arm where the muscle is tunneled through - that is a pretty standard sensation we all have -
0 -
My PS did indicate that it was a major complicated surgery, but due to the large size of my breasts, DD, on my small frame, the skin is quite thin. I plan on going down to a C. He feels this will be the best result possible, but I am still struggling with using my musculature to do it. I really appreciate your honesty. It's definitely beneficial to hear both sides.
0 -
Zenful-welcome to this forum, it is probably the most interesting thread in BC.org! No one holds back how they feel, and you will see in past discussions we are not all the same! This surgery has as many reviews both thumbs up and thumbs down as the most controversial movie! For me I too was given this as the only option for reconstruction by 2 PS. I would recommend getting another opinion just to make sure. I would have taken another route if offerered. I now am 4.5 months out from surgery with my TE fills completed to 800cc bilaterally awaiting exchange in September. I am glad to have foobs (bmx, with lat flaps the only choice offered) but it is a big price to pay in loss of sleep, pain (acute and maybe chronic) and scars both front and back, possible seromas...etc. I am ok with my decision and hope you can be with yours. It is a big decision and I am glad I am past it and working toward recovery.
0 -
Hi Zenful,
I've had a pretty good outcome with my bilateral lat flaps. I had TE's and then got implants about 6 months later. 3 plastic surgeons recommended it as the best option for me as I, too, had large breasts. I'm smaller than I was, but in a good way.
My scars faded pretty well on my back and continue to get better. I was able to have skin/nipple sparing surgery, so I don't have the additional scars from that, but I do have faint ones from a lift that had to be done in order to get them to look right.
Honestly, they'll never look as good as real breasts to me...but in clothes, bikinis...no one would ever know that I have implants much less had massive reconstruction. So, in light of all I've been through, I'm pretty darn happy.
I've lost some upper body strength, but it's not enough to slow me down and I'm sure if I worked at it, I could improve it.
We've all had slightly different outcomes and I feel awful for those that have chronic pain. I came out of it pretty much feeling whole again. Oh, I did not have radiation.
Good luck to you with whatever you opt to do!
.0 -
Headed to LapFlapVille September 10th with TE. Nipple sparing/skin scaring resulted in necrosis, implants had to be removed and downsized, then incisions didn't heal and implants were exposed and had to be removed. I can't get used to the flat/Concave look!
Will the TE's help me look like I have boobs or does it take a few fills for that? Any chance I could have the exchange done in 2013 for insurance reasons?
TIA!
0 -
Thanks Jen and Mama, I called back to the PS office to get clarification, and was told it has nothing to do with the size of breasts you want to end up with, but it is because I have so much breast tissue, it is wider and that space under the skin needs to be filled or I could end up with a lot of fluid collection. Not sure I fully understand. I am definitely going to seek a second opinion, but it sounds like you both got multiple opinions and received the same recommendation every time. I already struggle with posture problems, and am always trying to pull my shoulders back and shoulder blades down (probably due to my DDs). Isn't the lat muscle the one that helps you do that? I read that the lat also assists with deep inhalation and exhalation. Has anyone had difficulty breathing deeply?
0 -
zenful - that explanation makes no sense to me...im no doctor but the TE's go under your pec muscles, a pocket will be created to hold the te and eventual implant. If it is not a size issue (which i still dont get, my friend had 800cc implants put in and no lat flap) then i am not really understanding why they are suggesting the lat flaps
you may have strength issues due to having the pecs comprimised regardless of using the lat muscles. I had difficulty breathing in the beginning but thats because the expanders were pressing against my chest - nothing to do with the lat
0 -
Rozem, that is exactly my thinking. He is going to have to explain a whole lot more to me before I resolve this.
0 -
Hi Rozem/Zenful -
Just a quick note, my implants are not behind my pec muscles. I know this is atypical, but my PS used the lat muscle as a sling to hold the implants and preserved my pec muscle in the process. I didn't even realize it until after surgery. She explained to me that she preserved them this way on the off chance that the flap procedure failed...that way she would be able to use them as a last resort.
In my case, the lat procedure helped for the same reason Zenful's PS explained. In addition, I had quite a bit of sagging due to the size of my breasts prior to surgery. The lat flaps were a huge help in preserving the skin/nipple because they improved the blood flow to the tissue. My lift was pretty extensive and my nipples were completely moved. I can't feel them, but the nerves work and they respond to cold temperatures like they always did (sorry, probably TMI!).
If I'd thought I'd have had success with a "simple" reconstructive procedure (I realize that none of these surgeries are simple), I'd have done it in a heartbeat. But, after hearing from so many surgeons that this was my best option, I jumped in wanting to avoid a failed procedure that would ultimately end up requiring more surgery down the road.
0 -
Cat24, where did you have your surgery? I am also in Ohio ( toledo)
0 -
Zen-I don't have a problem breathing other than just with the TEs, not due to the lat flap. Posture not a problem either. PT helps some with strength and ROM. Keep asking questions and get the answers for your best decision. I don't think my skin would have been able to use 800 ccs with pecs and skin. My TEs are behind the pecs and lat muscle and I still had healing issues.
Hot Pink- I did start out with 500Cc at surgery, then started fills 8 Wks post bmx/lat flap. Now expanded to 800 Cc that are hard as rocks on my chest...really sucks to sleep. Awaiting exchange, waiting waiting, waiting....not sure you will make it to exchange this yr, but some PSs do it sooner than others, just ask yours.0 -
Zen, my surgery was in May, I have no problems breathing or with my posture. I just got the OK to stretch my arms over my head. Small set back with seromas , I've been told this is not uncommon. Two surgeons suggested that LD was the better option due to my size and a previous breast reduction. I'm pretty sure my TE's are on top of my pectorals, and I know for sure that my latissimus muscle covers my entire expander.
I am back to work, my biggest complaint is fatigue, Im sure it is from the roller coaster of treatment, then surgery, I'm totally de-conditioned, oh getting some of my shirts over my had is also frustrating, I literally have to learn how to do certain things in a different way.
My husband keeps reminding me that I'm only 2.5 months post op, and not to get too frustrated. I would say I am 75 percent back. 0 -
Hot pink- I had my Lat Dorsi surgery on 6/21/12 and did the exchange in September of that year. I came out of surgery filled to 300 cc and ended at 450 cc. I was glad to do the exchange rather quickly as I hated the TE's. They were really uncomfortable for me.
0 -
I think I posted on maybe the wrong post earlier, but I too am trying to find about the same reconstruction procedure. I have to have this kind of reconstruction as I am doing a delayed . I am glad that peolle are posting their experiences on here. I am just nervous as there is only the one plastic surgeon in my town. It would be too much of a hardship to go out of town to someone else. Looks like we are going to have to be careful but positive, and hope we do well.
0 -
rosesark - even if you are doing delayed reconstruction you can still go straight to tissue expander/implant. Is there a reason they are recommending the LD? doesnt look like you had rads
0 -
Rosem, I know on the left breast that I had a mastectomy on I have to go with latissma. It was a simple mastectomy with only the sentinel node removed. My cancer was along the areola, due to history bs said no skin sparing. I am going into the process of pmx on right breast that has no cancer. That one they can prob do with implant. I will see the ps thursday. I have an old gall bladder scar that ps says he doesnt think the blood vessel could be trusted to have the tram .I want to ask him if one breast is surgery with implant and other is ld, will they be close in size or shape? And lots of other questions I've readabout here.
0 -
Hi ladies! I'm 4 days post lat flap. So far so good. I have an appt with my PS tomorrow for follow up. The drains suck but I'm used to them by now. I've got 6 total. One thing that concerns me is how lateral they are. I was expecting to have them a little closer to my sternum in the middle, like I had cleavage again. What have some of your experiences?
0 -
mmadrigal - did they put the implants in? my expanders were very far apart but this was fixed at exchange
0 -
I spoke with my PS today (Ledoux, with PRMA) about my reconstructive options. I already had DIEP reconstruction last year, but before it was all completed (still no tattoos), it was determined that they didn't get everything and so I had a re-excision, two lumpectomies, and finally a completion mastectomy. I and my medical oncologist really wanted to make sure we got everything before moving on with reconstruction.
We talked about another flap procedure, and he could do a GAP. He does a handful a year. While it would work if I just wanted to match the other side, I'm not happy about the loss in volume. He said he could do fat grafting on the other side, but I'm worried about it showing up as calcifications and then going the whole biopsy route. Also, my concern is that the GAP flap goes between the skin and the pectoralis muscle, which means that any breast tissue which remains could be pretty deep and might be hard to find should there be a recurrence.
I'm somewhat concerned about the loss of muscle, given what I've read on the blogs. My PS says that he's had successful lat flap outcomes with swimmers and tennis players, and they have not had significant issues with loss of strength. Also, because it is under the muscle, any remaining breast tissue should be much closer to the surface than with a GAP. Finally, there's not much tissue coverage of the area closest to my sternum, and so the lat flap really seems a necessity with an implant particularly. Surgeon says that if lat flap or implant has serious trouble, then GAP can be used as a back-up.
Currently the plan is to do the lat flap and insert tissue expander (Mentor CPX3) partially filled. After a month it will be fills until I am at the right volume, and then after two months at the desired volume, and do the exchange (Mentor Memory Gel, smooth), including some alloderm. I was a 34C prior to all of this. After the DIEP I was 34B. Depending on how I feel I may end up with an implant under the DIEP on the "good" (prophylactic mastecomy) side as well. I'm trying to find out though if insurance will cover it, and if not, get an estimate for what it would cost me. I think insurance should cover it - "symmetry to match the reconstructed side" and WHCRA being what it is in the States, but technically they've both been reconstructed and the Dr's not sure. Has anyone else out there had similar issues?
0
