Latissimus Dorsi Breast Reconstruction
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aunt Paula, ask him have his previous patients ( that have had the lattisimus flap NOT the tram they are two different major surgeries) call you so you can ask them patient specific questions. You should interview at least two more plastic surgeons! I interviewed two in person, and third I could not get past the front door, due to lack of availability, and attitude of office staff. Good luck! I think you already know your answer about the first one, go with your gut.
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Aunt paula this was my 3rd PS. The first one said I would need the flap surgery because of the radiation. The second said lets try it without. I really wanted to avoid it so I went with PS #2. Well the rads killed the skin and ruined the implant. So on my own I went to see PS #3 as he came highly recdcomended. Plus #1 said he didn't do flap surgeries. I do know from lots of research that there is another procedure they can do without removing the Lat muscle. It is not as major. They take a flap of skin from under your arm and tunnel it over similar to the flap but without the muscle. My PS said beause of the rad skin I would not have as good of results. I wonder if this would be better for you. I would NEVER do this surgery unless I had to. I am 2 wks out today and still tell myself this was not worth it. Im sure time will change that but it is MAJOR!! I know not many surgeons do this other flap without the lat muscle. I cant rmember wht it was called but it started with a T and was a long word.
As for the recliner I wish I would have rented one. I am 2 wks today and down to 1 drain so I wont bother at this point but still in quite a bit of discomfort. I don't know how I am going to go back to work in 2 weeks. I already have a book full of appointments I have no idea what I am going to do:-(
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Tangles, that sounds miserable! I can't imagine staring down the prospect of going back to work when you still feel like this.
I am trying to get a second opinion set up (and a third, if I need it). After my BMX (Jan. 29--it sounds like several of us had it the same day), I was surprised by how not-traumatic it was to see myself and my incisions and how much in some ways I could see myself enjoying being flat. I am still ok with the scars, and the different landscape, but more and more I'm feeling the need for breasts again. I told my surgeon Friday morning when I saw him that I didn't need a prescription for post-mastectomy bras, was starting reconstruction in a couple of months and would be fine, etc. Then I saw the PS, and with my reservations about him/surgery, I did go for a bra fitting (and ironically, had the best bra fitting of my life, now that I don't have breasts LOL). I called my surgeon Monday and not only was he glad to write the prescription, but his nurse was hand-delivering it to the bra shop.
I have heard of the tunneling surgery and am definitely going to find out if I am a candidate for that. Anything to make it easier. If there were any way to get the same results without surgery, there is no way I would consider this. I hope you are able to get back to the things you want to be doing soon.
Jeepster1, I will ask him to have patients who have done this surgery/type of reconstruction call me. That is a great idea.
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Anyone out there that had this surgery did you like your results right away? Personally I think I look worse. I now have these giant wide boobs that sit under my armpits. I have not complained to the PS yet as Im sure there is still a ton of swelling, but the way I look now I could just cry. I pray this is not the end result:-(
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tangles- Sorry you are having a hard time. This is a BIG surgery. I also had a lot of swelling under my arms. I was told the muscle must atrophy. I thought it would never happen, but it did over time. I still have some discomfort under my left arm especially after a long (12hr) day at work. I wear a bra to help support under my arms more than to support the foobs. I battled infection and skin necrosis. I also had to have fluid removed from my back weekly after the last drain was removed. The expansion process now looking back was torture, but after the exchange to implants I healed well. Now with the nipple recon done and awaiting tattoos, I am happy with the results. Next week is my 1 yr bmx/LD flap recon anniversary. Hang in there and rest, rest, rest...it is the key to this recovery. I hope each day gets better for you and you can return to work as planned. But I hope you can take it easy when you go back to work and still get plenty of rest. I went back too soon and wished I had taken more time off.
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I find that wearing a tight bra with wide sides help flatten & smooth out those muscles. I am a couple of years out from bilateral lat flaps & I wear an underwire 24/7.
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Hello. I will be having my last chemo treatment this week. I'll be having a BXM on April 17th. Cancer is on my left breast but I am electing the BXM. Right now it is assumed that I will need radiation but not definite. I've met with three plastic surgeons and am trying to decide between two by tomorrow (monday). Reason being is that one surgeon is one of the top drs in the state and is holding the date for me. One surgeon recommends doing the latissimus flap surgery plus implant the same day as the BXM. The other surgeon recommends doing TE's first, radiation and then the flap plus implant surgery.
Everything I read online suggests that they are not done at the same time. I would love to hear experiences from anyone that had it done at the same time followed by radiation. I like the idea of one surgery but am concerned that the breast will contract from radiation and will then need another surgery.
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My Mastectomy was one year ago. I have not worn a bra since. I was hoping NEVER wear one again, but that seems like its not going to happen. I have another friend who tells me she has to wear a bra to bed for comfort. UGH. Well I guess just getting rid of this binder bra will feel good. I am a hairstylist and have my books full of people waiting to get their hair done next week. There is NO way that is going to happen. I cant even lift my arm above my shoulder. I cant believe it will be 3 weeks this Wednesday and I am still in this much pain. My hubby keeps pushing the pain meds but I feel I should be off them by now. Thanks for all your replies it helps to talk to others that have went through this......Im off to get the final drain out.
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I am so sorry that you are going through all this pain. Are you feeling any better? I'm 7 weeks out and am feeling back to normal. I'd say around the 5th week was when my pain went away. It is a very big surgery. My surgeon explained to me that a mastectomy is a 4 out of 10 and the lat flap is like an 8 out of 10. I regretted the surgery for the first few weeks. I still have this huge lump under my radiated armpit that developed after the surgery. Hopefully that will go away. I also have a bunch of purple veins on my chest on that side that they said could be lazered off. Well wishes to everyone!
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Also, my surgeon said that when the expansion is happening, they tend to expand into your armpit. He said that after the exchange is when they do all the finishing touches and move things to where you want them. My breasts look nothing alike. I was happy to hear that this will change : )
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It will be four weeks tomorrow. I am still pretty uncomfortable. Trying to get off the pain meds slowly, but its hard when I am still in pain. Im still at the point wishing to HELL I never went through with this. I am due to go back to work this week and no way is that happening. I will have to call all my clients and break the bad news to them. I went to immediate implants. Wishing I would not have done that either. After having the TE and all the fills I didn't want to go through with that again. I now have the widest boobs on the planet. They go way way under my armpits. . Im starting PT tomorrow. My left arm is moving fairly well, not 100% but ok. My right arm, radiated side, wont move at all. Cant even comb my own hair. I have come to the conclusion after this I must have an EXTREMLY low pain tolerance as I read someone on here went back to work at 3 weeks. HOLY COW! Maybe my body is just wearing out with having 3 surgeries, chemo and radiation in a years time................
PS the scars on my back are MASSIVE! I never in my wildest dreams thought they would be this large. I look like frankinstien.
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Oh no Tangles, I am so sorry! I wish I could give you some good advice. Are you doing range of motion stretches for your arms? You should tell your surgeon that you are not happy with the results. They should be able to do something about that. If not, maybe you could get another opinion. Can you get short term disability for being out of work?
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Yikes! I'm going to have this surgery early summer. Hang in there Tangles!! wishing you relief soon.
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Tangles, that sounds miserable! I hope you are able to get some relief soon, and get some feeling of normalcy back (that always helps me feel better) in your life.
I've decided not to have surgery this summer after all, and possibly not ever. I am just not sure that I want to take on a surgery of this magnitude, and I'm equally (if not more) unsure that I will be happy with my results. I'm happy with how I am now, and have my bras and forms if I need breasts for some reason (ha), so I'm going to take some time and work on getting into shape, and then see how I feel about the surgery.
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Hello...
I was diagnosed 3 weeks ago and am torn between #1 - whether or not to do both, since I only have it on one side. Everyone says just do them both and no more worries. #2 - whether to do the expanders/implants or the latissmus flap. I have to say that I'm leaning towards that. Wake up and have breasts and be done with it. I don't like the idea of the expanders for months and dragging this whole process out for many months. I am stage one, so hopefully once I'm done with the surgery, I'll be done....keeping my fingers crossed! Can anyone give me some advice? What do they look like?
Thanks so much for any input...
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I had a bmx with lat flap reconstruction for dcis (the second side prophylactic since I have a BRCA2 mutation) on March 21 and just wanted to weigh in -- it's still really early, I still have four drains and a lot of tightness but I don't feel horrendous. I have only been taking tylenol and valium since getting home from the hospital (post-op day 3 -- I came home Sunday). I probably could have used something stronger the first couple of days but I hate narcotics so survived on tylenol. By today, day 5, the pain is certainly tolerable. The worst part is the tightness, mainly in my breasts not my back. I feel like I'm wearing a very very tight corset, from the 18th century or something! My surgeon has me in a bra and some kind of band like thing around the bra -- I assume to keep everything compressed. I feel worst in the morning, I guess from lying on my back at night the swelling gets worse (I'm sleeping on 2-3 pillows but pretty much reclined in a regular bed, I didn't need a recliner). I have four drains -- the front (breast) drains have been draining no more than 20ml per 24 hours so I know they'll be coming out on Friday when I see my PS. The back drains are draining about 80ml/24 hours so I guess I will have those for another week or so. I know the tightness is to be expected but I'm hoping it will soon start to ease a little bit, or that my PS will let me stop wearing this tight band on top of the bra. On the plus side I think my breasts look great -- straight to implants, no TEs and they look pretty good to me. I spent a lot of time researching different recon options -- from gap flaps to pap flaps to tug or tdap (diep was not an option, too thin) to TEs and implants (I do have small implants behind by lat flaps) and will post about that another time when I have more energy. The other thing I'm finding is I'm SO tired. I nap all day. My surgeon says that's fine -- I need the rest. Good luck to all of you out there going through this or considering what kind of reconstruction to do. Everyone's experience is different and I found it helpful to read about what other people went through. For me each days gets a little better. . .
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Gabriella Im so happy your surgery went well. I think it is good to hear from several who had it. I think EVERYONE is different and hope my case is just one of the worst. You cant base your decision on one persons experience. I think my biggest advise going in would be to got15 do not expect to ever look the same again. You are having this surgery from cancer not getting a boob job. It is hard for me to look in the mirror and see my chest and remember this. I am 4 wks post op and still on narcodics. Mainly for my back. I have sever tightness on my front and know that is to be expeted but my back is still KILLING me. My doc is going to send me to a pain management specialist. My dr didn't want me to do much of any stretches for the first month so now that that is up and can start. I am pretty disappointed in the width of my implants. They go WAY under my armpit. I expressed this going in to him. Wish I would have pushed it harder. In his defence he says I cant judge them for probably 6 months. so I will wait before I decide my next step. I have come to realize at this point I don't care about appearance really. I just want comfort and being able to put my arms at my sides without a huge buldge would be nice. Once again congrats Gabriella ondoing so well. I have to say I am a bit jealous. My back is KILLINg me from just sitting at this computer chair so gotta go lay back down. I hope to have a better attitude and be pain free by summer
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Tangles I'm sure having had chemo and radiation makes surgical recovery much harder -- try not to compare yourself to other people who seem to be able to run a 5K 3 weeks after their operation (I read some of these stories and couldn't understand why I was sleeping 16 hours a day for my first two days home from the hospital)! You're body has to heal but is not starting from its ideal point of health. I have a good friend who had a lat flap done two years ago and she needed both chemo and radiation. She said she really didn't start to feel back to herself until about 9 months after her surgery, but now she is thrilled with her results -- both how she looks and how she feels. I think it's a longer process than most people realize, especially if there are other complicating factors, but it's so hard to be patient, especially where there are so many things in life waiting for us to get back to them. I'm hoping that in a few months or even weeks you'll be feeling much better. I know it may seem very basic but have you tried baths with epson salts for pain? (I'm too early to be getting in a tub but that was always my go to remedy for muscle pain in my previous life!) Also scars take a long time to fade -- I just had lunch with a friend who had a tram flap 8 years ago (for triple negative BC with 10 positive nodes!) -- her scars are barely noticeable and more importantly she feels great. It's a long process, especially the lat flap, I think. Maybe more work up front but I'm hoping that down the road the results will be good and last a long time. For what it's worth, my breast surgeon (not plastic surgeon) said that for athletic women she thinks the lat flap is a better operation because there are fewer problems with implants in the long run (I have implants under my flaps) -- the muscle holds them in place better for women who move a lot. Good luck to you!
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I would have to ask my PS if I could get in a bath yet. I don't think I could get out though. Im not sure I could push myself up out of the tub?? Im still pretty weak. I would worry about the warm water creating more swelling. I already feel like I could seriously burst open.
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Tangles one other thing I do that I think helps my tightness (which is my biggest issue so far) is a guided imagery download on my iPod. I ordered a couple of these before my surgery because I was very nervous but the one I use now is by Martin Rossman, MD, called Healing Well After Surgery. It came as part of a CD that had relaxation exercises for before surgery as well but now I'm just using the post-surgery part. I ended up ordering the CD but I think you can download just the MP3 as well. I'm not that into new age type of stuff but there is evidence that our brains are very suggestible and I find this recording to be relaxing and positive. I do have to try not to fall asleep when I listen to it -- the first part is meant to relax you but if you fall asleep then I don't think the suggestions (eg on how your body can use it's own strength to help you heal) will be as effective. It's certainly not the whole solution to any of our problems but maybe it can play a role, along with other things.
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Wondering if any of you ladies have very different coloring of your chest compared to the back flap? At about 8 weeks post surgery, mine seems very different and I'm wondering if that will go away over time? I also have these tiny white hairs just on my flap, which is an eye shape. It kind of creeps me out.
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Hello-
I am new to this section of the discussion boards. After my BMX in Nov 2012 - I got tissue expanders. Then had to do chemo then radiation. In Feb 2014 I got TE's out and implants in. Well - long story short it was a disaster. I have been walking around with gaping hole that won't heal for 2 months now and PS said enough is enough - it is never going to heal - I have to have it out - or have lat flap surgery. My radiation boost was literally right on top of the mx incision - no way this was going to work. Complicated - but I am going for the lat flap. I have it this Tuesday April 1. My question for you all is... I have a trip to Disney planned for April 18. My PS says if all goes well - I should be good to go - just no soaking in pools, etc. This is such a big trip! My kids will be so dissappointed.... I already ruined Christmas 2012 for them with the chemo and cancer. I really cry at the thought of having to cancel this trip. I am wondering - from all of your experience - is this unreasonable for me to expect to be able to go? My kids are 10 and 13 - and my husband will be with us. So - I guess if I am not at my best I can stay behind from time to time... I am just really nervous about this - but I have no choice! Something has to happen on Tuesday - I am at serious risk for infection if I just let this go. Under the scab is just the implant or alloderm....
I would appreciate your opinions here. I could read back over the years of posts here I guess... I am sure there is info somewhere!
M
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tangles honey I am so sorry you are still feeling horrible. I stopped posting on this thread because it was suggested that I was scaring the s**t out of the gals who were considering this surgery. I had an awful time with recovery - worst case scenario with chronic pain etc. Read back on some of my posts if you would like.
anyway I just want to give you some hope - I am about 1.5 years out from this surgery and feeling pretty good. My range of motion is completely back and even the pain is much much better, I honestly thought it would never improve. Im not suggesting it will take this long but I just wanted to give you some hope that it will get better. It took me a long time to move on but I have and don't think about it most days anymore. Im back at the gym on a modified program but i think this is also related to my pecs being compromised not just the lat. Its just insult to injury when breast reconstruction goes wrong.
many (((((hugs))))) and hang in there
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tangles i just wanted to add the things that i did to help rehab myself. - massage therapy, acupuncture, stretching, pain management doctors, etc etc
the thing that FINALLY worked for me was seeing this wonderful physiatrist (doctor who studies the muscular system) she put me on a very intense stretching program combined with lidocaine injections to the painful knots in my back. Basically when you mess with the lat muscle the other, smaller muscles need to compensate. In my case they didn't do a very good job and i ended up with tons of knots in my back that hampered the process of allowing the other muscles to do the work. Once i started stretching ( 3x a day for 30min) and she did the injections (focusing on different areas each time) everything started to relax and the muscles were able to do their job. PM me if you would like the stretching protocol she gave me
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Hi M! Sorry that you are having that experience with your reconstruction. The lat flap is a huge surgery. I was in the hospital for 3 days. I myself, would not be prepared to take on a trip to Disney that soon after the surgery. My body recovers pretty quickly and my pain really started to subside around the 5th week post op. But, everyone is so different. Maybe you could totally rock Disney that soon after surgery! Is there any possibility to wait until you return to do it? I wish you all the best!
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mfml, will you go straight to implant with your lat flap or will you need a TE? Lat flap plus implant for me was a piece of cake compared to lat flap plus TE. In both cases I was able to return to work full-time within 2 weeks. (Retail management, on my feet all day.) I would think the only thing holding you back is that you still might have drains.
rozem, so glad to hear that you are doing better!
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So you see everyone heals at different rates. I will be 5 wks post op on Wed. I could not go to Disney now. I am not even back to work. I am a hairstylist and can not get my arms up in the air nor could I be on my feet for very long. Yesterday I went with my hubby to the grocery store for the first time and I was exhausted. My chest is tight beyond belief and my back really feels like I am hauling around a backpack with 50 lbs of weight on it. I could never have walked around a park in the heat even for 15 minutes. I had bilateral and went straight to implants. I did NOT want to have the TE again. BIG mistake as now I have implants that go under my armpit. I think if I would have dealt with the TE maybe we could have avoided this. It makes me so so sad to think I may have to go on like this forever having the feeling of golf balls under my armpits. Anyway good luck with your surgery and I pray for you you have any easy time like some of these gals did and do not suffer like I did...........
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I was reading this topic for a while and thanks everyone for the information. I was diagnosed and had bilateral mastectomy in Nov 2011 and had chemo and radiation in 2012. I met my ps last month and she said I will have lat Doris with TE on left side and TE on right side. Last week I was told the surgery date is April 22. I am 5'4, 110lb, quite active, I do yoga, arriba, box fit and weight training 3-4 times a week and healed quite fast and well from the mastectomy surgery, chemo and radiation. But now I am so nervous about the oncoming surgery and afraid of the recovery. Can you please tell me how I should prepare for the surgery and what did you do to speed healing? For those who had similar surgeries for years, do you regret and are you satisfied with the result? Thank you!
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mfml - Since it doesn't sound like you have much choice on the timing of your Disneyland trip, just go for it. I healed very well after my BMX, but was a little slower on the lat dorsi surgery. I had it on my right side only and went to tissue expander. I have my exchange to implant surgery this Friday. I would say you may still have a drain possibly. I got mine out at 2-1/2 weeks and begged him to take it out. I did have to get fluid drained from my back once a few days later (but it was worth it to me). Any rides that will be bumpy may cause you some pain. Your energy level won't be back to normal most likely, but there are many pretty places to sit and relax if you need. If you could even postpone for a couple weeks, you would probably be in a better position to enjoy yourself. But I do understand what you mean about not wanting cancer (and the resulting treatments) to provide any more disappointment in your family's life. I'm a huge Disney fan (land and world) but probably would postpone a little so I could enjoy my time with the family. Good luck with your surgery tomorrow and with your trip!
Xinghong - I'm not sure there's much you can do to prepare before the surgery. I had a similary path as you and would say that I was a little surprised at time it took to start feeling like myself. It was about 3 weeks out before I started sleeping well, and getting my energy back. I took the first 10 days off from work, worked the next week from home and was back in my office for the 3rd week. My PS didn't want me back in the gym for 4-6 weeks. I went back at the 4 week time but started slow (bike and walking on the treadmill). By 6 weeks out, I was back to my 3 miles/day on the eliptical. Everyone is different, so just make sure you listen to your body. And make sure your PS is on board before you resume your normal workout routine. You don't want to undo anything after going through such a surgery. I'm very glad I did it (didn't have a choice due to radiation damage to my skin that had opened up), but I'll tell you for sure about my result after my exchange surgery. I'm ready to get this rock hard TE out, that's for sure (how soon we forget! It had been 3 years since I had gone the TE route the first time) Good luck to you!
Tangles - So sorry for your discomfort and dissatisfaction with your result. I hope things improve for you. I think we've suffered enough by this point in our treatment, so it's not fair that your pain is continuing. Hugs to you!
Kathy
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thanks Kathy for telling me your experience. Wow, you went back to work at 3rd week! I told company I would take 4 weeks off. I hope I can be like you and can get my energy back by the time when go back to work. When did you start stretching and lifting your arms after the surgery? Did you get a pt to help? How's the scar on your back? Is it visible? I am skinny and I don't have much fat on my chest. So when PS asked me how big I want for the new breast, I said between B to C is good. I was B before. I think it will be easier to expand the skin for a smaller size? But I also worried if it looks natural for skinny person to get implant? Anybody is skinny and how your new breast look like?
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