Latissimus Dorsi Breast Reconstruction
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junesummer - Keep in mind that most often people who post are those with complications or those presently going through the surgery. I started posting on this topic when I was contemplating it. I seriously considered quitting while I was ahead but now that it is long over I'm very glad I had it done. I'm glad to look fairly normal again. I have had 11 surgeries in 2.5 years. I would describe this one as the most difficult next to my BMX. My BMX was by far the hardest as I had D cup breasts removed. It seems most people turn the corner around the 6 week mark. I think I was back to work around one month and a couple weeks later I was doing much much better. Not 100% but a lot better.
When I talked with my PS I recounted the many nightmares I read on here and made it perfectly clear that chronic pain or disability was not an option. I'd rather skip reconstruction than to impair my quality of life. I went ahead with the surgery because he told me that these things were not going to happen. I trusted him. I would be very upset if I could not run or do the things I enjoy doing. It's not worth it. I am glad you're going for PT in advance. I don't see many who are prescribed PT ahead of time and I suspect it helped my outcome. You'll need help when you get home and I expect a week of company will be beneficial. It's good to have wonderful friends.
Seachain & nash - I don't want surprises in the operating room. I want to be carefully evaluated in advance and given accurate information about risks and expected outcomes. That should include a careful examination of my current condition and lifestyle.
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seachain, your back looks like mine.
My PS says she has never had anyone with problems like mine. Maybe I am very unique. Maybe she is lying.
She did my 2007 lumpectomy, is nationally respected and heads up the breast center at a major teaching hospital. Lat flap is her speciality and she was fully aware of my lifestyle and body type.
I had no reason not to trust her or think she and I were not on the same page. Nowhere have I seen info about the issues I have had so how could I have known to ask? When lat flap risks are discussed no one mentions a persistent iron corset. I have no issues with function or ROM. I simply feel like I am being crushed to death 24/7 with no end in sight. Maybe it's primarily from the mx. Maybe it's from the Lat flap. Maybe it's a combo of the two. I know some diep gals end up with iron bra and the sensation of an iron girdle. Frankly I think it's all a crap shoot
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And I mainly post my woes in hopes that someone else has had a similar experience and can help me. I do believe most people will do fine with Lat flap. Like Joanne said there is no pat answer to whowill do well and who won't. I do however caution people with strong lats to possibly consider another option.
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I am scheduled for a unilateral mastectomy and reconstruction on May10th. I am having a terrible time deciding between the latissimus dorsi reconstruction or the one that uses the fat and muscle (diep) flap reconstruction. I have done a lot of reading and sometimes I am leaning toward the latissimus dorsi and sometimes the abdomen. Would you be willing to share why you chose the latissimus dorsi breast reconstruction? or was this your only option?
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I'd go for DIEP. DIEP doesn't use muscle, only fat. TRAM flap uses muscle. If you have a good PS in your area specialized in DIEP, chose DIEP over anything else, just because it doesn't involve any muscle being used.
That is what I wanted to do unfortunately in my area there were only PS that were specialized in TRAM and LD flap. As I had a micro-C-section in the past, I didn't know what the TRAM would do to an abdomen that already had some cut muscles that is why I went for LD - that and the assurance of the PS that I won't have issues - yea right.
My opinion is - do DIEP. If you need the skin flap. If you need no skin flap go the simple TE+ implants or the one-step implant with Alloderm sling.
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sml, I agree with seachain that the best option is to not have any sort of flap if you can avoid it. The less cutting, the better. I would have gotten just implants or TEs the implants had that been an option. The LD flap was my only option for a variety of reasons, and fortunately, I've done well with it. The DIEP has the drawback of a longer recovery time, from what I was told. That would have been a problem for me, but maybe not for you. Unfortunatly, no procedure is perfect. They all have their drawbacks. All you can do is gather the information then choose what seems best for your situation.Whatever procedure you choose, get a surgeon with lots of experience doing that procedure. Good luck with your decision.
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Hello everyone, I just recently joined this site and I have been reading posts from different members, I am currently on hold for breast reconstruction, I had a recent set back due to the radiated skin exposing my TE left side radiated, my PS took the left side TE and left me with one right TE inflated to 310 cc. I am currently nursing an open wound, changing the dressing once a day every day. I am waiting for this open wound to heal on its own and it will take some time. My PS plan is that let the open wound heals and once it healed we can continue the reconstruction process and he suggested Lat Flap since I will need a healthy skin and muscle to rebuild my left chest. Any suggestions from any of you is greatly appreciated. Also, how to be a member of the picture forum. I really would like a visual idea on how to proceed with my reconstruction down the road.
Again. thank you!
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MVP, - I, too, had a spot that didnt heal on radiated side, although that was with an implant. The implant was removed, a TE put in (with maybe 50cc). Some months later, I had LD flap and TE switched for small implant. It wasn't fun, but also not as bad as I feared. PE helped regain rom.
LD was my only option.
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anotherNYCGirl - I am just worried with this open wound, I don't know how long it will take for this to heal or close up, also worried what it would look like when it's healed. Right now I am lopsided my right breast has the TE and the left chest is an opened wound
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anotherNYCGirl - do you have breast implant after the lat dorsi surgery on both side of your breasts? I hope you don't mind me asking.
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MVP, - I have 2 implants, but only had LD on one side (the one that had radiation many years before). Along with the LD was skin graft from the back, so that added new un-radiated skin to the breast .
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anotherNYCGirl - you said lat flap is your only option, if you have other option which will you go for? Did you had a hard time in terms of recovery after the lat surgery?
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I am schudeled for this summer for mastectomy with reconstruction LF suggested but I'm concerned because I swim twice a week, play Pickle ball once a week and kayak. Will I feel pain and inability to do these sports
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MVP, - I looked into using tummy tissue for recon, but chose implants to avoid the invasive abdominal procedure with tummy flap. Implants have a high failure rate if there is radiated skin, and I was one of the failures. At that point I needed LD flap and skin graft to repair and rebuild that side.
I had pt after, but some women have pt before LD, too, and that seems to help a lot.
My ps insists that all prior activities can be resumed, however, I don't feel that yet.
Good luck with your decision!
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anotherNYCGirl - thank you for the information, it does helps me with my decision for the future recon of my left radiated breast
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Good morning everyone, I just wanted to say Hi and Hello to old and new members like me on this site. I am still waiting for my open wound to heal, today is the first time I took a shower without the wound dressing and bandage since my PS suggested to do so, at first I am worried and don't know what to expect but it went well, I let the warm shower runs through my open wound, no pain and I am glad that I did it. I have an appointment with my PS this coming Tuesday, he will need to introduce me to another PS. I am married to a US Navy (active). I go to a military hospital for my surgeries, my PS is retiring from the Navy soon, right in the middle of my reconstruction with him, I was hoping that he will finish what he started on January 6, 2016, but since I had a few set back I will end up meeting a new PS, which I am hoping that it's a blessing in disguise that the set back happened, for me to have a better PS and better reconstruction outcome. I will do my best to update whenever I can. You guys probably be bored about my story, I just thought to share it and maybe someone is in the same boat as me. Best regards to everyone!
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Hi Jo-5
Thank your for your response to my post, I appreciate it. So question, how long does it takes for this big of a wound to heal? You mentioned the nurses packs it for you for three weeks, so maybe eight weeks before it healed? Also, how the skin looks like when it healed? Does the skin fused together? because my wound is wide open and I pack it with silvercel every day, the skin are separated from each other, I am just trying to imagine how will it look like when it healed.
My PS said that the wound will heal from inside out, does it mean the flesh will rise up as it heals?
Sorry too many questions, and it feels like I'm rambling.
Sometimes I blamed myself, maybe I went back to do Zumba to quick or too early.
Another thing, everytime I cough my left chest hurts (open wound side) but my right chest with inflated TE is fine. Is that natural?
I appreciate all the help I can get.
Marivic
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Jo-5
I did not meant to pry on your old wounds. I apologize for it. So if you don't mind my asking, what is the lat flap surgery you had for? if you said that you didn't had reconstruction. I will understand if you don't want to answer this question. You probably already posted your story on this thread of posts, and here I am asking you to repeat your story. I guess I will just continue reading the past posts. I am on page 20 already and there's a lot of posts to read. Have a blessed night...
Marivic
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Jo-5
Sorry to hear all of these happening to you, I do appreciate you sharing it again.
Reconstruction is not for every one, but I am just hoping and praying that I can have a successful outcome to whatever I started.
God bless you always!!!
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Two years ago April 25, 2014 my husband shaved my head so that chemo will not take my hair away from me, he then shaved his head to support me with this journey.
I thank God everyday for my wonderful husband and I love him very much.
Marivic
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I hear you. I did not shave mine, but cut it 1" short (from way below the hips length) before I started chemo. In some ways, because I had immediate reconstruction, thus I didn't see myself completely without breasts (if the shapeless lumps I wore on my chest for 1 1/2 years before the total revision can be called breasts), losing my hair hurt more than losing my breasts. Now, thank goodness, I have both, even if the breasts have no feeling. I still can get a lot of perks, lol.
Yesterday I went to get a bottle of wine (had guests for dinner) and the guy at the liquor store gave me their "Tuesday 10% discount" on a Monday and also an invitation for a select group of customers wine tasting at the City Hall for May. I was wearing a tank top with spaghetti straps (similar to the one in my avatar photo) and my hair down the back in ringlets. A boost of confidence for sure!
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seachain - wow that is good perks, discount for bottle of wine. I really like my hair now after it grows back, it's only shoulder length right now but I am planning to let it grow like the hair that I used to have. Some ladies that I spoke to that mostly chemo hair grows curly like ringlets but as it grows longer that it seems get straighter. I don't mind either or, having my hair grow back is a wonderful thing.
Now I just need to grow a pair of boob to get some perks like you .
I have a PS appointment today and hopefully I will meet my new PS and get started with his plans with my reconstruction. My open wound seems to be healing good, slowly but it looks good, not infected thank God but slowly healing. That is okay by me as long as it's going to the right direction, besides I cannot do reconstruction until this heals and I'd rather have my hubby home with me when I do the Lat dorsi with TE This 9 months deployment is a big challenge but I will make it. Updating you guys later after I see my PS today. GOD Bless!!!!
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Back from the PS appointment, I have met the new PS, we did not discuss any further about the reconstruction since I am on the wound healing process right now. Hopefully this new PS will be much better than the one I have. So far so good. Thank you God for the blessings!!!!
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Hello everyone, I hope all is well. I would like to ask some advice and opinions from all of you.My PS mentioned to me that I am a good candidate for Lat Dorsi or DIEP, reconstruction, right now I have TE on my right chest inflated to 310 CC and I am nursing an open wound on my left chest. Here are some concerns that I need your input
:- My right chest is pretty much inflated and the skin is holding the TE well, should I just go ahead
and choose the Lat Dorsi for my radiated side which is the left chest (with an open wound right now) and have breast implants exchange to both breasts? - I am also considering DIEP but according to my PS I only have enough fats for only one breast, so I will end up breast implant on my right chest and DIEP without breast implant on the radiated side. Do anyone did one side DIEP without implants and the other side with breast implant?
- Also, I have some stretch marks on my tummy, so if I chose DIEP without breast implant for the left radiated side my stretch marks will be on the skin that they will use on the left radiated side?
- I am also concern about healing time and long surgery time if I choose DIEP.
- One more concern, I will probably need as much healthy skin for the radiated side because my PS will get rid most of my unhealthy radiated skin, will Lat Dorsi works if I need a big piece of skin? Will the back donor site heal well if they cut a big piece of skin?
Please give me some advice and ideas on how to proceed. Thank you.Marivic0 - My right chest is pretty much inflated and the skin is holding the TE well, should I just go ahead
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Bunny1966, I was concerned about being able to swim and canoe after my LD flap, but I have no pain or inability to do those things. When I perform movements that use the lat muscle, it does still tighten which is a rather odd feeling since it it now supporting my breast implant. But it's not painful and doesn't keep me from doing anything that I want to do.
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Good morning to All.
I hope that everyone had a great weekend. This question is to anyone who can shed some light to it. I have read from some of the postings here that Lat Dorsi Lap skin color is different from the original breast skin color. If you have a radiated skin and the PS will remove most of it to replace it with the back muscle and skin does it mean that the skin from the back will be lighter or darker?
I appreciate any input or advice.
Marivic
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Joann, thank you for your input. I never had suntan on my back either, so hopefully it will not affect the skin color. And as you said that the texture is just slightly different, that's good to know. Thank you, I appreciate you!
Marivic
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MVP, as Jo said, it depends on your skin. The skin from my back does not match the surrounding chest skin which was darkened by radiation. Any suntans or burns I've had on my back are irrelevant compared to what radiation did to my chest. This wasn't at all obvious before the surgery when we looked back and forth between chest and back trying to compare skin tone. The PS's assistant thought I'd have a good match. But now that the two are right next to each other, there's an obvious difference. Maybe you won't have this if the surgeon removes all the irradiated skin. Ask him.
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Hi 2Tabbies, thank you for your input, if my PS takes out all the irradiated skin do I have enough skin at the back to accommodate the breast? Also, if he cut big skin from my back I'm concern about the healing of the wound. Please advise.
Marivic
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I know that when there's not enough skin for a graft they put subcutaneous inflatable balloons under the skin. Maybe this is what he will use? Did you ask him this question?
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