Latissimus myocutaneous flap
Hi
I would like to know if anyone has had this procedure? I had breast cancer 15 years ago and then treated with radiation. Breast cancer returned this year and I had a double mastectomy. I decided to go flat. One side healed normally. The other side due to radiation damage with the skin and underlying muscle and tissue did not heal right. A portion of it has healed to my ribs . Plastic surgeon said he could repair with this procedure. It involves a lot more than I thought I might need. I am very apprehensive because I don’t want to trade one problem for another. Any help in this surgery would be greatly appreciated.
Thank you
Comments
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@sandyk1 - We welcome you to the BCO community, though we’re sorry for the circumstances that brought you here. It’s completely normal to feel apprehensive about another surgery, especially after everything you’ve already been through. You’re definitely not alone in weighing the pros and cons of these reconstruction options, and we hope other members chime in soon with their experiences and support. Until then, you might find this page from our main site helpful as you consider your surgeon’s recommendation: Latissimus Dorsi Flap, TDAP Flap, and ICAP Flap Reconstruction Procedures
We hope this helps, and we're looking forward to hearing more from you soon.
Best,
The Mods
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Hi @sandyk1 -
Sorry you have had to join this not so exclusive 'club', but glad you have found us.
I had a lat dorsi flap as recon on one side. I had to google lat myocutaneous flap as I had not hear of that. It sounds like myocutanous flap is a SUBSET of the lat dorsi flap.
In your case, as I understand it, they would be doing the flap to repair damage done by radiation and you would still be flat? It sounds like the type of flap you are doing was kind of a predecessor to ps realizing they could use this for breast recon. I found this article in case it helps:
In my case, I was happy with the procedure and haven't had any lasting problems. My breast surgeon did set me up with some PT as soon as my PS cleared it just to be sure my muscles got completely healed.
I have heard of several people with issues as a result of their lat flap. Often, I think this is related to how experienced the ps is at doing flaps. So, the most important thing is to be sure that is the case.
Good luck to you.
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Hi @sandyk1,I haven’t had this surgery but @mandy23 gave you good information on it. Soon after radiation I had a thermal burn which affected my face, torso including both breasts, and left arm/hand. The burn surgeon did laser surgery on the areas with the most scar tissue, my hand and the left trigeminal nerve on my face, to minimize scar tissue. He wanted to use the laser on my radiated right breast but because there had been a tumor there it was contraindicated by the manufacturer.
I’ve managed the breast pain with gabapentin and other tricks but four years later I am dealing with neurological issues in my right arm. There is no diagnosis yet but one of the differentials is scar tissue compressing the cervical nerves leading to the brachial plexus, an atypical presentation of thoracic outlet syndrome. For that reason there is a good argument to have the surgery to repair the tissue stuck to the ribs. I don’t blame you for wanting to avoid another surgery but I now wish my scar tissue had been dealt with years earlier when it would have been easier to repair the damage.
All the best going forward.
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Thank you for you responding to my question. I’m so unsure at this point to do anything else. I was very grateful I did not need any chemotherapy. The cancer was right up to the chest wall but had not broken through. Lymph nodes were clear. I had grade 2 DCIS with comedo necrosis.
The first cancer 15 years ago was grade 1 DCIS. Lumpectomy followed by 6 week’s radiation. No chemo.
I had complications with the right side and needed a second surgery. Infection and a hematoma.1
