Latissimus dorsi flap reconstruction

1517

Survivor Sisters,
I need some advice and some feed back on the Latissimus dorsi flap surgery. I haven't heard much about it. My PS thinks this would be the best surgery for me. I had a right side mastectomy in February of 2008 and had the expander but because of fluid build-up and infection it had to be removed. Any information on this reconstruction would be help full.
I am also concerned because I am still so sore. Is this normal or does it also just take time??

ohilly

had this surgery, too
Hey, 1517, I had lat flap surgery twice (two mastectomies, one for cancer in January, and the other preventive because I am BRCA 1 on Sept. 18). The experiences were somewhat different: the first time I experienced incredible pain for an entire month, which then completely went away (I'm sure your soreness will go away, too). The second day out from this surgery, my drain accidentally got snapped off which caused fluid build up to the point that after many aspirations, the drain had to be surgically re-attached. For the more recent mastectomy and lat flap, I did not experience pain at all (I'm not sure why) but I am still have problems with fluid build up. They have now aspirated it twice and it continues to build up. How did this problem of fluid build up get resolved for you? It is getting really tiring being aspirated and having it build back up.

Regarding the lat flap itself, my reconstruction looks pretty good except that I have big scars. I had a 'one step' procedure in which they took tissue from my back and did an implant all in one surgery (not the tissue expander thing). I am very satisfied with it, and if I had to do it over, would do the same thing as long as it could be done in one step. Actually, my biggest concern is the fluid build up thing, which I read on the internet is very common with lat flap.

Hope this response helped you. If you have any ideas about handling fluid build-up, please email me. Ohilly

1517

ohilly said:

had this surgery, too
Hey, 1517, I had lat flap surgery twice (two mastectomies, one for cancer in January, and the other preventive because I am BRCA 1 on Sept. 18). The experiences were somewhat different: the first time I experienced incredible pain for an entire month, which then completely went away (I'm sure your soreness will go away, too). The second day out from this surgery, my drain accidentally got snapped off which caused fluid build up to the point that after many aspirations, the drain had to be surgically re-attached. For the more recent mastectomy and lat flap, I did not experience pain at all (I'm not sure why) but I am still have problems with fluid build up. They have now aspirated it twice and it continues to build up. How did this problem of fluid build up get resolved for you? It is getting really tiring being aspirated and having it build back up.

Regarding the lat flap itself, my reconstruction looks pretty good except that I have big scars. I had a 'one step' procedure in which they took tissue from my back and did an implant all in one surgery (not the tissue expander thing). I am very satisfied with it, and if I had to do it over, would do the same thing as long as it could be done in one step. Actually, my biggest concern is the fluid build up thing, which I read on the internet is very common with lat flap.

Hope this response helped you. If you have any ideas about handling fluid build-up, please email me. Ohilly

Thanks so much for the
Thanks so much for the response. I don't have the problem of fluid bild up right now but have heard of compression garments that help with that. Make sure you ask your PS and see if they can give you any ideas that will help. Thanks Ohilly!!

jamiesue1

Hi 1517, I haven't heard of
Hi 1517, I haven't heard of this procedure. I am having the DIEP flap recon. in January. Have you heard of it? He removes the fat and tissue from your stomach (no muscle cut) and builds breasts from it. So basically you get a free tummy tuck and any size boobs you want all covered by insurance. You have to have a tummy for this procedure. There aren't too many doctors that do this procedure so you would have to look into it. It's considered the new gold standard. I think it's because so many of these kind of procedures require cutting of muscle, which is a longer recovery and it leaves you with a weak stomach. Sorry I can't tell you more about your procedure.
Jamie

1517

jamiesue1 said:

Hi 1517, I haven't heard of
Hi 1517, I haven't heard of this procedure. I am having the DIEP flap recon. in January. Have you heard of it? He removes the fat and tissue from your stomach (no muscle cut) and builds breasts from it. So basically you get a free tummy tuck and any size boobs you want all covered by insurance. You have to have a tummy for this procedure. There aren't too many doctors that do this procedure so you would have to look into it. It's considered the new gold standard. I think it's because so many of these kind of procedures require cutting of muscle, which is a longer recovery and it leaves you with a weak stomach. Sorry I can't tell you more about your procedure.
Jamie

Jamie,
Thanks for the info.
Jamie,
Thanks for the info. Just read an article in our paper about this procedure. Will look into it. Good Luck with your surgery. and God Bless.
Sharon

seof

I like to be able to read
I like to be able to read and re-read information, so I ordered a book from the ACS online bookstore. It is "The Breast Reconstruction Guidebook" by Kathy Steligo. It is very informative, but not too much. You could try that, or talk to a plastic surgeon who specializes in reconstructive surgery.

As far as the soreness goes, I think it is not surprising considering that you had an infection and had to have the expander removed. i had a bilateral mastectomy with expanders in Dec. 2007 and still have occasional sharp pains, or tightness in the muscles when I over do it. If it keeps on or gets bad enough to keep you from functioning, talk to the Dr.

I plan to have reconstruction bilaterally with tram or diep in June because I work in Public schools and I hope doing it in the summer will give me time to recover without having to take time off from work. I talk to the surgeon in Jan.

I hope the surgery goes well for you.

Best wishes, seof.

1517

seof said:

I like to be able to read
I like to be able to read and re-read information, so I ordered a book from the ACS online bookstore. It is "The Breast Reconstruction Guidebook" by Kathy Steligo. It is very informative, but not too much. You could try that, or talk to a plastic surgeon who specializes in reconstructive surgery.

As far as the soreness goes, I think it is not surprising considering that you had an infection and had to have the expander removed. i had a bilateral mastectomy with expanders in Dec. 2007 and still have occasional sharp pains, or tightness in the muscles when I over do it. If it keeps on or gets bad enough to keep you from functioning, talk to the Dr.

I plan to have reconstruction bilaterally with tram or diep in June because I work in Public schools and I hope doing it in the summer will give me time to recover without having to take time off from work. I talk to the surgeon in Jan.

I hope the surgery goes well for you.

Best wishes, seof.

seof,
Thanks!! Talked to a
seof,

Thanks!! Talked to a someone tonight that is 14 yrs. cancer free and still has soreness at times. Guess that reminds us that we're still going strong.

I work for a Catholic school so will try to mine in the summer also. The best to you and God Bless.

gemsa

1517 said:

seof,
Thanks!! Talked to a
seof,

Thanks!! Talked to a someone tonight that is 14 yrs. cancer free and still has soreness at times. Guess that reminds us that we're still going strong.

I work for a Catholic school so will try to mine in the summer also. The best to you and God Bless.

Lat flap shorter recovery than tram
I had a lat flap reconstruction following a failed TRAM, and the recovery was much easier. The result is pretty good, can't notice anything when I am wearing a bra. The scars are bad, but hey, it's better than having cancer!



www.tinakoral.com

GreeneyedGirl

Lat flap
Hi 1517
I am 10 days out from having the lat flap done on my left side. It went amazingly well, and I am healing up wonderfully. I was scared, but have not felt the kind of pain that i had expected to feel. I am only taking 2-3 pain pills during the day, and take 2 at night to sleep. I too had an expander placed after my mastectomy-but we did not get the volume we had hoped for stretching the muscle and skin (which had been radiated for treatment). So, we went for the lat flap, which the surgeon suggested in the first place-I wanted to try less invasive tactics-and wanted to try expander and implant. I still have drainage tubes in, but will see the doctor midweek, and he may remove them (no fun). My bandages are all clean and not terrible to look at. The incision on my back is sealed up from surgery and doc will change it at the 2 week mark.
I hope I have given you some insight, and would gladly answer any other questions-
Melanie

1517

gemsa said:

Lat flap shorter recovery than tram
I had a lat flap reconstruction following a failed TRAM, and the recovery was much easier. The result is pretty good, can't notice anything when I am wearing a bra. The scars are bad, but hey, it's better than having cancer!



www.tinakoral.com

lat flap
Gemsa, thanks for the encouraging news. Know it will be rough but what else is new!!

1517

GreeneyedGirl said:

Lat flap
Hi 1517
I am 10 days out from having the lat flap done on my left side. It went amazingly well, and I am healing up wonderfully. I was scared, but have not felt the kind of pain that i had expected to feel. I am only taking 2-3 pain pills during the day, and take 2 at night to sleep. I too had an expander placed after my mastectomy-but we did not get the volume we had hoped for stretching the muscle and skin (which had been radiated for treatment). So, we went for the lat flap, which the surgeon suggested in the first place-I wanted to try less invasive tactics-and wanted to try expander and implant. I still have drainage tubes in, but will see the doctor midweek, and he may remove them (no fun). My bandages are all clean and not terrible to look at. The incision on my back is sealed up from surgery and doc will change it at the 2 week mark.
I hope I have given you some insight, and would gladly answer any other questions-
Melanie

lat flap
GreeneyedGirl,
You and Gemsa have been very helpfull. I had posted on other web-sites but did't get much response. How long was your hospital stay and did you have alot of fluid build-up after the surgery?? (Know there will pain -- expect that!!)I had trouble with the fluid with the expander before they took it out because of infection and that wasn't pleasant.
What is the back pain like?
It's so good to be able to talk to someone!!
Thanks again!!
1517

GreeneyedGirl

1517 said:

lat flap
GreeneyedGirl,
You and Gemsa have been very helpfull. I had posted on other web-sites but did't get much response. How long was your hospital stay and did you have alot of fluid build-up after the surgery?? (Know there will pain -- expect that!!)I had trouble with the fluid with the expander before they took it out because of infection and that wasn't pleasant.
What is the back pain like?
It's so good to be able to talk to someone!!
Thanks again!!
1517

Lat questions
I had all those same questions. I stayed overnight at the hospital and was there maybe 24 hours total. I had no pain. Woke up with a pain pump connected to me, which I used--but I was only uncomfortable, like the mastectomy. And over the first 4 days just had that stiff sore feeling. I still have drainage tubes in as we write-and my fluid is draining well. My back doesnt hurt, a few times it has itched a bit. It is sealed up from being in surgery and we won't change it till this thurs when I go in, so that will be my first time seeing the back incision. I am able to be up and moving about, but still major bedrest--told I am to be the queen. Pain meds, maybe I take 2 total thru the day--but take 2 at bedtime, and one around 4 am just to help me rest real good. They gave me an arsenal of pain meds, but just haven't needed them like we thought I would.
I will check in tomorrow, let me know any more thoughts on this stuff. I came to this sight in Sept wondering all the same questions you are asking. You will find support and encouragement here.
GEG
Doctor also suggested that I prop myself up, and lay on my back to rest, sleep-because the pressure will encourage the fluid to drain, and being elevated will encourage the fluid to naturally drain down.

debbie7020

GreeneyedGirl said:

Lat questions
I had all those same questions. I stayed overnight at the hospital and was there maybe 24 hours total. I had no pain. Woke up with a pain pump connected to me, which I used--but I was only uncomfortable, like the mastectomy. And over the first 4 days just had that stiff sore feeling. I still have drainage tubes in as we write-and my fluid is draining well. My back doesnt hurt, a few times it has itched a bit. It is sealed up from being in surgery and we won't change it till this thurs when I go in, so that will be my first time seeing the back incision. I am able to be up and moving about, but still major bedrest--told I am to be the queen. Pain meds, maybe I take 2 total thru the day--but take 2 at bedtime, and one around 4 am just to help me rest real good. They gave me an arsenal of pain meds, but just haven't needed them like we thought I would.
I will check in tomorrow, let me know any more thoughts on this stuff. I came to this sight in Sept wondering all the same questions you are asking. You will find support and encouragement here.
GEG
Doctor also suggested that I prop myself up, and lay on my back to rest, sleep-because the pressure will encourage the fluid to drain, and being elevated will encourage the fluid to naturally drain down.

lat flap surgery
I'm having a double lat flap done Thurs 3-26-09 and would appreciate any info you can share about how everything is going for you. I'm concerned about the pain, the drains, and being able to do the things I do now, like lift my grandchildren and work in my yard...lots of raking....do you feel any weakness? Thanks...

GreeneyedGirl

debbie7020 said:

lat flap surgery
I'm having a double lat flap done Thurs 3-26-09 and would appreciate any info you can share about how everything is going for you. I'm concerned about the pain, the drains, and being able to do the things I do now, like lift my grandchildren and work in my yard...lots of raking....do you feel any weakness? Thanks...

no weakness, but it takes time
Hey debbie~ wow a double lat flap...I know the concerns you have. I really was frightened for nothing. The surgery went beautifully and I healed well. It has been 5 mo today since my surgery. I excersize and clean house vigorously-using the muscle just fine. For 2 mo I was very gentle and careful. No cleaning or heavy lifting. But eventually my body healed up and am able to do pretty much everything normal. I could not lift my grandaughter right after surgery-but after about 3 weeks I sat with her on my lap, being very careful. Since you have a double happening, you may have to be more creative in how you love on them. But I pick her up now, no problem. I will be praying for you on thurs. You will be back in your garden before you know it.
Melanie

debbie7020

GreeneyedGirl said:

no weakness, but it takes time
Hey debbie~ wow a double lat flap...I know the concerns you have. I really was frightened for nothing. The surgery went beautifully and I healed well. It has been 5 mo today since my surgery. I excersize and clean house vigorously-using the muscle just fine. For 2 mo I was very gentle and careful. No cleaning or heavy lifting. But eventually my body healed up and am able to do pretty much everything normal. I could not lift my grandaughter right after surgery-but after about 3 weeks I sat with her on my lap, being very careful. Since you have a double happening, you may have to be more creative in how you love on them. But I pick her up now, no problem. I will be praying for you on thurs. You will be back in your garden before you know it.
Melanie

lat flap reconstruction
Thanks Melanie for the info. How long were you in the hospital & how long were you under anesthesia? Were you able to empty your drain yourself? God has been so good to me, I know he'll be there for me this time too. I really want to get back to my grandkids as soon as possible, but the littlest one really is a clinger.

Did you need physical theraphy? I go to see the plastic surgeon tomorrow(day before surgery) not sure what he's going to do. I guess they'll mark me the morning of surgery. My general surgeon is going to inject me to do a sentinal node biopsy...not sure of the pain that goes with that procedure. I'm one that needs to know everything, I can handle it better if I know. Alot of doctors don't want to tell you much as they're afraid you can't deal with it. So glad you're doing well and it's been 5 months--hope you're feeling pretty normal. Thanks again for sharing your info with me. Will try to let you know how things go as soon as I am able.

God bless,
Debbie

debbie7020

GreeneyedGirl said:

no weakness, but it takes time
Hey debbie~ wow a double lat flap...I know the concerns you have. I really was frightened for nothing. The surgery went beautifully and I healed well. It has been 5 mo today since my surgery. I excersize and clean house vigorously-using the muscle just fine. For 2 mo I was very gentle and careful. No cleaning or heavy lifting. But eventually my body healed up and am able to do pretty much everything normal. I could not lift my grandaughter right after surgery-but after about 3 weeks I sat with her on my lap, being very careful. Since you have a double happening, you may have to be more creative in how you love on them. But I pick her up now, no problem. I will be praying for you on thurs. You will be back in your garden before you know it.
Melanie

Surgery went well
Hi Melanie,

I had the surgery 3-26(Thur) and was released from the hospital on Sunday. Had 5 drains, but they were taken out Tues. I have a big V cut on my back, feels really tight across the upper back. I find it easier to sleep in a recliner for now as I can get up by myself. I don't change positions while sleeping but sleep pretty well. I'm doing some laundry(light stuff) and some dishes. Went to get a bite to eat today, still can't sit back in the seat as my back is really tight. I think I'm doing better than I expected. Lots of prayers....work wonders. Hope all is well for you and thanks again for your information.
Debbie

GreeneyedGirl

debbie7020 said:

Surgery went well
Hi Melanie,

I had the surgery 3-26(Thur) and was released from the hospital on Sunday. Had 5 drains, but they were taken out Tues. I have a big V cut on my back, feels really tight across the upper back. I find it easier to sleep in a recliner for now as I can get up by myself. I don't change positions while sleeping but sleep pretty well. I'm doing some laundry(light stuff) and some dishes. Went to get a bite to eat today, still can't sit back in the seat as my back is really tight. I think I'm doing better than I expected. Lots of prayers....work wonders. Hope all is well for you and thanks again for your information.
Debbie

forgive me please
Debbie, sorry i havent' gotten back to you. Fog brain since all my surgeries. I couldn't remember the last time I had responded to you and just found it.
Glad surgery is over for you. and you had more drains than me-wow-5! I too like all the info and answers i can gather prior to the big event. I did not need physical therapy after the lat flap. I gave myself plenty of time to heal. It has been just the last 2 mo that I feel more my old self. I am exersizing and that has helped to strengthen the back muscles and help me not feel so unusual about the placement of the muscle in its new spot. Take it easy on that laundry and dishes. You will definitely know if you over do it. Take care and again I apologize for not getting back to you quicker. silly me. I do feel stronger-5 mo out.
M

Pinkwarrior

GreeneyedGirl said:

forgive me please
Debbie, sorry i havent' gotten back to you. Fog brain since all my surgeries. I couldn't remember the last time I had responded to you and just found it.
Glad surgery is over for you. and you had more drains than me-wow-5! I too like all the info and answers i can gather prior to the big event. I did not need physical therapy after the lat flap. I gave myself plenty of time to heal. It has been just the last 2 mo that I feel more my old self. I am exersizing and that has helped to strengthen the back muscles and help me not feel so unusual about the placement of the muscle in its new spot. Take it easy on that laundry and dishes. You will definitely know if you over do it. Take care and again I apologize for not getting back to you quicker. silly me. I do feel stronger-5 mo out.
M

Lat Flap
Hi everyone.
Just wanted to share my story with you.Dec. 2006 diagnosed with DCIS in both breast.Family history of BC.My sister of 50yrs. old fighting for her life with stage 4 BC.I opt for bi lateral mast. blessed with early detection.Surgery Feb,2007 with re construction-tissue expanders placement. All went well.3 weeks later suture line in right breast broke open.need less to say I got infection.expander had to come out.PS said that with skin so thin on that breast we would wait for body to heal and then we did lat. flap with tissue expander placement .it look great . and hardly no pain. Started expanding both breast after a couple weeks .Expanded to d cup and now I have nice c+ cup .very happy with all results.Yesterday 4/7/09 had nipple reconstruction and from what I could tell before my PS wrapped me up OH my THEY LOOKED WONDERFUL!I;ve had set backs with this whole process and have had pain,but nothing compared to what I saw my sister go through.She losted her battle march of 2008.There were times when I just wanted to throw in the towel,but I didnt.I'm 52 now and a survivor of many things.I recommend to live life till it wont let you live anymore.God Bless