post latissimus dorsi flap arm/shoulder/back problems?

kidsandliz

In 2003 had a left mastectomy with free tram flap (was stupid not to have bilateral in retrospect). Now I have a new cancer (IDC) in my right breast which was, fortunately caught early (showed up on breast MRI but NOT the mammogram, and on the ultra sound once they knew where to look). So I am thinking about the latissimus dorsi flap reconstruction since another free TRAM or DIEP isn't an option. Not enough butt fat to do that one.

1) For people who have had this, what kind of long term strength or movement limitations, or differences between your two sides, do you notice. I had read that there will be some movements that can no longer be done, that pull ups are not possible with that arm, that if you are on crutches or in a wheelchair for mobility that this will be greatly impaired, that tennis, swimming, golf, rock climbing (I do rock climb) will all be affected.

2) Does anyone know what cup size you can achieve WITHOUT implants? I really really don't want implants. I am between an AA and A cup size (I supposed I could have the other side cut down since I am not done with that reconstruction - failed nipple, a few other small problems).

3) How long is recovery? I am right handed, this is my right side, I teach so will have to write on the blackboard (so will this hurt to do this for a while???). How long is the acute pain, and how long does it take to be able to more or less take care of daily living in a house full of kids who can help some but can't be expected to do everything (I am single)?

My surgery is Friday and to be quite honest I'd just like to run away from home and not deal with any of it.

Thanks,
Liz

austinsmom

surgery
I don't have any answers but I am having the same surgery in March, so you will have to let me know how your surgery goes. Where are you having your surgery? Wish you much luck. JJ

kick-ca-ass

June 2009 I had bilateral
June 2009 I had bilateral mastectomy with expanders. My right breast looks a little off because they took more tissue and lymph nodes. My plastic surgeon now recommends the latissimus flap when we replace the expanders with implants to make it look more natural and like my left breast. I'm concerned about the same issues as you; activities and general use involving the lack of that muscle. One previous posting mentioned wearing a tight corset post surgery to prevent seromas or fluid build up in the back that may need aspiration in the doctors office. I thought that was a great idea. she also said to sleep elevated to allow the excess fluid to drain down. Look for previous postings on this subject.

GreeneyedGirl

kick-ca-**** said:

June 2009 I had bilateral
June 2009 I had bilateral mastectomy with expanders. My right breast looks a little off because they took more tissue and lymph nodes. My plastic surgeon now recommends the latissimus flap when we replace the expanders with implants to make it look more natural and like my left breast. I'm concerned about the same issues as you; activities and general use involving the lack of that muscle. One previous posting mentioned wearing a tight corset post surgery to prevent seromas or fluid build up in the back that may need aspiration in the doctors office. I thought that was a great idea. she also said to sleep elevated to allow the excess fluid to drain down. Look for previous postings on this subject.

Oct 08 Lat flap done~
~Hi Liz,
I will try my best to answer your questions. I had a lat flap done on my left side in Oct 08. I was on the rest/take it easy train for 4 weeks, easing back into a routine over the next 2 after that. I found it "strange" to feel the muscle in it's new home, but over time it has felt more a part of me. It took time to resume duties, easing back in~like unloading the dishwasher one dish at a time, telling myself "at least I can do this, it may take me longer but i can do it". Also unloading the washing machine had to be done "one item at a time" just to allow my body to become accustomed to this new body part. I also didn't want to "undo" anything that I had just worked so hard to come through. By 6-7 weeks out tho, I was out shopping for the holidays with girlfriends (they carried my heavy bags) and feeling more like myself. I did notice it took me longer to lift and slide myself like in a sitting position, using that arm/muscle (and I am not a big person). But now that I am over a year out, it feels very much a part of me. I will resist anything that strains the muscle and doesn't feel right. My doctor said it can get over used and sore just like any muscle, but that i should get along fine. One note~ is you cannot wear an underwire bra with a lat flap~the underwires pressure can cut off the circulation of the muscle. So, that he told me was a no-no. I have found wire free bra's to be easy to find, and very supportive and comfortable.
You can private message me, if you have other questions before surgery. I was so scared before I went in, thinking it was really going to be painful. It was not for me. I followed doctors orders and healed up beautifully. Just got back a month ago from a vacation in Mexico, swimsuit~swimming and all.
wishing you a great outcome~ Melanie

kidsandliz

GreeneyedGirl said:

Oct 08 Lat flap done~
~Hi Liz,
I will try my best to answer your questions. I had a lat flap done on my left side in Oct 08. I was on the rest/take it easy train for 4 weeks, easing back into a routine over the next 2 after that. I found it "strange" to feel the muscle in it's new home, but over time it has felt more a part of me. It took time to resume duties, easing back in~like unloading the dishwasher one dish at a time, telling myself "at least I can do this, it may take me longer but i can do it". Also unloading the washing machine had to be done "one item at a time" just to allow my body to become accustomed to this new body part. I also didn't want to "undo" anything that I had just worked so hard to come through. By 6-7 weeks out tho, I was out shopping for the holidays with girlfriends (they carried my heavy bags) and feeling more like myself. I did notice it took me longer to lift and slide myself like in a sitting position, using that arm/muscle (and I am not a big person). But now that I am over a year out, it feels very much a part of me. I will resist anything that strains the muscle and doesn't feel right. My doctor said it can get over used and sore just like any muscle, but that i should get along fine. One note~ is you cannot wear an underwire bra with a lat flap~the underwires pressure can cut off the circulation of the muscle. So, that he told me was a no-no. I have found wire free bra's to be easy to find, and very supportive and comfortable.
You can private message me, if you have other questions before surgery. I was so scared before I went in, thinking it was really going to be painful. It was not for me. I followed doctors orders and healed up beautifully. Just got back a month ago from a vacation in Mexico, swimsuit~swimming and all.
wishing you a great outcome~ Melanie

Melanie - how do you private message?
How do you private message someone?

I'd never look good in a swimsuit. 63.5 inches of scarring from a free tram flap (on the other side) that had some messy complications.

Liz

pinkkari09

No answers but having a
No answers but having a latissimus dorsi flap myself on 2-11-10...scared and hoping it all turns out ok.
big hugs,
Kari

GreeneyedGirl

pinkkari09 said:

No answers but having a
No answers but having a latissimus dorsi flap myself on 2-11-10...scared and hoping it all turns out ok.
big hugs,
Kari

Private Message
Go to CSN Email to the left of the screen in the brown section. You then go to send a private message and put my name GreeneyedGirl in the to spot!
Type away and send it!
Melanie