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Implant recon or lat dorsi flap with implant??? Can't decide...

Posts: 33
Joined: Oct 2000

hi all,
well after three diff plastic surgeon meetings, i got three opinions! unbelievable....i am really struggling to make a decision. surgery is either the 3 or 4th of sept. both hospitals were bugging me to decide so i told them to go ahead and schedule.

i am young, thin and big-boobed, 34D so i'm not an easy case. tram flap is out, but the lat dorsi sounds appealing in that my own tissue is used to be more natural looking. i think either way i will have to reduce or life the other breast. anyone have any thoughts, opinions? the good news is my scans were all negative, did i mention that last time? oh well. take care.


Posts: 44
Joined: Jun 2002

Alas, I have no knowledge of the decision you must make. My one suggestion is to see if you can find someone where you live that is similar to you in body size, and ask them their experiences. It is only one, but it might help. You might also see if there is a breast support group sponsored by the hospitals where you are considering surgery.
In any case, my thoughts are with you.

Posts: 235
Joined: Oct 2001

Hi, dear, my daughter-in-law had a tram flap just 6 weeks ago. It has gone wonderfully well. She already wears T-shirts and looks just great. You mentioned no tram flap, but I agree with you that if you can use your own tissue, I surely would. That is then the end of that, no more worries. My Carmela is thrilled and very glad she took this course. The plastic surgeon did mention he will tweak the other breast and make them both more alike, but she is thrilled with what she has and is surprised he wants to do a little more. A perfectionist. When you shove them in a bra, it doesn't really matter, but he told her his professional pride wants him to do a little more. Congratulations on your scans. That is really good news. Good luck with your decisions, I think you are on the right track. Gentle hugs, Shirlann

Posts: 9
Joined: May 2002

Dear C:

The latissimus dorsi or back flap is usually only used when the TRAM flap isn't an option. It does remove muscle as well as skin and tissue; but it usually doesn't hinder future movement too much, unless you're a swimmer or a cross-country skier or somthing like that. The one drawback of the lat flap is that there's not much tissue there; it's usually used on very thin women (you said you were), and often used with an implant. It's also quite common to either lift, reduce or use and implant on the opposite breast to match the reconstructed breast. This is usally done at a later date, to better match the final look of the reconstructed breast. It is confusing....that's why it's so important to research your own options and make your own decisions. If you haven't already called Reach to Recovery (check the Internet or the American Cancer Society in your area), they can put you in touch with women who have had the same procedure. Ask for someone who's close to your body type and age. Did anyone mention the glute flap? That may be another option...they take the tissue from the lower buttocks (usually with the incision under the crease)...best of luck to you with your decision and procedure.


Posts: 1
Joined: Sep 2004

Dear Cathy,
I am not a candidate for the tram flap or DIEP(better than the tram they don't cut the mucscle), not enough to create 2 breasts. I went to see my plastic surgeon today and he told me he is going to use my latissimus muscle. I thought he was just going to put implants. I have a concaved chest (pectus) and scoliosis so I am really difficult to work on. My surgery is in
one week and he just told me that he is going to
use a man's silicon muscle implant to fill in the
cavity and then put the muscle over it and then
the implant with my own muscles over that. I have
tissue expanders in right now. I am really freaked out about him using a muscle in my back. Do you know anyone who has had this procedure ? I
am desparate to talk to someone. Thanks,

Posts: 8
Joined: Sep 2002

Dear cecramer:
What did you decide to do? I may be in the same boat as you and am confused.
Can you email at stashlil@aol.com?
I hope you are fully recovered and happy with your decisions. It sure is confusing!
Best, Lillyb

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