Bulge on side under arm after LD recon

Hi,
I had a LD flap reconstruction with expander 5 weeks ago. I haven’t started being blown up yet, but I am concerned that the bulge to the side of the implant/recon is massive! It feels like I have a tennis ball under my arm and I can’t put my arm down straight - I have to hold it out at an angle. I also feel that I look weird unless I wear baggy clothes.
I have been for Ultrasound to see if there was a collecton of fluid there, but it is not fluid, it is solid tissue.
Is this normal? I would be grateful to hear from anyone who has had the same operation.
I see the consultant again in 2 weeks so would like to know if it should be saying: “What are you going to do about this big bulge???” or is this something that would settle with time?

Hi I had LD recon in november with implant,i also have a bulge near the armpit my ps said it is the end of the implant. My op was a while ago now but do think you will still have a lot of swelling as it is still early days for you. But do still mention it.I have only just finished being expanded but have had problems with my skin due to radio. Hope it goes well for you. Helen xx

Hi Laika - I had an LD reconstruction in June 2007 and at first the lump under the arm felt like a big rock. Although still there it doesn’t feel as bad. I (and a friend who had the same done) was told it is where the back muscle is threaded through and that it won’t alter so stuck with it.

2 other ladies I know haven’t got the lump at all.

I have an appt on Thursday and hoping for a date to go in for the “dog ear” to be taken off. I have a tissue expander in but didn’t need it and breast nurse said the surgeon will take that out and put an implant in which will be softer than the expander because I had radiotherapy after and its so hard.

Nearly 2 years later I find the recon so uncomfortable, some days worse than others but would do it again !

Liz x

Hi ya had LD 4 weeks ago at first the bulge was massive but have been massaging my scar and the offending area with boots scar serum and it really seems to have done the trick …x

Hello Laika

I too have a bulge and like others have said was told it is where the muscle is threaded through.

It’s nearly a year since my ld flap and I’m now considering what to do re an implant - I haven’t got one atall, but may opt to stay lop sided as I’m wanting to be able to feel underneath it ‘just to check’ for mysterious lumps etc…

As Lizzie says, even some time on I still find it all very uncomfotable. I don’t know that I’d do the same again though… impossible to say isn’t it! The surgeons do try hard for us, but they don’t know what it’s like to live with it…
Td xxx

Hi,
Thank you for all your answers; it seems to be the luck of the draw whether you get ‘the bulge’ or not. I suppose if it is the muscle then I am stuck with it, but it is so uncomfortable and unsightly. Maybe I just had a massive muscle!

I am trying the Boots scar serum and Bio Oil in the area to improve the skin which is badly damaged by the radiotherapy - hopefully it will help with the bulge too - anything is worth a try.

Lizzie52 - did your bulge actually decrease in size or just feel better?
And what is a ‘dog ear’? I’m baffled. lol

Hi Laika

The bulge doesn’t feel as big when I put my arm down but looking at it it does - if you understand what I mean. Somedays it feels very uncomfortable and feels like a rock again. I suppose it depends what I have been doing. After nearly 2 years I was hoping to feel better than I do. I am actually at the hospital this afternoon to see the surgeon and breast nurse. I hope to get a date to go in for the “dog ear”.

This is the flap of flesh left over when all the swelling goes down and does actually look like a dog ear. Just excess flesh and I want it cutting off as gets very uncomfie under my bra. Also with having the tissue expander in the port is just where my bra is underneath so will be glad to get rid of it.

I still feel as though I have a big elastic bad round my boob and its being tightening - some days worse than others. But it is a lot easier as months go by

Liz xxx

The ultra sound showed that the expander implant was quite far into my armpit so that is probably contributing to the (large) bulge.
There’s not much I can do about that as that will have to stay until they finish blowing me up.
The expander is soooo hard; it feels like they have inserted a glass paperweight under my skin. The muscle which hasn’t yet realised it is no longer on my back, tightens around it in a vice-like grip, often for hours. I hope it will start behaving itself soon. This was something I was not warned about and it is worrying to hear that it still can do this after 2 years.

I haven’t got anything resembling a ‘dog ear’ but I suppose it is still early days for me. Are you still being expanded after 2 years?

Hi Laika - nobody tells you about the muscle contraction. It just sounds such a good idea having this type of reconstruction. It does get easier with time but mine still jumps when I cough etc but not as much. I am waiting for the day when it will just sit there !

Although I have an expander in - I wasn’t expanded. I was told I would have an implant in and it was only when I was being discharged the sister on the ward said that I had the expander and couldn’t answer the question why he did that, nor could the breast nurse. I think it was because I was having chemo (and with each chemo the boob seemed to feel worse ) and radiotherapy. The expander has gone very hard with the radiotherapy. I saw my surgeon last week and he is going to replace the expander with an implant and I am just praying that it will feel better than it does. It drags me down some days. He also said that he will lift the other boob up to match but can only do that about 3 months after.

It does get easier but it’s certainly taking it’s time.

Love Liz xx

Hi liz,
They did say that the muscle would ‘twitch’ but not that it would go into spasm for hours making even breathing difficult!
I originally had lumpectomy and rads 15 years ago but then got widespread DCIS in same breast so had mastectomy and LD flap.
I have the expander in place but it has not been expanded yet due to problems with the skin from the radiotherapy I had 15 years ago. It is very thin and not responding well to the stretching. The flap looks good though.
The surgeon did say when i complained about how hard it was that the implant will be softer than the expander, I do hope so.
I was thinking of going up a cup size and then having the other side done to match, but now I am beginning to wonder if I’d have been better of with the straight mastectomy. Time will tell I suppose…

I’m three years on since LD flap reconstuction with implant and I had nipple recon and reduction on the other side some months later. I can still jump the reconstructed breast around at will, but I’m totally accustomed to it and don’t even notice when it tightens of it’s own accord, when I’m working that arm for instance. I too had a bulge under that arm but it doesn’t seem so big now, perhaps it’s smaller or maybe I’m just used to that too, I can’t say for sure. As you said yourself, time really does make a difference to one’s perception of these things.

I wish you a speedy recovery and hope any further ‘tidy up’ surgery is as problem free as mine was. It’s a lot to go through and you’ve done well to get over the worst. The very best of luck to you and other LD flappers on this thread :slight_smile:

Hello Ladies

I’m on the waiting list for an ld flap reconstruction with expander - your comments have certainly got me thinking! Should have surgery July/August - any advice??

Lynda x

It seems that everyone’s experiences are different. I had the expander put in at the same time as my mastectomy so it probably feels much worse than if you have it done later when all the swelling and bruising has gone down and the muscle has had time to settle down.
Even now, 6 weeks after the operation, the boob around the flap is still the most awful colours of bruising and scares the life out of me when I pluck up the courage to look at it!
It is certainly worth reading through the previous threads on here, I wish I had found this site before I had my operation.

Thank you everyone who has taken the trouble to reply to my post, it has helped to know there is some light at the end of the tunnel :slight_smile:

Hi All- thanks for your posts. I am considering whether or not to have LD (the only recon available to me for various reasons) but it sounds like there is such a lot involved. Are you all glad you did it, or thinking back, do you kind of wish you saved yourself the time and hassle and kept on with the prosthesis?

I would not do it again without a 2nd opinion and a different surgeon - a competent one without an ego.

Like you, the only option available to me was the LD flap. I am 4 months on and overall I am glad I had it done. In a bra I look quite normal, the reconstruction gives me a cleavage which you cannot achieve with a prosthesis. Four months on from the op, the pain and swelling have subsided, but I do have some discomfort from the expander which is still being inflated every few weeks. Hopefully when I get the proper implant fitted it will feel much softer.
The reconstruction itself is a good shape but that’s about all I can say about it. It does not have any sensation and will never feel like my real breast. I haven’t noticed any particular weakness in my back. The muscle does get tight sometimes but my PS said she could deaden the nerve when I go back to have the silicone implant fitted. I still have a bulge under my arm, but the PS said this too can be addressed when they fit the final implant.
I knew as soon as I had cancer that my body was going to change for the worse. Personally, I feel more normal having something there to balance things up even if it is not a real breast.

hi all I am 3 months on from recon … the bulge under my arm has shrunk considerably …get the muscle twitching in my boob but I seem to be getting used to it …I too have no sensation on that one and although it looks fab in a bra … without …theres a different tale but as my first attempt at recon last year went horribly wrong and had to be deconstructed in march this year I am overall pleased with the result I am due to go back to the PS on 21 of this month and suppose a new nipple may be discussed .
The only thing I find really annoying is the back scar tingles constantly but I am learning to live with it …hope you are all doing good xxxxx

Specifically for feebones - yes I am so very glad I had an LD flap. See my recent comments under another post along the lines of “DIEP or LD?”

I had and LD Recon with implant immediately as I didnt need Chemo or Radio. I have to say , my experience seems much better then many I have read here. Exactly 1 month today since my surgery and already it looks great with clothes on. The scabs are nearly all off and the scar seems quite thin and light compared with my previous C-section scars.

Only a very small bulge under the arm, but there is a quite definite channel of missing tissue just below the breast on the side that looks a bit like someone wearing a bra with too tight a back strap that digs into the flesh.

Not sure yet how the pain, tingling and loss of sensation will change over the long term, but extremely happy with the results so far.

Mandy

Hi I had my LD recon in June 2008 and was told it takes over a year to settle down. How right they were. I had a bulge under my arm but with constant exercising and massage it got flatter. It may interest you to know that I was recently diagnosed as having lymphoedema in that area and have been given some massage techniques to do. The physio also told me that apparently it is very common to have some kind of swelling after surgery as it is the body reacting to surgery and protecting the tissue around the affected area. The massage has worked amazingly well and is now flatter than the none recon side.

I am really pleased with my reconstruction - it looks and feels fantastic and I do not regret having it done.

K xxxxxx