Hi folks. I am coming up to the end of my chemo, and next step is a mastectomy. (Already had WLE and axillary gland removal, but that was not enough as I still have DCIS on the path report).
I’ve pretty much decided against an implant as a) my breasts are large and b) I don’t like the idea of having something foreign inside me.
Has anyone on here any thoughts on the TRAM flap (taking fat and muscle from the abdomen) versus Lat Dorsi (taking from below the shoulder blade)?
I am just about getting my head around being single breasted for a while but I want to think long and hard about the recon. My breasts were always my best feature no more cleavage flashing for me.
I can’t speak for the Lat dorsi. But I had a tram flap in June 2005 and have never looked back! I had quite large breasts (36F). I had a recon on the cancer side and a reduction on the other size and now have two D cup breasts - evenly matched and can still sport a cleavage! I have subsequently had a nipple recon and an areola tattoo to complete the picture.
There is also the added benefit of a tummy tuck!
The operation was long - about 12 hours. I was in hospital for a week. I was out and about in week two and fully recovered after about 6 weeks. I would have no hesitation in recommending tram flap. I have never felt that I really had a mastectomy.
i can speak about the lat dorsi and for me it was fantastic, but i do only have a small bust and had to have an implant in as well, if your larger busted i think the tram is what they recommned, but please don’t quote me!!! have you looked on the "cancerbackup.org.uk? site, its got lots of information on both recons, or talk to the helpline on here
Hi,
Can i suggest that you ask about a DIEP. It uses skin and flesh from the tummy but no muscle. This means it is a faster recovery and you don’t have to sacrifice any loss of strength. LD also uses muscle. My plastic surgeon will only perform a Tram if the blood supply isn’t good enough for a Diep. This doesn’t happen often, usually only with smokers.If your surgeon doesn’t offer this op you shoud ask to be refered to someone else.
Regards
Kelley
You are also welcome to call our confidential helpline for further support and information on 0808 800 6000, it’s open Mon-Fri 9am-5pm and Sat 9am-2pm.
Have a look at www.optionsforbreastreconstruction.com which might help in your decision. I am 5 ft tall, size 12 with 34C bust. Had mast with immediate lat dorsi and overall am pleased as I still have a shape tho I have a dent so no cleavage flashing for me. I am told that can be sorted out not sure how tho! I have suffered with nerve pain which aint too great but this happens in a minority of women. I live in North East Scotland and am told that only 1 or 2 other lat dorsi patients have had this nerve pain. I am now on a painkiller which has helped immensely but the nerve pain may be around for some time i.e. andything from 3 months to 12 to 18 months. I also needed a small implant which I had hoped to avoid. Almost 2 months post op now and not able to drive, swim, or even walk too far or do too much in the house without my back and new boob going into spasm. Consultant says he had to go in deeper due to my lack of height.
I do see many ladies on here with no problems but think that most are much smaller in the bust than you are and they are active around 6 weeks post op with no pain. Good luck in your decision, trawl the net for more information on options and take care.
Oh, thank you everyone that is really helpful. Carole, I am really sorry to hear about your nerve pain, what a trial that must be and I hope they can do more for you as time goes on.
I have read about the DIEP flap, but it is not on the DVD they gave me to watch, so not sure if it is available or not - I’m seeing the plastic surgeon at the end of the month and will ask. From what I hear he has an excellent reputation (I am at the QE in Birmingham) so hopefully that would be possible provided I am suitable for it.
I dearly wish I could have a simultaneous recon but my oncologist is keen to irradiate the scar, not a recon breast, and I guess at the end of the day it is preventing recurrence that matters not low-cut tops!
Great advice as ever, thanks everyone, and would be interested to hear from anyone who has had DIEP or TRAM flap, especially recovery time and time for the abdomen to heal as I am most reluctant to give up my regular horseriding for long
hi.
i just want to add i had ld on DEC 6th. i am recovering slowly a lot more slowly than some but about the same as Carole . i feel well in myself and a bit frustrated now i cant do as much. i think recovery may be quicker if you have more commitments i have none… i am 49 don’t work and my kids have all grown up and left home so i can plod around all day and my husband helps a bit. the worst thing was getting out of bath and still is a problem but i have mastered it now. i have problems with mine healing but that’s my skin not the op. i haven’t driven yet although said i could. i do get nerve twinges just like electric shocks but because i know they are normal it is acceptable. i have other pains which have only just started not sure if normal one minute across top then in cleavage. not all time so no infection prob all just settling down. i must put your mind at rest i am 38c and my shape is perfect and cleavage even better. if i wanted to wear low cut tops i could no problem bikinis will be fine. and i had extra large scar as incorporated lumpectomy one as well. people cant tell the difference i must admit in the beginning i was a lopsided Jordan … i also thought the new one would be very pert and not look so normal so i nicknamed it perky that was b4op but no need its perfect. go for it…
Carole lovely to hear someone progressing on my level i read some are out andabout after two weeks going to concerts etc and i would wonder if anything wrong with me…
have a good day all
xx julie xx
Hi Flyright
I had mastectomy and immediate recon with extended lat. dorsi. flap in Nov. 2007. You need to check with your surgeon if you have enough tissue to get away without an implant, usually up to b cup is possible. Mine is all me and I am very pleased with the result, I think the TRAM would be more suitable if you are a larger size.
Good luck
I had free Tram Flap 11.12.07 and very impressed with results and recovery.
My PS recommended this op as I did not have enough muscle on my back so would also have needed an implant, luckily just had enough on my tummy after much measuring. I also have a freckly back so skin wasn’t a match either.
The op is bigger and its supposed to take more recovery but my PS also advised gave the better result cosmetically, I was out of bed on day 3 (slowly) and home day 5. Managed to get out on small walks by day 12, now on week 6 and out walking for 2 hours yeasterday, managing housework (hubby is doing the heavy jobs) and PS has given the go ahead to drive and get back to work as soon as I feel confident. (also have 2 kids still in primary school to pick up after so didn’t get in the habit of resting too much) I did have 2 tiny little areas that took a little longer to heal, one on tummy and other under the new boob, but this turned out to be a stitch in each area refusing to disolve, they are now sorted. I am rubbing in loads of E45 and the scars are really smoothing. After 2 years I have a cleavage and no longer checking down my top that my prosthises isn’t on show.
Hi Flyright, I had pedicled bi lateral trams in Birmingham 8 weeks ago, and am recovering well, just been given the go ahead to drive and swim. Still feel very tired with some pain in the abdomen particularly at the end of the day, and one new breast is still painful, I had an infection, and I think some fat necrosis there. I’ve decided to take more time off work, not ready to face that yet. Good luck with your plans.
no more cleavage flashing for me.