Hi. I have finished chemo and saw my surgeon yesterday to discuss mx etc. Originally i was told that i was having an mx,immediate recon using my tummy and a reduction on my good side. The surgeon has now changed his mind. He wants to do an ld flap and then a reduction at a later date. Reasoning behind this is that the recon and reduction ‘might’ not match. Can anyone who has had an ld flap tell me what the recovery is like, time in hospital etc. And if anyone has has ld flap and reduction at the same time? Surgeon has said that i can have both done at the same time, but need to be aware of the risks, i just feel so battered by the whole cancer thing that i just want it done!
Thanks in advance
Kerry xxxx
Hi Kerry
LD flap uses the latimuss dorsi muscle from your back, which they thread through under your arm. You usually also have an implant (which is filled with saline at intervals). You can do without this muscle, as other muscles compensate. It does not affect your core muscles which affect your stomach/back.
I had an MX + immediate ld-flap recon end of Jan 2011. I was in hospital 6 nights. I had 4 drains, the last one comnng out on the day I left hospital. I was soon up and about in hospital and was given plenty of painkillers, although the pain wasn’t as bad as I thought it might be.
Although I religiously did the required exercises, I have had problems with scar tissue in my back restricting my shoulder movement, so I have been having physio for about a month and things are getting better. Things have generally been ok, but I have had my down times when I wondered when the discomfort would end.
I still have some restriction and weakness in my arm and shoulder but it is getting better and I expect it to improve enough so as not to restrict me long term. I am going back to work next week (phased return). If it wasn’t for the scar tissue, I’m sure it would have been earlier.
You may also wish to look at two earlier discussions on ld flap
breastcancercare.org.uk/forum/viewtopic.php?f=34&t=30371
and
breastcancercare.org.uk/forum/viewtopic.php?f=34&t=28834
Julie
Hi Kerry
I had mastectomy August 2009 after chemo (I had IBC and chemo before surgery is standard in that case),then 3 weeks of radiotherapy which meant I had to wait over a year for my recon. which I’d promised myself on the day I was diagnosed!
November 12th 2010 I had extended LD with adominal flap which means I’ve just got my mastectomy (fading fast) scar across my new boob! The scar on my back hasn’t caused me any problems. I didn’t have an implant. My surgeon advised me to wait until my new left boob is more or less finished before he does the uplift/reduction on my right one. He did give me the option but I’ve decided to take it stage at a time so I’ve got the best chance of getting a matching pair! The down side is ofcourse more operations, however I’m quite happy to take my time.
I’m 34C/D (bit of extra weight from chemo plus the fact I’m still on herceptin - suspecious spot on liver on first CT scan - no sign since and jury still out on that one so its my safety blanket!) but slowly but surely I’m getting back to normal - ish!!! I’m having my first lot of lipo fill on 20th may (I’ll probably have to have at least two lots but we’ll see!) from my stomach and inner thighs.
I’ve been very pleased with the results and its great to have a cleavage again and be able to wear lower neckline tops even though I’m still work in progress. Bust enhancers from Peacocks @ £5 a pair are great for slipping in your bra to even you out while you are a bit lopsided!
By what you say you’ll be having immediate recon so are spared rads! and the wait! Sounds good as you’ll not be without a boob and at least one less op! I was in hosp. for a week. I think the worst bit is having to lugg the drains around - mine were taken out while I was in hosp. but I’ve seen on some of the posts that some people go home with them.
Just realised I’ve rambled on a bit! Hope it’s of use. You should get some other comments and advice from some of the other fantastic ladies on here.
Take care and look forward, anymore questions please ask. You can PM me if you want.
Mandyxxxx
Thanks for replying Mandy and Julie, i really appreciate it:)
My main concern is that i will be lopsided if i dont have both sides done at once. I am a G cup, so need a reduction or will look even odder than i do now with bald head, no eyebrows or eyelashes and round steroid face:/ The surgeon has explained that he cant guarantee a perfect match, but i am willing to take that risk.
Feel like i have been through enough already, and my confidence is so low that having lopsided boobs would really tip me over the edge. Totally admire anyone that can do though:)
Thanks again
Kerry xxx
HI MrsBird
I had mx and immediate LD flap recon with implant last November and am very pleased with the results. The surgeon told me exactly the same as you that if he did a reduction and uplift on the right side he couldn’t guarantee an exact match. I was a DD/E cup and wanted a reduction in my ‘new’ boob so really wanted to see what that looked like before having the reduction and uplift on the other side. I too was worried that I would look really lopsided but was told that I could have a small prosthesis to put in my bra if needed, but to be honest I don’t look too bad, nobody can tell when I have my bra and clothes on that I am lopsided - but with no clothes I def need that reduction surgery and will hopefully have this later this year. He did tell me that some ladies do have reduction at the same time with good results, but I was happy to wait. I was told that I didn’t need rads at the time, but that has changed and I was offered rads if I wanted them when my chemo finished (that’s another thread!) and have decided to go ahead.
Anyway I’m rambling on. Recovery from op was good for me. I was in hospital for 6 days and came home with 2 drains in and pain killers. It all healed brilliantly and I’ve got full movement back in my arm. The scars are fading and the one on my back is under my bra strap. I do advise you to do the after surgery exercises your BCN will give you. I was sceptical that they would have any affect as they looked so simple, but they worked wonders and I still do them now.
As your surgery is after chemo and with all the changes it’s done to our bodies already, I can completely understand why you feel you want one op - I may have made a different decision also if I had to make this decision now. Obviously, go with what feels best for you, it might be worth asking to see pictures of women who have had this surgery so you can get an idea of what the completed you may look like?? My surgeon was happy to show me pictures of his handiwork and my boobs are also on his powerpoint slideshow now!
Hope this helps Kerry. Good luck!
Rachel
Hi Mrsbird,
Totally understand about feeling self-conscious if left not matching on each side. Like some of the other ladies, I had mastectomy and recon earlier in year and waiting to see surgeon at the end of this year to get 'lift on other side. I would say recon side is about a cup size or less smaller than ‘good’ side, but to be honest with good bra and clothes on no-one would notice at all.
I was possibly quite passive with surgeon, as he prefers to let things settle and I accepted that. Hope everything works out for you though.
Morning ladies, thanks for your replies.
Think am going to go with the ld flap, hopefully with a recon and reduction at the same time, but if not i will have to live with it.
What was the recovery time? If i have mine at the beginning of june, do you think i will be ok to go on holiday on 22nd july? We only booked that early because the onc said it was ok, we cant get the money back -ryanair flights and private appartment. I know i wont be up to much, but the thought of my holiday has whats got me through this!!! We cant go any other time because all our staff have booked the remaining school holidays and school will not let any child be off in the first six weeks of a new term.
kerry xxx
Hi Kerry,
You should be recovering well at that stage and I’m sure you will get the benefit of your holiday post surgery. I had the ld flap too end of Feb. this year and was able from week six to drive again and get out with family who were up visiting on holiday. You will likely find that you still tire easier and really do need to look after yourself and keep up the physio exercises too. Have fun! You deserve it.
Thanks Ray:) Dont drive so thats not an issue. Fully intend to enjoy my holiday:))
Hi Ladies, here I am worried again !! You are all doing so well. and getting through the surgery. Everyone is different, and my DIL had her final Tax on Monday, now been told she will have the Mx next Monday, with recon in a few months, and rads in the meantime. Does this sound reasonable to you … I am confused, as she was going to have recon same time as mx. does it mean something is wrong ? Sorry to sound so pathetic !! By the way, did the Pink Walk on Sunday, along the Mon and Brec. canal it was FANTASTIC like all of you. xx
2 hours later, and evid. there was a crossed wire at the hospital… surgery now June 13th, so a relief, and just waiting to see what the surgeon has in mind. Just shows how a little misinformation really rocks the boat. Sorry to ask all these questions, just don’t want to ask our lovely DILY.!x
Hi gramgran
I had my treatment a different way to your DIL with MX and immediate recon, chemo then rads. It is usual, though, if your DIL definitely needs rads (I didn’t to begin with) that the surgeon likes to do a reconstruction after rads in case the rads affects the reconstruction.
Hope this helps
Rachel.x
Hi ,
I had mast and immediate ld reconn in 2009, recovery time was very swift, the only delay in the process was having the chemo after, I Can honestly say, no pain at all, good healing and a good result from the reconn.Today 2 years on im back at work, get a bit tired, and the reconn boob just feels the same as my other droopy one, I am amazed, never thought id be back to near normal.
take care xx
Gramgran; Sounds totally reasonable to me.
My hospital prefers NOT to do an immediate reconstruction for a couple to reasons:
- to wait to get results which prove that the operation has cleared all the cancer. It is most likely that the test will show that this is the case, but there are cases where more surgery is needed (so if the reconstruction had been done, this would have been a problem)
- if you need an implant (as I did, as I dont have enough fat to make a matching breast), you can’t have radiotherapy on a new implant, and rads seem to be fairly standard just as an insurance to clear up any stray cells (although I have no idea whether this is always the case).
Most people I know who have had breast cancer have had a delay between mx and reconstruction , whereas those who have had DCIS have been able to have an immediate recon.
I also have to say that I have found that the ‘journey’ through the treatment is usually explained bit by bit, so you can often expect one scenario only to find that when you get to that stage is is not as you expect. I think this caused me to be alarmed more than I needed to be.
This is only my experience, from my hospital, but I hope this helps.
Annie
hi ladies
thanks for your replies.
Had my mx and ld flap on tuesday and it looks awesome:)
kerry xxx