I am due to have reconstructive surgery on both my right and left side in two weeks time. Had both breasts removed in 2008. My surgeon has given me two options. The subpectoral recon using a permanent expander or the LD recon with a permanent expander. I am not sure which to go with…
I would like my new breasts to look as natural as possible.
I originally decided to go with just implants and my surgeon is happy for me to go with this option but he has said that the recon using the LD muscle has very good results. I am quite thin so worried that I will notice not having that muscle there. Also have a 6 mth old daughter so worried that having the LD recon will cause me problems with picking her up etc and worried about the pain after surgery.
I am nervous about the surgery and would like to hear from anyone how they have found having these surgeries…
Dear Hayzer,
I think deciding what kind of reconstruction is right for you is really tricky. I certainly went round in circles for a while, but eventually opted for the LD reconstruction and now four months down the line I am definitely glad I went for it. I was different from you in that I had my recon done at the same time as my mastectomy and just on my left side.
You say you want your breasts to look as natural as possible - that is what finally persuaded me to go for the LD recon as I compared the pictures and found these to be much more natural looking. I do not have an implant as I am only small breasted. My new breast is extremely soft and feels like my normal breast. Friends and family who have had a look are all really impressed with how natural it looks. I think if you just have the implants then the breasts will sit higher on the chest wall and also be much harder and therefore less natural looking.
On the other hand, obviously the LD reconstruction is a major operation and it takes time to recover. If you can get support to help with your daughter then take as much help as you can. My children are older now (13 and 10) but I would say that if I’d had a toddler I probably would have struggled to pick her up for at least 2 months - but now 4 months down the line I would be fine. Clearly I have only had one side done, which makes a difference, but I don’t feel my righrt arm is all that weak now.
There is some pain from the surgery, but they are very good in hospital at giving you planty of relief. I started on a morphone pump, then quickly moved onto other pain killers and then by the time I got home after a week I was just using paracetamol as and when I needed it. I did get some ongoing pain in the early weeks, but it was bearable and improved a lot with physio. I wouldn’t let the pain put you off because it is short term in the scheme of things.
Have you got the option of speaking to someone who your surgeon has operated on? I spoke to one of mine’s patients who had had LD and I found it really helpful. As every surgeon is different, talking to one of your surgeon’s own patients is probably a good idea. There is quite a bit more about this procedure on various threads under “reconstructive surgery”. Also, if you have any more questions I’d be happy to answer either through the thread or you can send me a message. xxx
Had skin sparing mx done 4 weeks ago with immediate LD flap reconstruction. Started to drive again now but have a seroma on my back which is a bit uncomfortable when sleeping. Lifting with my right side is still not possible, also can’t reach high up, it’s like there is no stretch left. I am doing my exercises and hope I will get more flexible as the weeks pass, my breast still feels quite like a muscle, not very soft, so everyone is different. However, I can wash my hair and take off jumpers overhead, so it;s not all bad news! Hope this helps! Tinaxxx
Hi Tina45,
I think it is still really early days for you - you sound like you are doing much more than I was at 4 weeks post op! But I can assure you it does get so much better each passing week. x
Lola, thank you for your reassurance, I don’t know why, but somehow, I assumed I would be back to “normal” pretty soon. Call me naive!! I am pushing myself, I have two young boys at home and it has got to be business as usual for them really.
Felt like I could have done with more research on the subject, there were only 10 days between diagnosis and surgery, my brain just went to mush really, (not sure it;s any better now)!
Hope the seroma goes away soon, another app with surgeon in beginning of April. Waiting for chemo to start next. Hugs to allxxx
Lola
I just wondered where you had your surgery. I’m struggling with this decision too but have been unable to speak with any of my surgeon’s previous patients - the hospital say they don’t put people in contact. I live in Sheffield.
Hi Awaden,
I had my surgery in Macclesfield. My breast cancer nurse arranged for me to phone one of the surgeon’s patients who had had both sides done with LD flap and have a really good talk and ask lots of questions. It reassured me greatly. When I was having my nipple done on Thursday the surgeon asked me if I would now be willing to talk to future patients in the same way and I said of course I would. I wonder why they won’t put you in touch with anyone? I think I have been lucky to have an absolutely wonderful surgeon who is both good at what he does and also has a very good bedside manner. Good luck with whatever you decide.x
I had a bilateral LD flap with implants recon at the end of October 09 and I have no regrets. I chose this option because everyone I spoke to said that it creates a more natural looking breast shape.
It is not an easy decision and I have to say I found recovery quite challenging and I had quite a few set backs (a haematoma which needed surgery to remove, seromas which lasted 2 months and an infection which fortunately was treated with antibiotics). I have been told I was unlucky but I think you need to be prepared for problems and be totally committed to wanting it done.
I was able to do most things after about 6 weeks but still had a lot of discomfort which was quite debilitating. After 3 months I was quite down and feeling that I would never be back to ‘normal’ again and some of the posts on this forum didn’t help, as some people said they never fully recovered. Then a few weeks ago everything suddenly started to feel much better and it continues to improve every week now.
Despite having quite a bad time I definately feel it was the right decision for me. I have just bought some new bikinis for my holiday and I look better now than I did before I had my mastectomy! I can wear anything and am already beginning to forget about the breast cancer (the mastectomy reminded me of it every day).
I have spoken to ladies who have had the subpectoral implants and two who had the double LD flap as I did. All were happy with what they had done but agreed the LD flap gives a better aesthetic appearance.
That’s a very inspiring story to share Anna and certainly has made me feel that it is only the start of the journey, I hope the seroma will “expire”. I suppose every surgeon and every individual produce a different outcome and it is easy to feel disappointment when the recovery is much slower and more painful than expected. I feel encouraged. Thank you for your comments. xxxTina
I had this decision to make in Feb (although only for my left breast, and it was immediate recon). I felt strongly that I did not want an implant as it would not look natural or match my other breast, and also could need replacing in future (more surgery) so for me the decision was fairly easy.
The LD flap is not an easy option as recovery takes a while, although everyone’s experience is different. I’m now 3 weeks after the op and can raise my arm some way above my head. It doesn’t feel that weak - if I had a toddler I could certainly pick him/her up without difficulty although not sure how long I could carry him/her around on my left side. The new breast looks very natural although feels very firm, but it takes several months for it to settle into its final shape, size and position.
The main problem for me has been my back - the scar is large and tight and restricts my ability to bend forward quite a bit. The lack of muscle also makes bending forward quite painful, although exercising is helping. I’m also having seroma problems (due to get it drained again tomorrow and it’s pretty painful today). I’m quite thin as well - my back does look slightly different (apart from the huge scar!) in that my left shoulderblade is now more pronounced with a bit more of a hollow underneath it (or it would be if the seroma wasn’t puffing everything out). But it’s not really noticeable.
Hope this is helpful. Best of luck with whatever you decide. xxx
Sorry I haven’t posted to you before and you may have made your decision by now. But just to reassure you that your second option would be ok!
I had bi-lateral skin sparing and reducing mx with immediate recon with permanent expander implants in December, and am very happy with the results. I realise there’s a difference having delayed recon, as you are.
Having both done means that they match - well, more or less. They are firm, yes, but not rock solid. I think I’m lucky that my surgeon doesn’t put them completely under the pectoral muscle - the top third is under the muscle, but the rest is under a dermal flap - just under the skin and dermal(?) layers. Was your mx skin sparing?
It’s a big op, whichever you go with, but the LD flap would be more so. But definitely worth doing!