Mastectomy and reconstruction with LD flap - muscle contracts!

Hi, it is nearly five weeks since my reconstruction with latissimus dorsi flap and implant and I am finding it really hard to come to terms with my back muscle now being in my front! When I pull open a heavy drawer, lift anything or even move my arm back or flex it, I can feel the muscle tightening in my reconstruction and I can even see the muscle moving! Can anyone please let me know if they have experienced this and whether it will get better with time…thanks!

Hi Kinnie

yes that sounds familiar!! I felt those contractions for for the first 6 weeks or so and my surgeon said my brain was just trying to assess what was going on. I also got a sort of ‘flutter’ in the breast for a good few months I don’t get that so much now either, but I do get it when I have any additional surgery, I had LD recon in October 2011 and have had 2 fat transfers to the recon site since and after each fat transfer I experience flutters.
I hope you’re pleased with your reconstruction.



Hi Jude
Thanks for that! Yes, I am pleased with my reconstruction -it is still quite painful somedays and hasn’t really softened down yet and feels a bit “alien” but I suppose that is only time. How long was it before you managed to get your arm high above your head? Mine seems to pull from under my arm! Had nipple reconstruction at the same time and that is rather large but have been told it will get smaller.
Nice to hear from you,
Veronica x

Hi Veronica

Good to hear you’re pleased with reaults. I did my exercises about 5 times per day, very painful to begin with but stuck at it and I’m sure that helped to get almost fulll flexibility back. I can’t remember exactly how long it took to get arm over head but I know it was all down to the discipline of the exercises and my wonderful physio, I think maybe 10-14 days post op? I noticed the improvement daily, i used to gauge how far I could stretch my arm up the wall.
I am having the nipple recon later this year then hopefully that is me sorted. Will you go for the nipple tattoo next?
My scar on my back, where I had the skin graft and muscle moved from was very itchy for months but settled and doensn’t bother me now at all, nearly 2 years later, my scar is a fine line barely noticeable .
HOpe your recovery continues to go well for you, if there’s anything else you think of just ask .


Hi, I am 4 years post ld flap, and my muscle boob feels just the same as the floppy one, it no longer feels like a lump of clay on my chest, my arm has full range of movement ,but I do get the odd twitch when I move in certain directions. Hate to tempt the gods but Ii am amazed with the results, not had nipple reconn, but used to the blind one, no one could ever tell.
take care xx

Hi Scone. I had a mx and had LD flap reconstructed flap reconstruction with small implant. This was August 2012, so ten months ago now. Each months seems a little better, but if I’ve had a busy day, then the back muscle gets very tight. i was interested read that you had some physio after your op. I felt that this might ease my problem after my op, so I asked my GP if I could have some physio at NHS hospital where I had op. he agreed as did my BCN. an appointment was arranged for me at the hospital, which I attended, only to be told by the physio consultant that they didn’t like doing physio on breast cancer patients! She also said as I had arranged it off my own bat, then she wouldn’t do any physio on me. I did complain as both my GP arranged it as did the BCN. Can you tell me, was your physio done on the NHS? Thank you for taking the time to read my post. Good luck from Kathy x.

Hi Truffle Shuffle,
Thanks for your reply, it was very reassuring to read. I know it is going to be a long haul, am probably expecting too much! It is only five weeks since mx and ld flap and it is good that I am not taking pain relief now. Have you got all the feeling back on your back where they took the muscle from and does the feeling of tightness go? I think, perhaps, I should stick at my exercises to get my arm higher but it does pull a lot.
Thanks again!

Hi Veronica,
Yes mostly just the odd spot which is a wee bit numb, but most of it back. I think it is best we cannot feel anything at first, as I am a wimp with pain. I do yoga and swimming, no probs, if I over stretch my back pulls but to any extent that it hinders anythiing I want to do, oh and I did notice in the cold weather if I walk for a few miles, my back does ache a little but again, no problems, ive completed the 10 mile breast cancer walk for the past 3 years now.
just give it a little time I am sure before 12 months you will back on the ball, and it will soon pass. I was told it takes 12 months for the body to adjust to the trauma and accept the new muscle boob.
take care

Hi Kathy
My physio was organised by surgical team immediatey after LD flap recon op and started about 3days later, that is a very strange reaction isn’t it not to prescribe physio for BC patients? I hope you pursue the option of physio, it really worked wonders for me.
good luck to you all with your operations and recovery.


Hi Jude and all who have had LD recon. I had mine done in Feb 2013 and am currently having chemo. Could anyone further down the line give advice about effects on recon of radiotherapy? I am worried this will have effect on the skin/recon-
Also recon breast is smaller- PS mentioned poss small implant but I would prefer fat transfers. This is later on I know but will I have to put on much weight to enable this? Like some of you I am quite skinny. I have this feeling that any back flesh I had is now pulled round and wonder when the tight feeling will ease?

HI Barbara

My PS advised me to gain weight for my fat tranfers after I had my initial LD, I was a size 8 and he said it gave him nothing to work with, over a 2 year period I put on a stone. I have hopefully had my last fat transfer so in the last month have lost weight not sure how much but I can get into clothes I’ve not got into for 2 years and feel much better as for my build the stone I put on didn’t feel comfy at all.
Everybody thought it was a wonderful task to be told to put weight on, but I’ve always eaten really healthily and been an avid exerciser so psychologically I found it very difficult .

Good luck with your future ops.
by the way, I’ve just returned from holiday and for the first time in 3 years I wore a bikini, I never thought I would be doing that again, felt so confident with my matching pair after 3 years of wearing a prosthesis. Must admit some of my scars were visible in bikini top but I’m sure I was the only one who noticed. It was a great feeling!!


Hi Jude
I’ll get cracking on the eating then! Like you it’s not something I relish doing but don’t want to have an implant added to smaller breast. You mention prosthesis- did you use something to balance up? I am just wearing loose stuff to cover up lopsidedness. If you have tamoxifen then doesn’t that bring on weight gain too?
Thanks so much for replying- it is so encouraging to hear that there is a positive end to all this- I’m still in chemo with radio to come. Your holiday bikini story a real uplift! Does your back still feel hard and strange?
Barbara x