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LD flap reconstruction vs implants

8 REPLIES 8
MrsF
Member

Re: LD flap reconstruction vs implants

Hi, I had a left side mastectomy and LD reconstruction 3 weeks ago.  I had the choice of implant or LD, the implant would sit in a hammock under the skin - the downside would be rippling of the implant which would show through the skin. The surgeon suggested the LD, taking muscle from my back, bringing it through my underarm and putting in the front - everything stays connected so theres no need to reconnect blood supply etc. I wasnt able to keep the nipple as the cancer was connected, so instead of this I have a flat round piece of skin from my back (presumably with the muscle attached underneath).  I had two drains which stayed in for a week, and the dressings came off then too. I have good movement in my arms and more strength than I expected. Some parts of my back and new boob are still numb but feeling is coming back although it will take a few months, but all good. My underarm is swollen still from where they created a tunnel to bring the muscle through but again in time this will reduce. I have a foot long scar down my back which is healing surprisingly well, although I feel some discomfort as I move about depending on whether sitting, twisting etc but not constant. I manage this with Ibuprofen and paracetamol as advised by the hospital. No driving for 4-6 weeks and no heavy lifting (vaccuming included), walking as exercise is encouraged but nothing else active apart from personal life 😉 if you feel up to it! The only weird part is the muscle settling down in the front - so I might pick a plate up and feel a slight twitch on my chest, I suspect its just getting used to it/settling down. 

I hope I've given enough information to help you. 

Evie-S
Community Champion

Re: LD flap reconstruction vs implants

Hi Emma - that’s great that you have such a lovely helpful and reassuring surgeon. It’s important that you ask him as many questions as you need while you make a decision. You really shouldn’t feel guilty about having a reconstruction, although I can understand where you are coming from as I have never got round to having a nipple reconstruction. Reconstruction and body image is such a personal thing, everyone feels differently about it. Only you can decide whether you would be happy staying flat, as many people are, or if reconstruction would help you to move forward. Maybe write down a list of the pros and cons, and also have a chat with people who have stayed flat - I believe there are groups called Flat Friends. Then you will know that you have explored every option - and I think your instinct will tell you what option you prefer.

I wish you all the very best and I genuinely mean it, please keep chatting and mulling over options on here if you think I or anyone else can help. Evie xx

UmLydia
Member

Re: LD flap reconstruction vs implants

Thanks Evie. That is so helpful to know it is possible to have a successful reconstruction. I worry a lot about the possible things that could go wrong and even feel a bit guilty to think of putting myself through more surgery etc when I could just accept my body as it is. 

But my surgeon is lovely and he made me feel that if I do want to have a symmetrical body again it is possible. He also said to think about the positive side, not just the negative. 

I am small breasted too. I will ask to see photos of reconstructions. 

Thanks a lot. 

Emma

 

Evie-S
Community Champion

Re: LD flap reconstruction vs implants

Hi Emma - my implant is on top of the pectoral muscle, it sits in some sort of sling thing (I think called Braxon). I’m quite small breasted and I can see a bit of rippling of the implant, nothing much, but if you had one under the muscle I don’t think that would be an issue.

You’ve asked some good questions and I had to go and lie down to see what it feels like!! No I don’t feel like I’ve got a foreign object in my body, I really am not aware of it when I’m dressed or exercising, hence why I had to check before I answered your question. I’ll try to describe it..... I don’t have much if any feeling in my right breast and when I lie down, it’s a bit like lying on a firm but soft ball. It doesn’t hurt at all, but it’s firmer than my left one. I don’t sleep on my front but I am fine to do things like yoga poses. The skin doesn’t feel tight or uncomfortable, only my arm sometimes gets a bit stiff after having a node clearance.

I hope that helps a bit, but I’m happy to answer as many questions as you think of. Have you asked your surgeon to show you any photos of previous operations he/she has done? It might help you to make your decision. I have a friend who had the LD flap, from her back, and she continues to do Pilates without problems - I think she had an implant too.

Evie xx

UmLydia
Member

Re: LD flap reconstruction vs implants

Thanks so much Evie. Do you feel like you have a foreign object in your body? Like if you lie on your stomach can you feel it?  Does your skin around the implant feel tight or uncomfortable sometimes?  

My implant would have to go under the pectoral muscle, is yours like that? 

It is such a difficult decision thanks so much for your support. 

Emma

Evie-S
Community Champion

Re: LD flap reconstruction vs implants

Hi Emma - I just wanted to drop by and offer my experience with an implant. I had my implant at the same time as my mastectomy (also my right side), about 4 years ago. It doesn’t exactly match my real one, the implant is slightly bigger and more round so I wear a small breast form on my real one to even things up under clothes. I am very happy with my decision and really don’t notice it any more. I can do yoga, sport etc without problems.

Reconstruction or not is such a personal decision, and you are doing the right thing by asking lots of questions and finding out other people’s experiences. I am very happy to chat more about an implant and answer any questions if I can. 

Evie xx

UmLydia
Member

Re: LD flap reconstruction vs implants

Thanks DJD for sharing your experience. My first reaction was exactly the same as yours. I can accept my body and just wear a prothesis. My surgeon told me to focus on getting better, I still have months of targeted therapy ahead. But he made me feel it might be possible to have a reconstruction and a new symmetrical body again. Until then I had only seen all the risks and extra trauma. 

I feel really confused, luckily I don't have any decisions to make for a while. But i thought it would be good to hear other reconstruction experiences, especially the dorsal flap. 

Am going to see prothesist this week and also get a bikini and special bra. It's all still very new. 

 

 

DJD
Member

Re: LD flap reconstruction vs implants

Hi Emma - just thought I'd add my 'two penneth'. I know of people who've had recon and implants.  Both options have had good outcomes. I had a right side mastectomy 4 years ago and, like you, was advised not to consider reconstruction or implant before treatment was complete.  I was also told that there was no time limit to consider a recon or implant.  When treatment finished and I felt properly recovered (probably a year or so), I was asked again at a check up appointment about recon.  I gave it lots of thought but decided I wasn't prepared to put myself through surgery again.  I'm content with my lot - I wear a prothesis, which isn't detectable when I'm dressed. I'm pretty active and it doesn't impede my lifestyle.  The downside for me, is having limited and pricey options for bras, and having to be aware of necklines when shopping! I know staying 'battle-scarred' isn't most people's choice but just wanted to include it as a  third option.  Reassuringly, recon is still mentioned at check ups - so, my experience would suggest that perhaps you don't have to make a decision just yet.

UmLydia
Member

LD flap reconstruction vs implants

Hello

I had a masectomy in Febuary and wasn't eligible for immediate reconstruction. 

Am now flat on one side. Am thinking about reconstruction. In my hospital they only do LD (using part of dorsal back muscle) reconstruction or implants. 

The idea of cutting off a piece of back muscle seems horrific but the surgeon in charge has a good reputation. Has anyone had this kind of reconstruction? I would be worried about chronic back pain. Apparently I would lose arm strength. Would love to hear other experiences of this type of surgery and if you were happy with the results. 

The other option is implants. At first I thought I would never want to do that to myself and would just accept being flat. Is anyone really comfortable in their body, as in not even noticing the implants and being able to do yoga and things like that without feeling discomfort?

Would really value any advice or ideas from ladies who have decided to go for reconstruction. 

Thanks. 

Emma