LD flap bulge under arm and range of motion

gaspasser

Hi,

For various reasons the main one being a large infection that has required multiple wound debridements and a wound vac on my left reconstruction side I am considering the LD flap down the road in 3-6 months. Previously I had a bilateral mastectomy and TE to implants. My one implant exchange was the start of my long term infection that has finally cleared , but has left me with only a LD flap option after seeing a few plastic surgeons to recommendations. I have looked through several of the LD flap posts and have seen some people do very well recovery wise and others be left with several very devastating recovery issues and permanent effects. My hear goes out to you who have had that happen. And I thank you all for sharing your experiences.

I'm 38 and very active - runner and I enjoy swimming and occasionally kayaking. My main love however is running. I also require the use of my arms at work. My two questions is will I be able to maintain my love of running and swimming etc after the recovery period is done and perhaps PT , stretches daily, etc? Also, how many of you have had the "bulge under the arm" remain after surgery and how profound of a physical bulge is it? My right side has a implant from my TE/mastectomy because the side was never infected. Will I be very asymetrical because of the under arm bulge? I am not as concerned with the reconstructed breast matching. I know that is not a given having gone through so many surgeries and the remaining landscape of my chest wall post wound vac etc.

Thank you so much for your help. Also, is there any questions you wish you would of asked your surgeon ahead of time that you didn't ? I would love to hear any insight for me to hopefully go in fully prepared and by some small miracle end up with as minimal side effects as possible.

Thanks,

gaspasser

Lula73

I had DIEP flap instead of LD flap. You mention you're a swimmer...that LD muscle is one of the ones you need for swimming. And you need it as you get older for posture. Have you considered muscle sparing natural tissue recon like DIEP, GAP or SGAP? Even thin women can do them with the right surgeon. Here is a helpful link: www.breastcenter.com

Runrcrb

i know nothing about the bulge you mention or LD flap. As an active person 20 years older than you I encourage you to talk very frankly with surgeons about your goals. And find women who’ve been through similar surgeries. And be happy that Lula73 posted the above link. I have been happy with my experiences here in my home town but have also read the raving about the center Lula mentioned above. It sounds like you are a person who should definitely investigate that center.

I would use a muscle consuming reconstruction option as a very last resort for someone as active and young as you.

gaspasser

Thank you for taking the time to respond and for the link. I will continue to research all options of technique approach and surgeon. The reason i asked about the lat dorsi is because given my situation ot was what the few plastic surgeons i have seen including the one who did my initial reconstruction at time of mastectomy recommended. Due to the condition of the skin and very thin pec muscle that remains after my multiple debridement, and now an open chest with my wound vac they feel I need a muscle flap independent of reconstruction. I've had over 10 surgeries since my infection to try to treat a multi drug resistant infection and not much muscle remains. I have rib exposure in certain spots with the wound vac on.

I am quite thin, but the main reason is the necessity to close my chest and have a muscle in place for long term. Thanks for responding and the link. I really appreciate everyone's input.

Thanks!