lap flap with an implant
Entering the world of reconstruction after almost four years. Underwent a mastectomy, chemo and radiation. Seems I do not have enough fat tissue to have either abdomen flap surgery (although I find this hard to believe) as I have a c-cup on my single remaining breast. Lap flap surgery with an immediate implant is the recommendation of two seperate PS. Any one out there have experience with this??? What is involve from the minute you wake up to about 6 months out. I'm frightened.
Comments
-
I had a lat-dorsi flaf reconstruction with tissue expander. (only my right side)
My surgery was Sept 2013. Coming out of surgery, I was sore, and had a hard time moving my right arm, but it was more flexible than after my mastectomy.
I had 2 drains, one in front, one in back. I have a 12" incision across my back; even now, 8 weeks later, has no feeling to the touch. (which is so wierd!)
I went back to work 5 days after surgery. Drains came out after a week. One week later I started the 'fills' for my expander. I had 6 fills.
Just saw PS yesterday to discuss my exchange surgery, which will be in 2 months. Looking forward to that, but also a little nervous. I'm a B+ cup on my left side, which fluctuates with my weight. Sadly, I have gained 15 pounds this last year between chemo, and all the stresses of my life.
Anyways, PS is planning the implant to match my natural side. He will also do a maxoplasty? (lift!) on my left (natural) side at the same time he does the TE exchange. I was hoping for a bit of an augmentation to my chest, but he has told me it's highly unlikely I will be any bigger, as the tissue on my right side is stretched as much as it can, and that the radiation had done extensive damage to my chest, limiting the choices.
I'm not sure how the PS's feel you have enough back tissue to create a solid C cup on your mx side - seems like a big, single step. But then, I'm not a surgeon...lol..
Don't be frightened. In my opinion, this is so much more exciting and tolerable than the diagnosis and chemo! It's the start of getting your life back on track. I can't wait!! -
Sounds like your surgery was a great success if you had both drains out and returned to work within five days!
My surgery will not be a lat flap with expander but a lat flap with an implant. I wonder where the skin will come from for the new breast as it will match a B+/C-. My current skin is too thin to use from the radiation, my abs didn't have enough fat (although I find that very hard to believe as I too have gained weight) so that's why I'm having this surgery.
I thought I would take three weeks off to get me through the holidays without being completely exhausted. I work as an elementary school teacher and students hug me all day long. This concerns me as I don't know how durable the stitches will be.... any thoughts on that issue?
One more question if you don't mind... how long was the hospital stay? I will be traveling 4 hours from home for this surgery and part of my concern is making appropriate plans for my family....
I'm very nervous, I have waited so long because I hate to reenter the world of pain after the mastectomy and all that chemo and radiation... There is no one that I know of that has gone through this. Everyone in my small circle of acquaintances had reconstruction right at the time of the mastectomy. So I thank you for taking the time to respond. -
Well, just had another appt with my PS and I have my option all wrong in my head!! I can't have an immediate implant, but must do the TE as described earlier. I don't know how I missed that part. I think I just wanted this to be done and now I'm in for a long, long haul. My surgeon is 3 hours away from home and I'm wondering what I am getting myself into and if I shouldn't bother because all the travel will be too cumbersome. Sad.... -
Don't be sad! This is a good thing! If you're travelling that far, then you're likely going to one who's good at what he does.
Trust me, once the process starts you will be happier. I couldnt' believe how much my mood lifted after every appointment.
My PS is 2 hours away, and for my fill appointments was between 1-3 late for appt's. A 5 minute fill appointment took me 6-7 hours. I rewarded myself with a Starbucks and a pumpkin cheese muffin after every fill, to enjoy on the drive home.. :-)
As far as the surgery, I was given the option to go home that day or stay over. I chose to stay the night, as we have 3 kids, 3 dogs at home, and life is chaotic. Thought I would feel better if I spent the night in the hospital and could get home during the day and get settled by the time the kids were home from school. I was groggy from anesthetic (I always am!) but felt much better than I thought I would! -
nmcd - I had a SNS BMX in Feb - had TE placed and then over the summer I had implants. I hate the implants and am now scheduled for a bilateral "hip flap" (like an sgap, just taking fat/tissue from higher up). Like you, I don't have enough to make a full B/small C cup from the flap alone, so they will be using a small implant to give me more projection. I am traveling to NOLA, and am nervous as heck, but the ladies on these boards have provided a wealth of information, and for the most part they all seem happy with their decisions, so I feel I am doing the right thing. Like you, the travel (from DC to NOLA), leaving kids at home, time off from work (yet again - third time in 12 months going out on leave), seemed VERY cumbersome....and for a while I did not see how I could do it. But, I knew this was the route I wanted to go, and the doctors are the best, so it is worth it and any inconvenience in the end. If you have a top notch doctor, then try to look beyond the inconvenience for the next 6-12 months...the results of this will be with you for a lifetime. So, IMO, it is best to get it done right, and by the most competent doctor the first time (speaking here from experience, as I went with "quick and easy" implants the first time around and now regret it).
I can't help you with the specifics of the surgery, but I wanted to wish you luck. It seems not many of us have implants with the flaps.
(edited to correct typos) -
Hi there,
I'm kinda new to the boards. I've been considering either the LAT flap and the hip flap. I had a failed TE (without the flap) last feb and was about to do the lat flap when I met a gal who had gone to NOLA and really recommended it. I'm not a fan of having an implant, worried I'll reject it, contracture, weird looking boob etc...! I had a TRAM flap in 1999 on the opposite side so DEIP isn't an option. Have you heard much about recovery time with the hip flap? Seems like it'll be hard to sit down for a while, lol! Are you already scheduled?
Thanks in advance for any info!
Pam -
Thanks for the support. I'm working myself into a nervous frenze! Glad to have conversations with people who actually understand. I had someone say to me at work today that I was a little old for implants.... really? Anyway, I was wondering dayzoo, if you had skin taken from your back as well as the muscle... seems your recover was/is spectacular... I recovered well from the mastectomy so I am hoping for the same positive result. I wonder how much radiated tissue will be removed and if one side of the back will look much different from the other.....
I am traveling to Boston to a reconstruction specialist. No dr. in my area specializes in working with radiated tissue, thus the travel. I am wondering if I will be able to drive myself to and from "fills"? The first one or two maybe not, but will I feel well enough after that? I have no family other than my husband who can help me out and he will run out of sick time ~ just another hurdle....
This post has a negative tone, I'm not negative, just anxious. Too much time from decision to surgery for me. -
Hi nmcd...
Yes, I had a large amount of skin and tissue taken from my back. I have a 12" scar diagonally up my back, that's healing well. PS Says up to a year for this scar to fade - not too worried about that scar. I have a teardrop (?) shape incision on my breast where he inserted the skin from my back. There's actually a freckle there that I recognized from my back now...hahha..
Although I couldn't tell, the tissue on my chest wall is too thin and damaged from the radiation I received in 2009. Hence the lat flap. The expander has nicely stretched out my skin, and I am currently awaiting my exchange surgery date - likely January.
When I first had my surgery (lat flap) I had a hard time doing basic things at home - I couldn't cut a tomato, pull open a door, etc. Now, 10 weeks later, I have 95% of my strength back. The leftover muscles in my back have taken over and trying to make up for the latis dorsi that was moved to my breast.
How far do you have to drive to your PS?
If your experience is like mine, driving yourself is no problem - the ache from the fills starts later on in the day, but it's totally manageable with advil/tylenol. Have your hubby save his sick time for surgeries, not the fills... :-) After each of my fills, I treated myself to a Starbucks for the long drive home. Turned some music on, and enjoyed the peace and quiet..
In my opinion, the reconstruction experience is much easier and less painful than the mastectomy, and mostly, chemo...
Good luck! Keep us posted!!! -
Dayzoo,
You are a wealth of information for me. I go tomorrow for my last appt with the PS before surgery on 12/2. It is a 3 hour drive (each way) if I don't hit Boston traffic which can easily turn it into a 4 hour drive. Sounds to me that my surgery will be similar to yours. The skin is being taken because what is on my ribs (can't say chest) is too thin and would tear with an expander. I'm not worried about a scar on my back, I actually could care less. I won't see it so it won't matter! Does the right side of your back look different from the other?
My fears have been reduced by your information. I can't imagine anything worse than the chemo...I lost 30% of my body weight in the first two months! I feel better, thank you. My husband has put aside one sick day for the day of surgery and one for picking me up then bringing me home, then he's out. Sounds like I can easily travel by driving myself.
You indicated you had 6 fill, how far apart where they, weeks, months? Is there flexibility with timing of fills? I have had a trip planned for the spring that is very important to me and I don't want to have to cancel it, that is why I ask.
Again, thanks. -
Good luck on your trip today! Hope you don't hit traffic!
Sounds like you had a terrible time with chemo - so sorry to hear. I actually gained weight with mine - between the steroids and lazing around, I added 10 pounds. Am trying desperately to lose it before my exchange surgery.
As far as my back appearance, my right side does look a little leaner than my left, but again, when I lose weight it should look perfectly symmetrical.
My fill appointments were one week apart - and are totally flexible. I could have postponed any of them for a week or two, but I just wanted to get them done and over with. Yes, you'll be able to go on your trip! My recommendation would be to have a fill atleast 3-4 days before you go, as you don't want to be uncomfortable on your trip. The PS's are usually pretty flexible with that.
As far as your inital surgery, you may be able to come home that night, but it is quite a drive for you, so it would depend on the time of day your procedure is. I walked in the OR at 9:45am, and I believe I was done by 1:30. Your insurance may or may not cover the nights' stay too? Here in Ontario, all of these procedures are covered under our provincial goverment health system, so the $$ is something I don't have to worry about.
Keep me posted! Can't wait to hear! -
Everything is moving right along. The appt was very interesting. Seems I will be in the hospital for approx. 2 nights, then can journey home. The PS said I will be filled between 60 to 70% at the surgery and will also do a lift on my remaining right breast. This means three surgical sites, front left, front right and back left... how do you sleep??? Really, how do you sleep? He thought it would be two weeks before the first outpatient fill then maybe only two others to get me to a C cup. I forgot to ask about how long I wait for the exchange, that question will answer itself over time.
Bought Bruins tickets for my family to enjoy the Saturday night before the surgery. Hopefully that will take my mind off everything.... -
Surgery was yesterday, ps says it went well. Pain is greater today than yesterday. Not sure when I will be released from hospital. I guess all is well right now.... -
I'm looking for some advice... can I take off the surgical bra during this recovery? Pain is managable with tylenol during the day and pain meds to sleep. Heading to dr on Tuesday for appt an perhaps one of the drains to be removed. Just wondering if I can take this compression bra off for a few hours... -
Hi nmcd...
Glad your pain in manageable - hope you're doing well.
I never had a compression bra - went home without a bra at all. (I'm a uni) My drains were in for a week.
I showered after day 4, then found out at my 1 week appt that I wasn't supposed to (oops!)
Good luck - hope you're happy so far! -
I think I'm doing ok, I have nothing to compare the experience to... I have taken two showers and they both felt great. Removed the plastic type tape on my front sutures, but not my back. I can reach them and my husband just can't bring himself to do it for me. I am black and blue and yellow on the expander side, that rubs on the compression surgical bra but I think that must be normal too. I see my PS tomorrow in Boston (snow on the way ~ oh my) and hope he is happy with everything and removes my two drains. One drains just under 10 every 12 hours and one just over 10 during the same 12 hours. I don't know what his minimum is, I will definately learn that tomorrow. I will ask to come out of the very tight bra. When I take it off to shower my skin still feels quite tight but not painful, just uncomfortable. I guess I'm doing just fine. I don't sleep much but I am tired, that's funny to me. thanks for your support, this is such a lonely journey full of questions.... -
Just had my first fill. Not painful at all. Area is numb so I didn't feel a thing. Took advil about an hour after on my ride home and I'm not in pain right now at all. Going back next week for next fill on the day after Christmas. How long did people wait from the time of their last fill and the implant put in place? Dr. said he would choose the implant at the time of my last fill when he has a better idea of shape... does this make sense...? Seemed ok to me... anyone have an implant preference I should consider?
-
New question, if anyone has a chance to answer that would be great. Fills have been going just fine, once a week for several weeks. I am approaching the last fill and the PS told me to book the surgery for the end of February. I am wondering how I will feel after the exchange surgery and what I will need to make the process go more comfortably. Will I need to be on pain meds for a while or will otc meds be enough? How long did most people take off of work and when did you really feel more like yourself? Will I go straight to regular bras or have to wear something else? Advice and experience sharing is what I'm looking for, can you help?
-
Hi nmcd...
Glad it's going well for you.
My exchange surgery is booked for Jan 28th, so I'm interested to hear what others respond to you.
My PS told me I would have drains again. It's also day surgery - I will go home that night. I believe it's a much easier surgery than the lat flap.
I'm also having my native side lifted and hopefully a small implant put in as well.
Good luck!
A
-
I have bilateral lat flaps with implants. I had the first lat flap done on my rads side with TEs placed on both sides. During the fill process I had a skin failure on my non-rads side, so I had a lat flap done on that side with permanent implants placed on both sides.
Exchanging to implants is a piece of cake compared to TE surgery. I had to have the implant replaced on my rads side (more than once) but returned to work in a week or less each time. I used prescription pain meds for maybe the first 2 days. My rads side gave me lots of problems throughout the reconstruction process, but all is well now & I am very pleased with my results.
Hope it is smooth sailing for you all!
-
Dayzoo, looking forward to you sharing your experience with your upcoming exchange. Good luck to you with that! Please let me know all the details, I'm very curious about everything. My PS hasn't said anything about drains but our verbal exchanges are very short! He is more of an in the moment, matter of fact kind of guy. My PS did the reduction/lift on my regular side at the time of the TE surgery and I can tell you that didn't bother me at all. I compared the situation as a broken finger and a broken arm, which will you notice more... I didn't even feel much discomfort on the lift side at all, my focus remained on the TE side and back.
DLL66, glad to hear that the exchange is a piece of cake compared to TE surgery, sorry to hear you had complications. I think I am having a skin failure issue but I don't know, there seems to be a hole along the scar line. Is that skin failure? I see my PS on Thursday so I will ask about the hole then...I need to travel to Europe this spring and I am trying to figure out how long I need for recovery, how I will be dressing, etc. so that I can make plans that work for me. Any suggestions on the amount of time I will need to feel well again?
-
nmcd, in my opinion you should put a call in to your PS' office Monday morning. It's probably nothing, but it is better to keep them in the loop.
My skin failure happened with TEs. It started out as fluid leaking along the suture line, turned into a small hole & then over the next day the skin thinned out & I had a huge hole (bigger than a quarter) by the time I made it in to see my PS.
Everyone is different, but you should be pretty much back to normal in a week or two after exchange surgery.
-
Thanks, made the call and sent a photo by phone as I live 3+ hours away. PS didn't think it was skin failure, nothing is leaking. He will follow up on Thursday when I see him. Thanks. How long until you could wear a regular bra? Again, thanks.
-
I was back in a regular bra in under a week. At my last exchange I had some pocket work done, so I had internal stitches in the IMF. PS said to go back to a tight underwire as soon as I could tolerate it, It was not comfortable but I could tolerate it, LOL.
Glad you checked with your PS!
-
I keep thinking about your post and I can not figure out what IMF means, lol! After my appt this past Thursday my PS surgeon explained that my expander has shifted from back to front, which explains the square ledge on top and closer to my underarm than he had it. He says not to worry. Of course I worry! Does this mean it is likely that the implant will shift as well? The really good news was he said no drain for me ~ yeah! My exchange date is Feb 28! Wish it was Jan 28! Oh well.
-
IMF = infra-mammary fold
-
Heading to the PS in a week to pick out the implant in preparation for the exchange surgery in late February. Anyone one have any positive stories to share?? Seems there is a healthy debate between saline and gummy....
-
Hi, Had rt MX 2011(Oct). Implant too large Exchange four times due to radiated tissue not healing and going to a smaller implant each time.Now I have no implant and have been healing very slowly. I weigh about116 and use a manual wheelchair due to SPMS. Do my own transfers. I want a boob! Suggestions?
-
Wow, you have had a really tough time... I have no suggestions at all, sorry. Did you have an expander first? How did that heal if you did? Four exchanges seems like a lot!
-
Hi nmcd, I am of similar dx and am 5 years out. Will be having a lat flap with implant this summer and am nervous. All sorts of questions and worries in my mind. Its nice to read others stories.
-
KFinnigan,
I was a nervous wreck, that's why I had waited over four years. I will be happy to help guide you through. I am a month an a half out of the original surgery and have had three fill (not counting the fill at the time of the surgery). I'm a fairly active 50+ woman who hikes, skis and bikes for fun, not competitively (I say this so you can compare physical level). The first three weeks where more difficult than I had anticipated but certainly not the worst thing you or I have been through. Just tougher than I thought. I'm an elementary school teacher and as such it really is a physical job in so many different ways and I couldn't really perform. I took the time off and added a fourth week by backing the surgery up to a school vacation week. Right now I feel great! I have been skiing and snow hiking for fun. Strength had been returning to my side, for example, I can pull out drawer faster and quicker every day. The filled expander is odd but I bought a bra at Victoria Secret one cup size larger (D for me) and no underwire, and it fits in just fine. My reduction/lift on the other side was swollen enough that the bra fit just fine. I am very comfortable in this bra even across the scar line on my back.
I'm happy to help, I was quite alone and had no idea what to expect. Let me know if you have any questions. I have my exchange at the end of February and I wonder what that will bring....
Categories
- All Categories
- 679 Advocacy and Fund-Raising
- 289 Advocacy
- 68 I've Donated to Breastcancer.org in honor of....
- Test
- 322 Walks, Runs and Fundraising Events for Breastcancer.org
- 5.6K Community Connections
- 282 Middle Age 40-60(ish) Years Old With Breast Cancer
- 53 Australians and New Zealanders Affected by Breast Cancer
- 208 Black Women or Men With Breast Cancer
- 684 Canadians Affected by Breast Cancer
- 1.5K Caring for Someone with Breast cancer
- 455 Caring for Someone with Stage IV or Mets
- 260 High Risk of Recurrence or Second Breast Cancer
- 22 International, Non-English Speakers With Breast Cancer
- 16 Latinas/Hispanics With Breast Cancer
- 189 LGBTQA+ With Breast Cancer
- 152 May Their Memory Live On
- 85 Member Matchup & Virtual Support Meetups
- 375 Members by Location
- 291 Older Than 60 Years Old With Breast Cancer
- 177 Singles With Breast Cancer
- 869 Young With Breast Cancer
- 50.4K Connecting With Others Who Have a Similar Diagnosis
- 204 Breast Cancer with Another Diagnosis or Comorbidity
- 4K DCIS (Ductal Carcinoma In Situ)
- 79 DCIS plus HER2-positive Microinvasion
- 529 Genetic Testing
- 2.2K HER2+ (Positive) Breast Cancer
- 1.5K IBC (Inflammatory Breast Cancer)
- 3.4K IDC (Invasive Ductal Carcinoma)
- 1.5K ILC (Invasive Lobular Carcinoma)
- 999 Just Diagnosed With a Recurrence or Metastasis
- 652 LCIS (Lobular Carcinoma In Situ)
- 193 Less Common Types of Breast Cancer
- 252 Male Breast Cancer
- 86 Mixed Type Breast Cancer
- 3.1K Not Diagnosed With a Recurrence or Metastases but Concerned
- 189 Palliative Therapy/Hospice Care
- 488 Second or Third Breast Cancer
- 1.2K Stage I Breast Cancer
- 313 Stage II Breast Cancer
- 3.8K Stage III Breast Cancer
- 2.5K Triple-Negative Breast Cancer
- 13.1K Day-to-Day Matters
- 132 All things COVID-19 or coronavirus
- 87 BCO Free-Cycle: Give or Trade Items Related to Breast Cancer
- 5.9K Clinical Trials, Research News, Podcasts, and Study Results
- 86 Coping with Holidays, Special Days and Anniversaries
- 828 Employment, Insurance, and Other Financial Issues
- 101 Family and Family Planning Matters
- Family Issues for Those Who Have Breast Cancer
- 26 Furry friends
- 1.8K Humor and Games
- 1.6K Mental Health: Because Cancer Doesn't Just Affect Your Breasts
- 706 Recipe Swap for Healthy Living
- 704 Recommend Your Resources
- 171 Sex & Relationship Matters
- 9 The Political Corner
- 874 Working on Your Fitness
- 4.5K Moving On & Finding Inspiration After Breast Cancer
- 394 Bonded by Breast Cancer
- 3.1K Life After Breast Cancer
- 806 Prayers and Spiritual Support
- 285 Who or What Inspires You?
- 28.7K Not Diagnosed But Concerned
- 1K Benign Breast Conditions
- 2.3K High Risk for Breast Cancer
- 18K Not Diagnosed But Worried
- 7.4K Waiting for Test Results
- 603 Site News and Announcements
- 560 Comments, Suggestions, Feature Requests
- 39 Mod Announcements, Breastcancer.org News, Blog Entries, Podcasts
- 4 Survey, Interview and Participant Requests: Need your Help!
- 61.9K Tests, Treatments & Side Effects
- 586 Alternative Medicine
- 255 Bone Health and Bone Loss
- 11.4K Breast Reconstruction
- 7.9K Chemotherapy - Before, During, and After
- 2.7K Complementary and Holistic Medicine and Treatment
- 775 Diagnosed and Waiting for Test Results
- 7.8K Hormonal Therapy - Before, During, and After
- 50 Immunotherapy - Before, During, and After
- 7.4K Just Diagnosed
- 1.4K Living Without Reconstruction After a Mastectomy
- 5.2K Lymphedema
- 3.6K Managing Side Effects of Breast Cancer and Its Treatment
- 591 Pain
- 3.9K Radiation Therapy - Before, During, and After
- 8.4K Surgery - Before, During, and After
- 109 Welcome to Breastcancer.org
- 98 Acknowledging and honoring our Community
- 11 Info & Resources for New Patients & Members From the Team