Lattisumus Flap after 2 staph infections

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Kms2016
Kms2016 Member Posts: 20
edited August 2018 in Breast Reconstruction

Hi all,

I am scheduled for a lat flap on June 19th, only 2 1/2 months after my second TE removal due to a staph infection. Has anyone had this done this soon and had success with it? I’m just concerned that it may be too soon, but my PS says 6-8 weeks is a good recovery time for the infection to heal. I’ve already had 4 surgeries since October and am nervous it won’t work again.

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  • exercise_guru
    exercise_guru Member Posts: 716
    edited May 2018

    Is this the same Plastic surgeon who did the other work? I personally would travel if need be. I would let everything heal and I would explore if a lat flap is my only option? Would this be on both sides? Would the implant go under the muscle? If so that sounds like a lot of muscle to give up after such a short time recovering. I have a lot of weakness from my pectoral muscle and If I had to go back I think I would try to find someone who could create a sling on the outside of my muscle. I would try to avoide the lat flap because I am having such upperbody weakness as it is. I assume a DIEP is not an option? I am not saying whether to do it or not I am just saying trust your body. It is fine to wait until you get your strength back and have more confidence.

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  • Kms2016
    Kms2016 Member Posts: 20
    edited May 2018

    Yes it is the same PS who did my previous surgeries. It will not be on both sides. My left side has been doing great since the TE was placed in October. For some reason, my right side doesn’t want to cooperate. The plan is to do a lat flap with a TE placed behind it. So the flap will basically be putting healthy tissue in between the TE and previously infected tissue. The DIEP does not sound like it would be an option for me. My PS saysI don’t have have enough there to cut into. I really do want to get it done and be done with surgeries, but I know i shouldn’t rush it either.

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  • CBK
    CBK Member Posts: 611
    edited May 2018

    kms2016

    You poor thing 4 surgeries since October? I don’t blame you for wanting to delay. You should take your time. As long as the asymmetry isn’t bothering you too much.

    My right side too did not want to cooperate. I had trouble from day one on that side. My breast surgeon actually said she took too much tissue from that side. I was set for expander exchange to final implant and my right side opened a tiny pore sized hole. I was leaking fluid, not from expander, but from within. PS scheduled surgery quickly as she was concerned about an infection.

    April 9 was my surgery. Lat flap was a very easy recovery for me. I have excellent range of motion and no pain. My skin on that right side is a normal color FINALLY 🙌🏻and foob looks amazing. I have a silicone implant under the pectoral muscle.

    I wish you much luck moving forward. Take your time on your decision. I would be happy to discuss my experience with lat flap procedure if that is a concern. You can DM me any time.

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  • anotherNYCGirl
    anotherNYCGirl Member Posts: 1,033
    edited May 2018

    Kms, - I, too, had multiple procedures due to problems healing on one side. My ps removed an implant because that (radiated) side had a tiny opening that would not heal. I was not at all aware of it, but he said that it would get infected if he left it alone any longer. He then waited 4 1/2 months before doing lat. I did avoid infection, thankfully. Perhaps the longer wait for lat was because it was radiated skin, but I was fine waiting!

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  • Kms2016
    Kms2016 Member Posts: 20
    edited May 2018

    CBK,

    I’m glad to hear the lat flap was an easy recovery for you. I had a surgery on April 9th too! Mine was an explantation of my TE due to infection though 😟So far, all of my surgeries have been fairly easy recovery times, so i expect the same for this one. I’m just more nervous at the thought of my back muscle being cut into. I just finally got my full range of motion back on my right side. My PS told me if I let the fear of another infection stop me, then I will never want to complete the process. She’s right, and I do want to be done. So I’m trying to put my fears aside and try to think positive that it will work this time.

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  • Kms2016
    Kms2016 Member Posts: 20
    edited May 2018

    anotherNYCGirl,

    I’m glad you were able to avoid infection. That’s great news! I guess it is possible because of radiation to wait longer. I did not need any chemo or radiation, just tamoxifen on a daily basis, so I have been very lucky there. I think I’m going to go ahead and keep my lat flap surgery as scheduled and see how things go from there.

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  • Oneof7
    Oneof7 Member Posts: 59
    edited May 2018

    Perhaps seek a second opinion from different Dr?

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  • Oneof7
    Oneof7 Member Posts: 59
    edited May 2018

    I will have DMX in June 2018.  Met with surgeon today and she said they'd be using saline implants, not silicone.  Just wondering why as you guys all seem to be getting silicone.  Is LatFlap when you take implant from other area of body (in this case Lattismus?)  I'm really hoping to get back to work in 3 weeks.  So many unexpected events seem to be popping up for you guys.

    All my best wishes for speedy recoveries for all!

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  • CBK
    CBK Member Posts: 611
    edited May 2018

    KMS

    Range of motion for me is not an issue in the least and once the lat flap was completed the circulation to the breast area completely came alive. I had a purple foob (with tissue expander) for almost a year on right side. Now I have healthy blood flow and coverage.

    Oneof7

    I’m wishing you a very successful surgery. I think it’s plausible if you are having DMX with just tissue expanders you could be back to work in 3 weeks depending on your type of work. But don’t be disheartened if may be a bit longer based on your healing.

    Lat flap is a surgery that takes the lattisimus muscle and threads it through to area of front breast. In my case, I needed additional tissue coverage and my circulation was compromised with just straight tissue expander reconstruction.

    My PS only uses silicone. Insists it delivers the most natural look. She says saline implants give a more Torpedo type of foob 😆. Love my PS, been a Godsend through this entire year.

    Ladies best of luck. We will get this done. Come out stronger on the other end!!

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  • Kms2016
    Kms2016 Member Posts: 20
    edited May 2018

    I am definitely ready to get this done so I can continue my treatment and eventually have my silicones placed. I should have been completely done by now, but unfortunately I’ve had to go through these obstacles. My PS also said the silicone gives a more natural look. I have gotten a second opinion in the past when this happened the first time, and the infectious doc I saw wasn’t worried about a second infection. Boy was he wrong! I’m hoping the healthy tissue from the lat flap will work this time.

    Oneof7, good luck to you on your BMX. My healing process went well and I was back to being able to do things around the house by the end of the second week. Just remember to follow your instructions afterwards and make sure you do your arm exercises! I think that helped speed my healing process after my BMX

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  • Kms2016
    Kms2016 Member Posts: 20
    edited July 2018

    Hi all! I haven’t posted in a while, but I did end up having the lat flap procedure done and am now 6 weeks post op and doing great!

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  • Wink22
    Wink22 Member Posts: 39
    edited July 2018

    Hi Kms:)

    Glad to hear that you had your surgery and are doing well! I am going to have BMX with LD flaps and expanders on Sept 13th...hoping you might want to tell me more about your experience with the op and your recovery? Do you have full range of motion now? I find myself reading more and more trying to prepare myself

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  • gaspasser
    gaspasser Member Posts: 34
    edited August 2018

    Kms 2016 thank you so much for posting. I hope you are continuing to do well! I am likely have a left side lat flap in a few months and I appreciate hearing about your recovery. I would love to continue to hear how you are doing! Do you have any advice on what you think was most helpful so far? I had a BMX TE to implants. My one implant became infected, was removed and the infection never cleared despite implant removal and several debridements. It was multi drug resistent so 5 PICC lines and now a wound vac later I need a muscle flap so the lat flap on that side was recommended to me by a variety of PS to try to obtain rib coverage, etc. My chest is finally beginning to close with the wound vac but skin is paper thin and my pec muscle is gone in some spots from the past infection. So lat flap it seems. I am very nervous because of so many potential problems described here on the various forums. Thank you and best of luck continued forward!

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  • Kms2016
    Kms2016 Member Posts: 20
    edited August 2018

    Wink 22,

    My post op recovery wasn’t horrible, but I did have quite a bit of pain for the first couple weeks. Now I’m 8 weeks post op, and I still don’t have full ROM, but it’s getting there. I never expected when I chose a double mastectomy that Iwould end up with a scar on my back, but as nervous as I was, I’m glad I did it. I do still get a lot of muscle tightness too, but it’s not bad. Anyway, good luck with your surgery. I wish you a fast and speedy recovery :)

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  • gaspasser
    gaspasser Member Posts: 34
    edited August 2018

    Wink22 best of luck and please keep us posted after your surgery next month. Those of us needing that particular lat dorsi approach over the next few months really appreciate hearing about your experience. As Kms2016 mentioned, it's not the approach I envisioned needing but it sure helps to be able to have the support of those going through the same surgery.

    Kms2016, thanks again for sharing too! It really helps hearing from people like you. Just hearing your progress makes a world of difference so Thanks!

    Sara

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  • Wink22
    Wink22 Member Posts: 39
    edited August 2018

    I will definitely post after my LD surgery, gaspaser:) I am a bit nervous now as the date gets closer, but I like and trust my PS and just want to get it done and begin recovering from this whole crazy year. These boards have helped me a lot.

    Thanks kms for telling me about your recovery. I am seeing a Physio before surgery to work out a rehab program for after the op. I hope that you heal quickly and regain great ROM x

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  • CBK
    CBK Member Posts: 611
    edited August 2018


    I had a lat flap on April 9th 2018 so I'm almost 5 months post -op!

    As far as pain post -op, it was a complete non-event for me. I only took torodel once or twice and then just some Tylenol here or there. Once my drains came out ( the worst part of the experience) I was back at my regular yoga classes.

    My surgeon made incision between back and underarm in a place that honestly I'm so pleased with. I never worry about the scar showing in any of my summer clothes/ workout clothes.

    I want to offer my support to any of you that need it. I understand how difficult it must be with all the negative feedback on these boards to go through this surgery. There are so many factors that go into a successful outcome. I was lucky to have had an extremely accomplished reconstructive surgeon that i developed a strong trust with.

    Stay strong ladies and be in touch.

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  • Wink22
    Wink22 Member Posts: 39
    edited August 2018

    Thank you, cbk....I really needed to hear that now. I tossed and turned last night thinking of the upcoming surgery and if I would be able to still do the things that I like, one of them is yoga:) Makes me happy and hopeful to hear your story

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  • CBK
    CBK Member Posts: 611
    edited August 2018

    Wink-

    Not only will you be doing yoga, it will be part of your healing! I really liked and continue doing some yin yoga to heal.

    My surgeon said it could be a full year to get back full range of motion and strength. But I was lifting my arm overhead right away. I guess the only time I notice difference from side to side is when I do side plank, but I will get there.

    Don’t hesitate to reach out.

    Peace!

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  • Kms2016
    Kms2016 Member Posts: 20
    edited August 2018

    Yoga is definitely going to help with the healing process. I am 10 weeks post op now, and just had my last saline fill last week! This morning, I got up early enough to watch the sunrise over the ocean as I went for a jog on the beach for the first time since my lat! I was a little sore jogging, but it wasn’t bad. My ROM still needs some work, but with stretches to help the lat tightness, it is getting a lot better :) I cannot wait until I’m able to get the silicone transition! Wink22, your surgery will go great, and you’ll be back to doing what you love in no time!

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  • CBK
    CBK Member Posts: 611
    edited August 2018

    KMS- When are you having your final exchange, do you know yet? So happy you are doing well !! Mine is scheduled for September 28th.

    I can't imagine having the tissue expander in with lat flap, I have silicone implant on lat flap side. I would think that alone would limit motion and cause more tightness. Tissue expanders are so uncomfortable.

    Sounds like you had a beautiful morning.... Wishing you more to come!!

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  • Kms2016
    Kms2016 Member Posts: 20
    edited August 2018

    CBK,

    My exchange won’t be until December. Merry Christmas to me! I should have had it done this last March, but with the infections I had, it was pushed back. I’m so glad I’m doing well too, it has definitely been a rough year! Good luck with your exchange! Yes I did have a beautiful morning thank you :) I love and feel so grateful to be able to wake up every morning to an awesome sunrise over the ocean :) Gloomy rainy days make me feel blah lol

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  • CBK
    CBK Member Posts: 611
    edited August 2018

    Kms2016- you can take whatever time you need for silicone exchange.

    I can ask my surgeon but she didn’t want to do silicone implant exchange until about six months post lat flap!!

    I wish I was healing on an ocean shoreline. Enjoy!

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  • gaspasser
    gaspasser Member Posts: 34
    edited August 2018

    Thanks again CBK for sharing along with the other ladies like KMS for people like wink and I who have it upcoming. It makes so much difference in helping go in with a good attitude and a lot less fear. Thanks!

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  • CBK
    CBK Member Posts: 611
    edited August 2018

    Gasspasser?

    Maybe think about showing your DX and therapies.

    Best

    CBK!!


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