Lateral Thigh Perforator Flap Breast Reconstruction A Success!

Options
Outdoorsy
Outdoorsy Member Posts: 35
edited September 2018 in Breast Reconstruction

My stage 1 breast reconstruction was successful! I had bilateral nipple sparing mastectomy surgery locally on March 2, 2018 and then traveled to New York City to have my breast reconstruction. After discussing my various donor options with my microsurgeons, Dr. Joshua Levine and Dr. Robert Allen, I decided that they could take my saddlebags. I sure wasn't going to miss them! So, I now have new breasts and two 8-9" scars on my outer thighs where my saddlebags used to be. The breast reconstruction surgery I had is called lateral thigh perforator flap or LTP.

My surgery was on March 19, 2018, and I was discharged from the hospital March 22. The two breast drains I had were removed prior to my discharge. I was walking around the day after surgery, walking the hospital hallways on days 2-3, shopping on day 4, walking around a mall on day 5, and walking 4 NYC blocks on day 6. On day 6 I traveled back home and have been doing as much as I can around the house. On day 8, I stopped using the little pain medication I was using.

My thigh incisions are pretty tight, so I'm hoping they loosen up soon. I'll have my thigh stitches removed next week (or at least every other stitch and then the following week I'll have the remainder removed). I still have 2 drains in my thighs that are still pulling quite a bit of fluid. At this rate, the thigh drains may have to stay in another week or two.

From what we can tell so far, stage 2 (which I scheduled for June 1) will involve smoothing out a lump near the end of my right thigh incision using liposuction and possibly fat grafting to adjust for breast size differences and any fullness issues.

Overall, I am happy with my decision to go with the LTP surgery instead of PAP or SGAP. With my LTP surgery, I'm not sitting directly on my thigh incisions. I can imagine that I would have more pain with PAP or SGAP, since those incisions would definitely have had much more contact with sitting and sleeping.

My hope is that this post will help future readers with their decisions regarding tissue transfer breast reconstruction.

· Share on FacebookShare on Twitter

Comments

  • Outdoorsy
    Outdoorsy Member Posts: 35
    edited June 2018

    Update: I was doing so well, but on April 10, 2018, I ended up with infections in both thighs/donor sites and a hematoma in the left thigh. The infection explains why my donor sites were still draining so much. I was in the hospital on IV antibiotics for 4 days, then my surgeon pulled my drains, opened up part of each incision, and cleaned out the remainder of the infection and hematoma. I was outfitted with a "lovely" wound vac machine connected to each thigh. It sucks the fluid from my donor sights and helps to close my wounds from the inside. This requires me to have visiting nurses come to my home to change the dressings and to see a wound specialist at my local wound center once a week. For me, dressing changes happen every Monday, Wednesday, and Friday.

    Unfortunately, on May 3, 2018, I ended up with yet another infection - this time mainly in the right thigh. I was in the hospital, again, for IV antibiotics. The wound vac stayed connected to each wound.

    Well, after being home from the hospital and finished with my week of IV antibiotics, on May 3, 2018, I ended up with ANOTHER INFECTION in the right thigh! We think that the antibiotic I was on just wasn't working for the infection I had, so, I ultimately ended up taking a different antibiotic (which I'm finishing up now).

    I still have the wound vac machine connected to each thigh, which is working in making my wounds smaller. I just wish it would work much faster. If the infections stay away, I suspect I'll have the wound vac at least another 4 weeks. I sure hope that my current antibiotic removes any and all infection...COMPLETELY!

    By the way, my breasts are doing well. I'm so glad they did not acquire any infection. Once my wounds are closed and we're sure there's no sign of infection, I'll have my stage 2 surgery.

    · Share on FacebookShare on Twitter
  • SCGirl50
    SCGirl50 Member Posts: 43
    edited June 2018

    Outdoorsy I hope you are doing better. That is a lot of complications. I had the SGAP reconstruction. It never hurt due to all the nerves that are severed from the site. The worst was the drains as you know.

    · Share on FacebookShare on Twitter
  • Outdoorsy
    Outdoorsy Member Posts: 35
    edited June 2018

    SCGirl50 - That's good that your SGAP wasn't painful! And, yes, those darn drains are horrible!

    I'm doing a bit better and haven't had any new infections. I still have the open thigh wounds, but they are getting smaller. My wound care specialist had me stop using the wound vac on June 13 and switched me over to using a type of ribbon dressing with silver in it. I am sooooo happy that I don't have to lug around that wound vac anymore!!! I had it for 8 weeks. I was hoping to have my stage 2 surgery in July, but I don't think my wounds will be completely healed by then.

    · Share on FacebookShare on Twitter
  • SCGirl50
    SCGirl50 Member Posts: 43
    edited June 2018

    Wow! What we have to go through to feel whole again. I am having my revision in 9 days. Little tweaks here and there. I had to do SGAP because I didn't have enough fat anywhere else. It took my whole abdomen for just 1 breast and I am only a B cup.

    · Share on FacebookShare on Twitter
  • Outdoorsy
    Outdoorsy Member Posts: 35
    edited June 2018

    I bet you're excited to have the revision surgery and to being (hopefully) done! It sounds like our body types are similar. I tend to hold more weight below my waist, so my stomach wasn't a great option on it's own. I would have had to use stomach and had it wrap around towards my back (extended diep). And then I probably would have been an A cup.

    I certainly hope your tweaks go smoothly and that the outcome is satisfactory to you!

    · Share on FacebookShare on Twitter
  • Nanpop
    Nanpop Member Posts: 75
    edited September 2018

    outdoorsy. Were you happy with the results asthetically?

    · Share on FacebookShare on Twitter
  • Outdoorsy
    Outdoorsy Member Posts: 35
    edited September 2018

    I'm scheduled to have my stage 2 surgery September 17, 2018, so I'll post again afterwards. If you haven't seen another post from me by October 1, feel free to bug me for one. I'm happy with my breasts, so far, but will need to have the skin flaps removed from underneath of each breast and may have some fat grafting to fill the upper poles of my breasts. I'm currently not happy with the way my thighs have healed but am hopeful that my surgeon will fix them. I had complications from infections, but even before that, I noticed that I would need to have some liposuction to smooth out my thighs. During my stage 2 surgery, my surgeon is going to liposuction around my thigh incisions to, hopefully, get them looking more even. I currently have indentations that are very noticeable. When I leave the house, I wear pads (that I made) taped to my thighs to "fill in" my thigh indentations. Overall, though, I'm still glad I made the decision to have the perforator flap breast reconstruction.

    image

    image

    image

    · Share on FacebookShare on Twitter
  • buttonsmachine
    buttonsmachine Member Posts: 930
    edited September 2018

    Thanks for posting an update, outdoorsy! I think you look great!

    I hope your stage 2 surgery goes well, that you heal quickly, and that you are happy with your final results. :-)

    · Share on FacebookShare on Twitter

Categories