• EJK's Avatar

    Latissimus flap breast reconstruction

    Asked by EJK on Friday, February 7, 2014

    Latissimus flap breast reconstruction

    I had a tissue expander implanted with my mastectomy, but now the PS is saying that there's not enough skin left to complete reconstruction with just that and an implant. She's recommending a latissimus flap, and I'm trying to do as much research as possible. Fortunately there's lots of time to make a decision, and I do plan to seek a second opinion.

    But I'd also love to hear from anyone here who had that procedure about your experience. What was the recovery like? How long before you could go back to work, do every day household chores? How long before you were fully up to all normal physical activity? Was there PT involved? It's hard for me to imagine that not having your latissimus dorsi muscle in place to do its job wouldn't present long-term challenges.

    9 Answers from the Community

    9 answers
    • geminimishy's Avatar
      geminimishy

      I'm confused. Isn't that the whole point of the tissue expanders? For me they add 50ccs every time I go in and eventually I will have enough skin to do full reconstruction with implants. Maybe I'm missing something.

      about 7 years ago
    • junie1's Avatar
      junie1

      as with you, my daughter, maria, (tiaria30), had tissue expanders put in at the time of her double mastectomy,, and when they started doing the fill,, her skin would not stretch like they wanted. so they had to stop filling them. about a yr after her surgery,, they could go back in,, remove the tissue expanders and do the DIEP flap surgery. That is where they use the lower stomach tissue to built your new boobs. This surgery is intense and long (time wise). But my daughter is pleased with how it turned out.. then a yr after that re-con,, they put her nipples on.. Is the one you are talking about the Latissimus flap,, is it where they use your back muscles, tissue to make your boobs?? Both surgeries will require time to heal,, you will be limited to how you do things in the beginning, and with time,, and probably little PT,, learn how to get around. Good Luck to you,, maybe more women will give you more insight on both proceedures.. Good Luck,, june

      about 7 years ago
    • Braids' Avatar
      Braids

      I had tissue expander put in after mastectomy. After expansion, I had additional chemo and radiation. Finally had the implant put in. After one months time, the incision scar opened up about one inch possibly due to my skin not being thick enough according to the plastic surgeon or maybe radiation damage to skin. As I do not have enough fat in my stomach to to the DIEP flap, he has recommended the latissimus flap to me also. I spoke with a women at my breast cancer support group who had the procedure. She does not have any restricted movement but does have a large scar on her back. I don't know if she had any PT, I'll have to ask her. I wondered too about lasting effects. Unfortunately, I have to put it off as I'm back in chemo for another type of cancer I have, Leiomiosarcoma. Gynecological/oncologist has recommended I not have any surgery until and if we get that into remission. Watching two small lesions on my lungs. Pray next CT scan shows chemo has taken care of them.

      Good luck to you and let us know how it goes.

      about 7 years ago
    • EJK's Avatar
      EJK

      Thanks for the answers. Geminishy, I agree the point of TEs is to create enough space and skin to insert implants, but they have to have something to work with. In my case the tumor was growing so rapidly that the planned skin-sparing mastectomy just wasn't able to spare enough skin, so the PS says she'll need to supplement the implant with a flap. As I said, I'll be getting a second opinion, but want to gather as much info as I can about the option she is recommending.

      And yes, junie1, this is the procedure where they use back muscle. Which is what I'm concerned about, because presumably that muscle has function where it is.

      I want to understand as much as I can about both short and long term effects. I feel like fighting this disease has already taken away so much of my life -- weeks recovering from surgery, weeks feeling lousy due to chemo, more weeks to come travelling to radiation daily while managing fatigue. I hate to add extra months for recovery from more surgery, but then again I hate to have to put on a special bra to walk outside and not look freakish. If I had the choice of going completely flat I'd jump on it.

      Finally, Braids, I'm really sorry to hear you're having to deal with yet more cancer on top of all of this. Best of luck with that, and I'll keep my fingers crossed for a good CT scan for you. Hugs.

      about 7 years ago
    • debsweb18's Avatar
      debsweb18

      I'm looking for more information as well. Due to radiation my implant only reconstruction is not very desirable. The skin is too tight causing flat parts. You'll definitely want to wait until after radiation.

      about 7 years ago
    • junie1's Avatar
      junie1

      my daughter almost went flat chested,, she was flat for about 2 yrs,, till the did the DIEP flap proceedure,, she did not feel like a freak when she put on a tank top, or a shirt,, she was the same person she always was,, she just didn't have those "triple d boobs" she had,, but she was our maria,, and will always be maria,, boobs or no boobs,, let us know what proceedure you have done, and how it goes,, good luck,, junie1

      about 7 years ago
    • PinkPickle's Avatar
      PinkPickle

      I've had a Lat dorsi reconstruction and would have to recommend the DEEP recon instead. They only use part of your Lat Dorsi muscle so it doesn't take the entire muscle away. The tricky part of the Lat.Dorsi surgery is in not damaging the nerves when they are moving the muscles to create the pocket for the permanent implant. I am 3 years out from my recon and have chronic pain syndrome because of the injury to my nerves. Not fun at all.
      I would ask your surgeon how many Lat. Dorsi recons they have done successfully. I also have to add that my actual reconstructed breast looks amazing. I did not have any work done to my other breast and they match beautifuly.
      I do have a large scar on my back, but I'm not one who cares so much about it, after 3 years it has no discoloration or "wrinkles"
      I was 43 when I was diagnosed and in fairly good shape. Because of my peripheral nerve damage resulting in chronic pain I am very limited in my ability to work, much less work out.
      Good luck, ask questions and remember to weigh what is truly important to you before you make any final decisions.

      about 7 years ago
    • Kmack927's Avatar
      Kmack927

      My expander experience has been a fail as well. IT has now been in for 18 months. After 6 months of trying to expand it and months of PT as well as the process was very painful my PS felt like I would benefit from a TRAM or DIEP (newer and less long term problems as it does not take the muscle like TRAM) anyway the Dr. recommended the DIEP problem is she is the only surgeon in Oklahoma that can do it and just found out last week I will not be able to have the surgery until May because of her schedule (they told me in November it would be Jan/Feb)The expander has been a very painful debilitating experience for me how bout you? I have been off work this entire time because of the lifting limitations of the expander. I provide therapy to kids with disabilities. I would ask about the DIEP surgery and find out how many surgeons in your state are certified to do it. There seem to be a lot in Texas, California and New York.

      about 7 years ago
    • Kmack927's Avatar
      Kmack927

      @geminimishy the tissue expanders are meant to expand tissue, but if radiation destroyed the tissue there is no tissue to stretch. they were only able to get 200 in mine over a 6 month period, before I was recommended for a DIEP. I am a small person to begin with so because of that and radiation I was told by new surgeon they shouldn't have been used.

      about 7 years ago

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