• Should I have a Latissimus dorsi back flap reconstruction?

    Asked by Mamajane on Thursday, August 13, 2015

    Should I have a Latissimus dorsi back flap reconstruction?

    After some complications with my expander to implant surgery, I'm now looking at Latissimus dorsi back flap surgery. What is the down side to this surgery?

    12 Answers from the Community

    12 answers
    • debsweb18's Avatar
      debsweb18

      Its a long and hard surgery.It took me 5 weeks before I could go back to work. It's been over 1 year and I sometimes feel pain and stiffness in my back. However I'm glad I had it done.

      over 4 years ago
    • whirl's Avatar
      whirl

      I had silicone implants thus I have no personal experience. I worried because when you rob Peter to pay Paul there will be compromises. I would talk with your plastic surgeon about what the loss in your back may cause. I bench press for strength and core work. I had concerns what the loss would prevent me from doing such items. Also I have heard of chronic back pain from the proceedure. Questions I would address would be what have been some of the complaints of their patients from the surgery, what limitations might it cause, and possible complications.

      over 4 years ago
    • EJKIRBY's Avatar
      EJKIRBY

      I also had silicone implants and have had not problems. Had the mastectomy, latissimus flap and tissue expanders all done at the same time in January 2013 with the implants put in in April 2013. I had not problems at all with the latissiums flap - no pain and no loss of strength. The scar is minimal and low on my back so it doesn't show when wearing low back tops.

      over 4 years ago
    • Pinny's Avatar
      Pinny

      I had my surgery around a year ago after numerous infections. I have a large vertical scar but after going for some PT I have complete mobility. I didn't have much pain at all because everything is numb. If I had everything to do over I would have my bilateral mastectomy and do NOTHING! No expander so, no implants, NOTHING!

      over 4 years ago
    • MelanieIIB's Avatar
      MelanieIIB

      Mamajane, I had diep flap reconstruction because I did not want any muscles taken and complications that can arise from that. Whirl had some good suggestions for you of questions to ask. Your life style should be considered (are you athletic, lift weights, lift heavy things in your job or everyday life) these things can be affected by removing that muscle. As always, everyone's body reacts differently. Here is a good article about it from breast cancer.org. http://www.breastcancer.org/treatment/surgery/reconstruction/types/autologous/lat-dorsi

      over 4 years ago
    • peachpoppy's Avatar
      peachpoppy

      I had a mastectomy 2 years ago and was flat until April 2015 when I had the DIEP, which failed on one side so my only good option was to do the Latissimus Dorsi back flap with an expander (still waiting to have the expander replaced with implant). So I feel like I've had a little taste of everything.

      As for reconstruction vs not, I'm glad that I went thru with the reconstruction. I was content flat, but am now realizing I feel better with breasts. As for the procedures, the DIEP was MUCH easier than the LD! The fact that there is no muscle involved I think made all the difference. I would do the DIEP again without hestation - it was easier than my c-sections. The downside is numbess and a very large scar. The flat stomach is even better than the breasts, if I am being honest.

      LD was much more painful, and continues to be now (3 months out from surgery). The scar is very large and boomerang shape so that it doesn't show in a tank top, but there is a bulge under my arm that looks like excessive back fat, which may diminsh or be surgically removed in a future surgery, I'm not that far out yet. I have a lot of muscle tightness and the area is very sensitive/sore. I don't notice any significant loss of muscle use or anything like that. My doctor said that there would be no impact to daily acitivites of normally active people - so far he's been right. But I haven't gotten back to my normal yet (playing tennis, yoga, etc) so we will see. The other downside for me with this procedure was the implant that was needed to match the DIEP side. I hadn't wanted implants and the future maintenace they will require.

      Hope that helps. Reach out with any other questions you have. And good luck to you.

      over 4 years ago
    • Nonnie917's Avatar
      Nonnie917

      Just my opinion mamaJane, but I would go with the stomach DIEP flap reconstruction. If you have enough fat in your lower abdomen that is. I had that done and while it was a long recovery for me it was worth it. However, there is one draw back. Because the reconstruction will be made from fat, if you lose weight you also lose volume in the new breasts. After I had that done the doctor asked if I was losing weight because I had lost some volume and I was losing weight. So, because of that I opted to have implants. I should have done that from the start, but the PS wasn't available when I was going to have my surgery. They usually do that during the removal of your breast tissue. So I had to have mine done later. Took two additional surgeries and I just had the headlights done June 1. Took me two years to decide if I wanted them or not. After looking at myself and feeling detached from my body, I felt like it needed to be done. I get the tattooing in about 3 months. So really what it boils down to is research and ask questions of your team. That is the way to get the best answer for you. Good luck and be sure to keep us posted.

      over 4 years ago
    • PinkPickle's Avatar
      PinkPickle

      I had the lat. dorsi flap surgery 5 years ago... I have major nerve damage due to the surgery causing chronic pain to a very serious degree. I also have a few friends who have had the same surgery and have no problems at all. I'm not the norm, but feel like I have to let you know what can happen. Some days it's a test of my will just to get out of bed, but I rarely let the pain win!
      If I were to give my best friend advice I'd tell her not to have this kind of reconstruction. That said, there are risks with every type of reconstruction and ultimately it comes down to what makes the most sense for you. Best of luck to you!

      over 4 years ago
    • mofields' Avatar
      mofields

      I also had the lat flap surgery - in November 2015. I had problems with my skin after radiation so it was only reconstruction surgery that would work for me. Actually it hasn't been that bad. I had a saline implant put in (I had just the left breast done and my PS tweaked the right side for symmetry). Post surgery I was out of work for about 5 weeks (no heavy lifting for a couple weeks, about the same kind of restrictions as the mastectomy surgery). The scars are different as they move muscle from the back to the front, but the good thing is the healthy back skin that comes to the front. I have a football-looking like scar on my breast, and a 6-inch or so scar that runs under my left arm to nearly the center of my back - I call it my shark bite. If you do your post surgery PT you should have no range of motion problems (I have full use of my arms and back muscles). Now some forms of exercises my take longer to get back to (like tennis, weight lifting, and some swimming movements), but you can get back to those if you take care of yourself and do what you are supposed to do PT wise. As for pain, not a lot, sometimes if I do too much during the day (lifting-wise or housework) I'll feet it - it's always going to be there as feeling the muscle, but it is not bad at all - nothing a little over the counter pain reliever can't take care of.

      over 4 years ago
    • sheila56's Avatar
      sheila56

      I am a two time breast cancer survivor. The second time of course, I had to have a mastectomy since I had radiation along with the chemo. So in 2013 and I got an infection and had to have the implant removed. This time I am going with the latt flap. I am on "whatnext" asking questions and getting good responses I feel. Also my PS says I will be able to do everything I can do right now after the surgery. He said that if I go with the DIEP I would have problems with weak stomach for the rest of my life; and I have been told by people on here that is not true; so maybe subjective for different people; but that is what he told me. Someone on this post stated they had physical therapy and I plan to do that. I have been active with my workouts so I feel that is beneficial in the big scheme of things; I am strong. So I am pretty confident this is a good surgery for me. We all have to weigh our options and discuss, discuss, discuss with our doctors our concerns and even doing all that nothing is going to be perfect; it could be, but probably not in our minds.

      over 4 years ago
    • Donnabakins' Avatar
      Donnabakins

      Research, research, research! Don't rely on information from your plastic surgeon. I was told my breasts would be better than before cancer. I don't care what they look like anymore.

      I am four years out. I had pre-existing scoliosis that never caused problems. I have almost constant back pain now and significant nerve damage. I have developed a severe herniated disc in my neck and also herniated discs in my middle and lower back. I have limitations in my arms and can't open heavy doors. I have severe neuropathy and my hands go completely numb. I have spasms in my breasts that are very apparent and embarrassing. They are especially severe when I am tense, fatigued, or stressed. I believe the muscles still think they are in my back and the spasms are reflexive.

      There are those who have had this procedure without significant problems. There are others like me. Check for Facebook support groups. I would definitely have a microsurgeon perform the procedure as opposed to a plastic surgeon.

      about 4 years ago
    • mofields' Avatar
      mofields

      Donnabakins, do you think your herniated discs in your back and neck are caused by the reconstruction? I just developed a herniated disc in my neck, which hurts constantly and needs surgery, but with the high deductible insurance we have we'd have to pay nearly $5,000 up front that's not going to happen soon. I never thought it might be related. What are you doing to help your back and neck?

      about 4 years ago

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