Deciding upon which type of reconstruction surgery to have after losing part of your breast, or all of it, or both of them, to breast cancer is often very difficult, so I decided to devote all of my blog posts this week to a discussion of the various types of reconstruction surgery that are available, together with a little feedback from women who have undergone each type of surgery.
The Latissimus Flap
The latissimus flap is a pretty standard breast reconstruction method, first utilized way back in the 1970’s. Your surgeon will take a flap from your latissimus dorsi muscle (located on your back), with or without attached skin. The flap is elevated off of the back and brought around under the skin under your arm to the front of the chest wall. The main vessels remain attached to the body to ensure proper blood supply to the flap. The latissimus flap provides soft tissue to allow complete coverage of an underlying implant if one is utilized.
The latissimus flap is most commonly combined with a tissue expander or implant, to give the surgeon additional options and more control over the aesthetic appearance of the reconstructed breast. This flap provides a source of soft tissue that can help create a more natural looking breast shape as compared to an implant alone. Sometimes, for a thin patient with a small breast volume, the latissimus flap can be used alone as the primary reconstruction without the need for an implant.
The latissimus flap can be used for reconstructing one or both breasts. You will have a horizontal scar (although some doctors create vertical scars) running under your shoulder blade on the reconstructed side, approximately 5″ long.
Length of Surgery: for one breast, 2-3 hours (this may vary according to your surgical team).
Hospital Stay: 1-3 days
From A Practical Point of View…
After this surgery, it’s normal to have some restriction of range of motion of the arm on the affected side. Also, because you now have muscle tissue in your new breast, when you contract your latissimus dorsi muscle, you will feel your breast contract as well. This may annoy some women. I chose this type of reconstruction for myself and I’m used to the muscle contraction now – it’s a great party trick (lol).
Some survivors say they wish they had never chosen this surgery because they have suffered from a great deal of post-surgical back pain, presumably there was some nerve damage done. For myself, I have experienced no such problem. I have had to be extremely proactive with stretching and yoga to regain my muscle strength and range of arm motion, as well as a particular type of massage to reduce adhesions from scar tissue. Since I’m a massage therapist, I created a video to explain the procedure so others could get their massage therapists to do this for them.
One further thing I have noted – the area around the scar on my back is still numb, eight years later, and it itches sometimes. It’s also numb along the side of my body over the area where the tissue wraps around and I have a lot of loose, slack skin on the side of my body where the muscle wraps around. If I were younger and worried about such things, I might need a further surgery to correct that.
All in all, most survivors who chose the latissimus flap reconstruction were happy with their surgeries. Here’s an inspiring YouTube video of a woman who underwent this type of surgery.
My suggestion? Make sure you discuss your options thoroughly with your surgeon so that you know all of the pros and cons each type of reconstruction surgery will entail and choose the one that makes sense for you and your lifestyle.
If you choose to have reconstructive surgery, please read my article Tips For Surgery – Useful Items to Take With You. Another article that might be helpful: My Top Favorite Things to Promote Surgery Recovery.
Reference: breastreconstruction.org, breastcancer.org forums
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Hi Marnie, I had a mastectomy with immediate latissimus flap reconstruction in Oct. The reconstruction has been amazing with really good, natural looking results. I am not a small woman and have a fairly large bust at 40C, but did not need an implant or tissue expander due to my back muscle being very big – I swim lots! Because of the masectomy as well, my surgery took 8 hours, I had 2 drains (one out after 2 days, one after 5 days) and 7 days in hospital. I still have some numbness and itching along my back scar, but you cannot see the scar under my bra line. I have a small bulge under my arm which may or may not go down, but with a bra on you would never know I had had surgery. I would definately recommend this surgery and would certainly recommend immediate reconstruction if that is an option.
Thanks for sharing your reconstruction journey with us! Good info, much appreciated. Sending hugs!
Great post! Been reading about ways to get over pain in my lats recently. Thanks for the info!