Thursday, April 9, 2009

Latissimus Dorsi Flap

I met with my plastic surgeon, Dr. Hijjawi, yesterday to discuss my upcoming surgery on April 28th. The surgery itself should take about 3 hours with a 1-2 night stay in the hospital (you can bet I will be opting for a 1 day stay! LOL). I will probably have 3 drains on that side that will stay in for approximately 2 weeks. Ughhhhh! Not looking forward to the drains quite honestly, but I made it through the last time and whatever I have to do to get myself a set of boobs I will do! Below is some information regarding the kind of surgery that I am having. I have lost so much breast tissue that he has no other option but to remove some skin from my back to create the right size boob, thus the reason for the dorsi flap procedure.

Latissimus Dorsi Flap

The latissimus dorsi (LD) flap is a standard method for breast reconstruction that was first utilized in the 1970’s. The LD 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. Occasionally, for a thin patient with a small breast volume, the LD flap can be used alone as the primary reconstruction without the need for an implant.
Latissimus Dorsi Flap Reconstruction

Latissimus Dorsi Flap Reconstruction

Many surgeons will resort to the use of an LD flap as a backup option if a patient has wound healing problems or soft tissue failure in the setting of an implant. The LD flap can also be used as a salvage procedure for patients who have had previous radiation, and are not candidates for other autogeneous procedures. A large open wound on the chest wall is also an indication for an LD flap in patients that need chest wall reconstruction alone, without creation of a breast shape.

The thoracodorsal artery is the primary source of blood supply to the LD flap. At the time of breast reconstruction, the muscle flap, with or without attached skin, is elevated off of the back and brought around to the front of the chest wall. The main vessels remain attached to the body to ensure proper blood supply to the flap. The LD flap provides soft tissue to allow complete coverage of an underlying implant.

The length of surgery for LD flap breast reconstruction is typically two to three hours, and requires one to three post-operative days in the hospital. The initial recovery time is two to three weeks. Depending on the patient, the scar from the LD flap donor site on the back can be placed diagonally or horizontally. A horizontal scar can usually be concealed under a bra strap. Patients generally have no major long-term physical limitations from taking the latissimus muscle. Activities of daily living and most exercise can be resumed without significant loss of proficiency.

Secondary procedures after an LD flap reconstruction can be done in about three months. These may include expander implant exchange, adjustment procedures to improve breast symmetry, and nipple areola reconstruction. As with any type of reconstruction, if chemotherapy is needed, any additional surgery must await completion of treatment. Such additional procedures are typically done as outpatient surgery with a rapid recovery.

You are an ideal candidate for LD flap reconstruction if you:

* are thin with a small breast volume
* have excess tissue laterally and upward across the midback
* have had previous radiation and are having an implant reconstruction
* are not a candidate for other autogeneous procedures
* are having a partial breast reconstruction in order to correct a lumpectomy defect
* have thin skin that requires extra coverage for an implant
* desire a more natural appearance than that of an implant alone
* are having immediate or delayed reconstruction

You are not an ideal candidate for LD flap reconstruction if you:

* do not wish to have additional scarring to a part of the body other than the breasts
* have had previous chest-wall surgery such as a thoracotomy
* participate in extreme competitive sports such as mountain climbing, skiing, and swimming

Wednesday, April 8, 2009

Tuesday, April 7, 2009

I have started reading this book upon the recommedation of Netherfieldmom and highly recommend it to anyone who is a cancer survivor and those who are not. It is written by a dedicated doctor and scientist who was faced with a brain tumor. This book combines memoir with a clear explanation of what makes cancer cells thrive and what inhibits them, and describes both conventional and alternative ways to slow and prevent cancer. "Cancer cells lie dormant in all of us-and we all must care for the "terrain" in which they exist." This is information you won't get from your doctor! Some of the information he presents I was aware of as I have done quite a bit of researching on my own (yippppee I am up to 8 supplements now! LOL Suzanne Sommers here I come) and some of the information was eye opening for me! Get the book, you won't be disappointed. Living a lifestyle that inhibits cancer from returning is my goal. Take charge of your health now before you are faced with cancer like I was!

Love to all and still walking in this damn cold weather,
ps 8 days until vacation but who's counting!!

Sunday, April 5, 2009


Spring is here! It is official when the pussywillows pop and the pair of mallard ducks that visit our little creek come back. Today we are expecting 2-4 inches of snow! HONESTLY!

So..... I am off for a walk before the snow flies.

I leave you today with a picture of my little naughty dog! Pure sweet naughtiness!