Tuesday, April 6, 2010

Reconstruction

I'm in NO hurray to have reconstruction done, that's for sure.  And I now know what my option is.  Backflap and implants.  I met w/ my plastic surgeon yesterday and I like her very much.  She know's I'm in no rush to schedule this surgery.  I'm thinking maybe the Summer of 2011.  This is what I learned yesterday:


Since I had radiation, my chest would not be able to support implants, alone.  In a nut shell. . .My doctor will move muscle and skin from my back to my chest. 


Hospital stay:  1-2 days  Recovery time:  3-4 weeks


This is what I have to look forward to. . . see why I'm not in a rush?  Smile.


What to Expect During a Latissimus Dorsi Breast Reconstruction:

You will not be awake during your mastectomy or reconstruction, so you will have intravenous sedation or general anesthesia. Talk to your surgeon and the anesthesiologist about which will work best for you, and be sure he or she is informed of all medications and supplements you are taking. If you are having a mastectomy and reconstruction at the same time (immediate reconstruction), your general surgeon will first remove your breast, sparing as much skin as will be safe to keep.


Getting Ready for Latissimus Dorsi Breast Reconstruction:
Your plastic surgeon will use a skin marker to carefully plan for the incision that will create your skin flap. A pointed ellipse will be drawn on your back, over your latissimus dorsi muscle. This ellipse will become the skin flap that closes the incision for your reconstructed breast. When the incision for the flap is shut, it will be about 10 to 15 cm in length and follow the line of one of your ribs.


Moving Muscle and Skin:
Your plastic surgeon will make an incision on the skin markings, raising the skin and muscle flap. A tunnel will be created under your skin so that the flap can be relocated. This tissue flap will go through the tunnel to the front of your chest, keeping its blood supply intact. This ensures that the skin and muscle will continue to live in their new location. The skin will be positioned so that it fills in the skin that was lost during your mastectomy. If you need an implant, the muscle will be draped over it to create the new breast mound.


Closing Incisions and Starting Recovery:
Your back incision will be closed, and a surgical drain may be placed in it to help remove excess fluid. On your chest, the skin flap will be carefully joined to the mastectomy incision. If needed, scar tissue from your mastectomy may be removed in order to create a smoother skin texture at the new incision. Some patients may need a surgical drain in the reconstructed breast to help prevent fluid build-up and promote healing.


Recovering from Latissimus Dorsi Breast Reconstruction:
You may need to stay in the hospital for three or four days as you begin healing from breast reconstructive surgery. If you have surgical drains, you will learn how to empty those and keep records of the fluid volume. Report pain if you have any, so that it can be treated. Don't go right back to work – plan on taking it easy for three to six weeks for recovery. Be sure to have someone around to help drive you and do any lifting. Be sure to go for your follow-up appointments so your surgeon can keep an eye on your incisions and dressings and remove your drains.


I had a crazy dream last night that I met w/ my oncologist and I forgot to bring my list of questions so I just sat there, didn't say a word.  My list is in my purse.  No way will I forget it.  Jeff will be there w/ me. 


Gotta run.  Will write more later this week.


Love,
Nancy

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