The Final Chapter

Having little faith in the surgeon I had spoken to previously  I was overjoyed at the news I was being referred on to a new surgeon and after the first meeting with the new man I walked away feeling confident. I felt this man had more of an interest in the final outcome. We discussed the different procedures and he was totally against my first choice of the tissue expander, because the skin was badly damaged from the radiotherapy he felt there was no way the skin would stretch enough and could see problems down the line so I asked him as a professional what would you recommend.
He said the only one he thought would be both successful and aesthetically pleasing was the Latissimus Dorsi Flap. I knew this all along but didn’t want to think of facing another major surgery but by the end of the meeting I had decided to hell with it, in for a penny in for a pound! This surgery was not necessary but something I wanted for myself, in my mind this was the final chapter and it may as well have a good ending so I agreed to the Dorsi flap surgery. Now all I had to do was wait.

Latissimus Dorsi Flap
The latissimus dorsi is a large fan shaped muscle which lies across the mid-back. This can be separated from its normal attachments and swung to the front of the chest to recreate missing tissues and create a breast. A tunnel under the skin is created to deliver the flap to where it is needed. The muscle is normally used together with an attached piece of overlying skin known as the "skin paddle".
The skin paddle is used to recreate the skin that was removed during the mastectomy and the underlying fat and muscle to recreate the missing breast. Unfortunately the reconstruction of a breast using only the latissimus dorsi flap is only possible with very small breasts; usually the procedure needs the addition of a silicone breast implant or tissue expander to produce a satisfactory breast reconstruction.
Latissimus dorsi breast reconstruction leaves a significant scar on the back measuring approximately 9 inches; this scar is usually placed transversely so that it can be hidden by the bra’ strap.

The day finally arrived March 31st 2011 three years after I received the news I had breast cancer. I arrived early that morning and met with the surgeon for a final talk on what was being done that day, he would be also using an implant behind the new tissue and muscle to match the size up to my right breast, I told him he could do whatever is needed once I am asleep I couldnt care less so he left to get ready.

All I remember of the surgery is walking down to the theatre getting hooked up to a drip and waking up back in my room in the middle of the night. There were so many tubes and drips hanging out of me I couldn’t get out of the bed, I closed my eyes and was off asleep again until morning. Best invention in the world has to be the pain button for controlling your pain, click click and the pain reduces straight away so although it was a long procedure it is not so bad coming out the other side. There were a lot of dressings so I couldn’t see the final outcome but the shape looked good, of course there was swelling so I looked a bit lopsided but another week or so would tell the tale. I had four drain tubes coming from my side and for me taking those drains out was the most painful part of this whole process, they go at least ten inches under the skin and pulling them out was like a hot poker moving under the skin, I was so happy when the last of them was gone. I spent six days in hospital and then returned home, I was given a support bra which had to be worn day and night for the first couple of months, it reminded my of the big corset bras my Gran used to wear but I needed the support for my back so it didn’t really matter what it looked like. Because of the dressings I still hadn’t seen the final outcome but was determined to have a look once I got home. Taking off the dressings I seen the scar area in the front was still quite raw and red but the shape was looking great, the scar on my back gave me a bit of a fright as it is quite long but as the surgeon said once I have a normal bra on it will be hidden from view.

I had a return visit to the surgeon four weeks after the surgery and he was both happy and surprised at how fast the scars were healing, the pain from the surgery was fading and I was able to do a lot more around the house etc. the swelling has gone down and now I am looking forward to wearing a normal bra again and not have to think about what tops I can and cannot wear because I have a cleavage again the sky is the limit on clothes.

I would recommend the surgery to anyone thinking about it, yes it is worth it to feel good about yourself again, it looks a bit odd because there is no nipple on the breast but it is possible to have more surgery done and have the nipple attached, personally I am happy to leave well enough alone but that is just my choice, its not as if I will be going topless on the beach any time soon.
For now I feel I am done with this illness, a visit to the hospital every six months for blood tests and a check up and my medication is all that is left. So now I find I have so much running through my head, things I have put on the long finger are now accessible and I look forward to tomorrow and what it will bring.

I would like to thank you all for reading my story and I hope in some way it has helped people understand that although cancer is a frightening prospect it can be dealt with effectively with the help of modern medicine and a positive outlook.

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