Category Archives: latissimus flap reconstruction

My Breasts – One Year Later

One of my regular readers asked for what amounts to a critique of The Twins from both my perspective and my husband’s. So here we go: What I think of my boobs almost one year after reconstruction.

They’re BIG. I know we’ve been over this before, but DAMN. They’re still really big. Those of you who have seen the breast reconstruction photos know I’m not even half kidding. Those are ALL me. No implants. After all the problems I had related to implants, I insisted that they not be used.

They look natural. They bounce, they sway, they’re not plastered to my chest like a pair of angry headlights. They even do that fallout thing. In other words, when I’m laying on my back naked, they migrate towards my armpits like normal boobies do.

In a push up bra I have cleavage for DAYS. AND they pass the Pencil Test with a 4.0 GPA.

I love the Twins and I’m beyond grateful to have them so please understand that the critique I am about to give is in NO WAY meant to imply that I’m not happy with what I have. These are observations on my own reconstruction that other women may or may not experience.

There are really only a couple very minor things. First, on the cleavage side of my right breast there is this one little spot where the flap was sewn in that looks just a little bit uneven. The only angle that can be seen from is the top and in this photo you have to look very hard to see it. The right breast is the top photo.

You can see a tiny bit of lumpiness where the green intersects with the breast. It is also a little flat on the front from that angle making the breast look slightly squarish.

The left breast, pictured below, is a better example of the slightly squarish look shown here. This HAS improved over the past year.

There is also a very minor indent where the scar is but that’s just what happens with any scar.

As far as the feel goes, they are pliant, yet firm. Since *I* know how they were constructed I know that firmness comes from the transplanted latissimus flap muscle. On the bottom outside edge of both breasts, if you probe, you can feel the outer edge of the muscle flap.

When you do a full on grope, it’s the muscle that makes up the firmness and the fat that makes them soft and pliant.

Many of you have asked for the perspective of my husband, Ken. I will be asking him to write guest articles on the more emotional aspects of necrosis and recovery from that in later installments. In the mean time, here are a few of his comments on the Twins one year out from surgery.

Ken: “Due to the procedure, there are some areas that are a little squarish. Considering what Dr. Elliott started with, they’re AMAZING! They also came out much bigger than both of us expected but that’s NOT a bad thing.”.

When asked about what my breasts feel like, he comments, “They feel amazing and they fit my hands well. They’re big, they’re full and they have a nice heft to them.”. He thinks that, appearance-wise, the Twins are a good size for my frame.

In general he reports that he can’t feel the flap. If he feels in detail, he can feel the scar tissue (the scar lines where the flaps were inserted) but nothing unusual.

Tomorrow I will post detailed photos of what the Twins AND my back look like exactly one year after reconstruction so stay tuned.


Sore Flap

I have noticed over the last week or so since I started the program that I have some problems. I have a silver dollar sized area on the outer edge of my right breast that feels like someone is boring into my breast. The spot isn’t where the wire ends on bras. It’s about an inch forward of that, towards where my nipple would be if I had one. If I probe, I can feel the edge of the muscle flap.

Now I’m SURE I definitely overdid it this past weekend. Saturday Ken and I took the “Keys To The Kingdom” tour at Walt Disney World’s Magic Kingdom. It’s a FIVE HOUR walking tour. Of course there were short breaks and 30 minutes for lunch. We’re talking about a 3.5 mile hike around the park. For me, that’s like running a marathon.

We got up at 6 am so that we could be there by 8 to check in because the tour started at 8:30. Then our lovely guide Evelyn, proceeded to take us all around the park. It was a fantastic tour and I recommend it highly. This tour was on top of the run I did on Friday.

After a nap, we came back since the park was open til midnight and stayed until nearly closing. I was pretty worn out but I thought maybe with a good night’s sleep and some aspirin, I’d feel better. We slept until we woke up and I was sore and tender but I figured if I walked, I’d stretch out the soreness. After a nice breakfast of fruit and yogurt, we went BACK over to Magic Kingdom. As we were walking out the previous night, I found a child’s hoodie sitting on top of a covered trash can so when I dropped it off at City Hall, the woman there asked if i would like a fast pass. It was good for one attraction. Since we hadn’t gotten to go on Space Mountain since it re-opened after refurbishment in December of last year, aches and pains or not, We were GOING on Space Mountain. By the time we made our way to the back of the park, I was starting to feel like a zombie. But by damn I wasn’t going to give in.

After Space Mountain we went all the way BACK out to the car and drove over to Animal Kingdom. I wanted to milk this weekend for all it was worth since we so rarely stay over night. So we took it reeeally slooooowlyy. By the time the park closed at 6pm, I was spiking about a 4 on the pain scale. That’s the highest it’s been for a long time. I was firmly convinced that I had died some time the previous night and no one had bothered to tell me.

By the time we got home I was thinking that I might have done something to my right breast flap, i was in that much pain. So I grabbed the ice pack and tossed down some Tylenol. This morning, I was in even worse shape. I went to change my bed time top and it felt like the flap was ripping. So I called Patti at Dr. Elliott’s office.

She was kind enough to reassure me that I hadn’t done any damage to what they had done. She suggested I take ibuprofen the rest of the day and resume normal activity tomorrow. She said that getting back to my old self (or in my case, better than my old self – my words, not hers) was going to be painful.

So here I sit, waiting for Ken to get back with ibuprofen. I’m SO not looking forward to running tomorrow but I’m NOT going to skip it. I’m just shifting it to T-TH-S this week instead of the usual M-W-F.


In Honor Of Mardi Gras: My Boobies!!

Ladies and gentleman, in honor of the 2010 Mardi Gras, and because I can’t be there in person to do this, I present to you…. <drum roll please>


Okay, okay, so they’re not MY boobies. And that’s actually spelled Bubis according to a few sites I’ve looked at. These two on the left are Blue Footed Bubis. There is also a species of Red Footed Bubi on the Galapagos Isles as well. See the photo below.

Yeah, I know. Feathered Bubis just aren’t the same. And so, for your viewing pleasure, I present to you, my new breasts about a month after latissimus flap breast reconstruction. (see more about that here: living_latflap.htm#how The reason there is tape on them is to keep the scars from becoming keloid scars. Those are thick and ropey. The tape helps them heal flat.


Latissimus Flap Breast Reconstruction Photos

Since I posted the necrosis photos and a description of each one yesterday, for Valentine’s Day I am celebrating the Twins by sharing with you just what a latissimus flap reconstruction looks like not long after surgery. For those not familiar with this type of breast reconstruction, please see this link for more information: living_latflap.htm#how

This is not graphic like yesterday’s post. The link above is actually more graphic and shows part of a lat flap procedure.

The first photo you see is my back. The long scar lines is where the latissimus muscle was removed from before it was migrated under the skin of my armpits. And yes…I AM a tattooed chick ;-)

Where you see the gauze, that is protecting the entry point of my surgical drains. I have talked about those in previous posts. Just do a search for surgical drains for more information. on those.

The second photo below is of the flap itself. It is the oval-shaped inset. This is VERY soon after the surgery. Those wrinkles relaxed over time and I no longer have them.

And finally,  below we have a happy pair of bouncy baby Twins! I went from a C cup with my original breasts to no breasts to an E cup. I still have nipple reconstruction when we can afford it, but right now I’m just thrilled with my Girls. I’d like to add that these results were accomplished WITHOUT breast implants. Those breasts are all my own, natural tissue.

The white tape you see outlining the flaps is to help the scars heal flat. This reduces the chances of keloid scars. I’ve talked about those in other posts too. If you have any questions, please don’t hesitate to contact me at boobcast (at)


Fallout – The Implant Difference

If you are one of my regular readers, you know that I had implants with the initial breast augmentation and lift surgery. If not, implants are used to replace the breast volume that has been lost either over time or due to breastfeeding and pregnancy. They can also be used in the case of benign fibroid removal to help fill out the breast blGflA

My surgery was purely cosmetic. My breasts had degraded as far as they could go. According to the RN at one consultation, “they weren’t going to get any worse”. By degraded I mean that the areolaes covered the entire end of my breasts, my nipples pointed at the ground and my breasts had very little volume. They looked like a couple of pizza slices hanging from my chest wall.

It is not physically possible to put breasts back where they were when you were 18. Skin stretches far too much for that. What they CAN do is add volume. That’s where the implants come in. But there are big differences once the implants are in. Remember, these are foreign objects placed in your body. So they are not going to act like your own natural breasts.

Here’s what I’m talking about when I say “Headlight breasts”. They look like they were pasted on her.

Whether they are saline or silicone, they are not going to feel or act like your own natural tissue. For instance, with a natural breast in a 30+ year old woman, when we lay down, we end up with our breasts migrating towards our armpits. This is commonly referred to as fallout.

It’s just what breasts do after a certain age.

With implants, those puppies aren’t going anywhere. You lay on your back and they stay where they were put. They may move a little but not like real tissue.

This is one reason I advocate for tissue-based reconstruction whether it be TRAM flap or Lat Flap reconstruction for women who have lost their breasts.

The other reason is the feel of the breast. I can only speak from the point of a woman who has had saline implants. You can FEEL the implant through the skin. From my perspective it feels like you’re squeezing a warm, overfilled water bottle.When I poked at them, I could HEAR the saline sloshing sometimes.

My husband says, “They were very hard kind of like groping a hard, squishy melon. Well, something not as hard as melon but not as soft as breast tissue.”. He enjoys my reconstructed breasts much more. The reason he likes the tissue reconstruction better is that “they’re natural. They’re all you”.

The down side to tissue reconstruction is that, on a deep feel, you can feel the edges of the flap. You really have to search for it, but it’s still there. For my husband, there IS no down side now that the flap has softened.



In the recent post “Rub Me The Right Way”, i got some misunderstandings cleared up about what adhesions are and aren’t. Patti, the RN at Dr. Franklyn Elliott’s office in Atlanta, answered some questions for me. For those not aware, Dr. Elliott of Atlanta Plastic Surgery, is my most excellent surgeon who created the Twins from the wreckage that was my chest.

Patti explained that what I have in that place on my back that feels really tight is actually scar tissue. She said the best way to break that up was stretching and exercise. So this afternoon I decided to try stretching on our big white yoga ball.

I sat on it, bent my knees and gently rolled so that I was laying with my back arched across it. My muscles screamed at me from the stretching and I made myself hold the position.

After the initial muscle pain died down, I started mentally probing for the sharp pain that came from stretching the scar tissue.

There was none.

So I tried turning over on my stomach and stretching that way.

More muscle ache ensued but still no sharp pain from pulling scar tissue.

Since that wasn’t working, I tested out stretching on both my right and left sides. Still nothing.

I have come to the conclusion that there is a Ball FAIL here. So in the next few days I’ll try using the Wii Fit and see if any of the yoga positions (the ones I can manage) do anything to stretch out the scar tissue.


Rub Me The Right Way

Today we’re discussing ways to break up scar tissue adhesions.

Since the first day after surgery my back has felt tight, as though I were squeezed into a proper corset. For those not familiar with corseting, it is an undergarment from the Elizabethan era worn on the torso that uses boning to give a more shapely figure. The boning then was whale bone because of it’s strength. Today the whale bone has been replaced by plastic. But for some diehards, there is steel boning.

At one point in my life I was the half owner of a web based Renaissance fashion company. I traveled all over the south east dressed in Elizabethan finery to promote the company. So I know what it’s like to be corseted.

The last time I spoke to someone about this, it was a massage therapist client in southern Georgia. He suggested that the reason I still feel like that is because the scar tissues has adhered, or grown on to, the fascia layer of skin. Thus the term “adhesions”.

According to Patti Bergley, the nurse at Dr. Elliot’s office, I do NOT have adhesions. Adhesions refer mostly to bowel tissue adhering to the abdominal wall. I just have scar tissue. The scar tissue is tight and will, according to Patti, soften over time. What will HELP with that is exercise and stretching.

I told her that when I stretch it feels like things are tearing in my back. She said that was a good thing. Stretching and exercise will actually do more to increase flexibility than cross fiber friction massage. From a medical standpoint, all massage will do is soften the scar tissue.

I have an exercise ball. You know…those big rubber balls with the 2 foot circumference that you lean back on. So I’m going to start using that and see if it does any good.

As usual, I will report back.


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