Breast Cancer Comics: LAT Flap Four Square
Q. What does breast reconstruction “flap” refer to?
A. The most common method of rebuilding a breast with body tissue is to cut a piece of muscle and fat (from belly or shoulders, for the LAT flap), but leave it attached on one end, so it retains its original blood supply. The surgeon then “tunnels” this piece of tissue under the skin to its new location on your chest. This is called a “pedicle flap.”
If the tissue is completely cut, and then reattached in its new location, it’s called a “free flap.” Free flaps are a newer procedure, and much less commonly performed, as they require a very skilled surgeon, one who’ll spend hours reattaching blood vessels. (Obviously, only tissue from your belly or back is close enough to your chest to become a pedicle flap; if it’s from another location, it would have to be a free flap.)
Q. So OK, let’s assume my breast reconstruction will include a TRAM flap or LAT flap. It sounds very involved. How long is the surgery, and how long is the recovery?
A. This is a major operation. Surgery will probably last 5 to 8 hours; and you’ll spend 4 to 7 days in the hospital. Recovery time is upwards of six weeks, though that’s highly personal; I had a free TRAM flap and felt able to go back to work on a limited basis after 2 weeks, while other women I know, who’ve had the same surgery, struggle for months afterwards trying to feel “normal.” Talk to your surgeon about what kind of recovery YOU might expect; he or she, knowing your medical history and your body, should be able to give you an estimate.
In addition, if you want a nipple reconstruction, that’s a separate operation, and it’ll be done afterwards–either several days latger, or sometime in the future. Don’t worry, it’s MUCH less involved; it should be done under a local anesthetic, and probably take an hour or less. The surgeon will use some of the skin on your breast, or perhaps take a tiny bit from your thigh, to build a nipple. Later, you can have the areola (the dark part around it) tattooed on, if you like.
There’s a much, MUCH greater level of detail about the actual surgery I could go into here, but as each surgeon and each cancer center or hospital approaches this surgery somewhat differently, it’s best for you to speak to your surgeon in depth about your particular procedure.
Next Reconstruction FAQ: What Happens After TRAM or LAT Flap Surgery?