The below question is answered by Richard M. Kline Jr., M.D. of The Center for Natural Breast Reconstruction.
I am 44 yrs old. I had a lumpectomy/chemo/radiation for my left breast in 2003 and I had a mastectomy on my right breast 2009. I went ahead and did a prophylactic left mastectomy as part of my reconstruction process. I had a Latissimus dorsi muscle flap on my left breast and started the process in September of 2009. Apparently, some nerve that was to be severed was not and I now have constant spasm/pain that I of course, still need to camouflage in my clothing choices. The implant is not under the flap, its just below my collar bone. Now, is it possible to reverse this type of surgery as the symptoms are painful/disabling? Can this type of surgery be revised? Is there any other option for me for function/pain/cosmetic-symmetry?
Sorry to hear about your problems. I obviously can’t say for sure what you need based on this limited history, but here are a few thoughts.
If you are referring to the thoracodorsal nerve that “runs” the latissimus, that can certainly be divided with additional surgery. However, I can’t say for sure that that is the source of your pain. If your implant is very high, and especially if it is hard, you may have capsular contracture, which can be very uncomfortable, especially in a radiated area. It is also possible that the spasms are in your pectoralis major muscle, which is (or should be) in front of the implant.
If you have adequate donor tissue in your abdomen or buttocks, it may well be possible to “discard” your entire L reconstructed breast, and replace it with a breast made entirely of your own tissue. We have done this many times in similar scenarios, and most patients seem to be significantly happier afterwards. However, I must stress that operating for symptoms of discomfort is not guaranteed to work, and involves other risks.
If you’d like to send photos of potential donor areas, or have our nurse or PA call you for more info, we’ll be happy try and give you more specific advice.
Center for Natural Breast Reconstruction
Best of luck to you, and please feel free to ask any more questions you may have.