Jo Taylor: Lat-Flap Reconstruction

Jo Taylor: Lat-Flap Reconstruction

A recent article in the New York Times referred to a study showing that women who'd had reconstructive surgery reported higher quality of life than women who opted not to have reconstruction after a mastectomy. We were puzzled by that, since reconstruction prolongs physical recovery and sometimes results in complications.

So SHARE asked Jo Taylor, a British blogger and the creator of the After Breast Cancer Diagnosis website, about her experience with so-called lat-flap reconstruction. Though she's largely happy with her decision, she has some caveats.

Here's what she said:

It felt like a simple choice for me nine years ago. I was a 38-year-old mother with a 5-month-old and a 2½-year-old when I was diagnosed with breast cancer. Told I needed a mastectomy, I decided straight away to have immediate reconstruction. Then, three days after my diagnosis, I visited a woman who'd had a latissimus dorsi flap procedure, in which tissue from the upper back is moved to the chest to re-create a breast mound. After I saw her results, I decided that was the kind of reconstruction I wanted to have. So the mastectomy and reconstruction were done in one 10-hour surgery.

At the time, I wanted the reconstruction just to feel like me again. I didn't think about aftereffects, long-term pain (which I still have nine years later), or the extra surgery involved in a latissimus dorsi. It was all about getting back to the old me—with breasts.

I would have preferred a double mastectomy with implant reconstruction. The recovery would have been easier, and the result would have been breasts that would always match. But I was told that the doctors would not remove a healthy breast. And with a single mastectomy, the latissimus dorsi procedure was able to create a better match of my remaining breast than an implant would have.

Despite the pain and a very difficult recovery, I eventually got back on my feet. But it was definitely not the "boob job" some people think it is. The main issue for me was lifting my young children when my husband went back to work after taking seven weeks off to be with me.

The results of my surgery are very good, and I am pleased I had it. I see it every day if I choose to look in the mirror, but I don't always choose to do so, because it is a reminder of what cancer has taken from me. I feel like a prisoner to it. It's a visual life sentence to what has happened. Though no one can tell the difference between my breasts when I'm wearing a bra, I now have a perky 25-year-old breast with a tattooed nipple alongside a 47-year-old breast with a real nipple. When I'm cold, the effect is there for all to see—on one breast. So I always wear a padded bra or an insert to cover my real nipple. I could never go braless. When I am lying down, my reconstructed breast will never end up in my armpit, and it will never droop like my other breast. Also, my reconstructed breast in no way feels like a normal breast. The skin feels dead: I do not have much sensation in my reconstructed breast or the area of my back where the muscle, tissue, and skin were taken from. But when it's cold, the small implant that was placed in my reconstructed breast makes that breast colder than my real one. These are the kinds of things surgeons don't always tell patients.

Women should know that reconstruction is not an easy path. It is a long and drawn-out process that doesn't always go according to plan, and many problems can arise. Some women opt for a double mastectomy without any reconstruction, and again, after thinking about this, if I had the choice, it may have been an option I would have thought more about. Breast cancer is hard enough with the surgeries, treatments, and other therapies that sometimes last for years. Whatever you decide, though, you have to feel it is right for you, because you will live with the decision for the rest of your life.



Jo Taylor