DL flap

[suzan54]

I had a mastectomy with a DL flap (may have been TRAM flap?) reconstruction 7 months ago.  The muscle used to form my new breast is still very hard and I experience edema in the breast, side/back and some down my arm.  I had 2 infections after surgery and I also have connective tissue diseases - Undifferentiated, Sjorgren's and fibromyalgia. Will this muscle ever soften up?  It makes it very difficult wearing a bra.  I only had 2 lymph nodes removed, sentinel and axillary. Does the muscle being hard indicate it is dieing? Thank you

[Archibald S Miller III, MD,FACS]

The muscle in a tram flap can be obvious for up to a year, but it eventually settles down. As you get further out, this should resolve. Infections can cause problems. The autoimmune diseases can also prolong your healing and promote other issues. At 7 months, it is highly unlikely the muscle is dying, but go back and talk to your reconstructive surgeon and tell him or her your concerns.

                     arch s miller ms md facs

[KD2]

I have had my tramsflap surgery 5 years ago. I had edema and the muscle seemed hard and  obvious when I did any movement. After a while it was not so obvious. The muscle on the outside, under my arm still seems hard. The edema should subside by now though.
Watch for lymphedema. Did you have a radical mastectomy?  Ask you oncologist about that a.