PRMA Patients Share Their Experiences

Terri Coutee, Tucson, Arizona - DIEP Flap Breast Reconstruction

Watch Terri's Video Testimonial

January 2002.... 

I received a phone call from my doctor confirming that the biopsy taken on New Year’s Eve, 2001, was positive for breast cancer in my left breast.  Two lumpectomies, 18 weeks of FAC (fluorouracil, adriamycin), and cyclophosphamide) chemo and 6 weeks of daily radiation later I completed my cancer treatments on October 15, 2002.  The chemo was the most difficult part for me.  I was told at the time that the chemo only increased my chances of non recurrence and survivorship by less than 5%.  I was only 47 at the time and strong as well as strong-willed.  I had the “bring it on” attitude and more importantly did not want to look back and regret not doing everything I could do to eliminate any possible microscopic cells lurking or from having the cancer return. Our two sons were young, one still at home and one just starting college.  I had a lot to live for.   I ended up in the hospital with a neutropenic fever from the chemo depleting my white and red blood cells to dangerously low levels.  I was being treated at MD Anderson at the time.  I remember my oncologist walking into my hospital room as I lay in my bed bald and ashen in color and saying to me, “If we don’t get you on Procrit (red blood cell booster) and Nuepogen (white cell booster) the chemo is going to kill you.”

I made it through both chemo and radiation and in the years following my diagnosis I worked hard to stay healthy and strong. I took Tamoxifen for five years and remember celebrating the day I swallowed that last pill.  Each year I went for my mammograms I stopped by Starbucks to treat myself to my favorite latte.  One more year… YES!  I returned to work and even returned to achieve a lifelong dream of attaining my M.Ed. in January of 2014.  I loved being back in school and things were going, as they say, just swimmingly.  I had a goal and purpose in mind for my degree when it was completed.

Fast forward to April 2, 2014….

I went for my routine mammogram.  The attending physician was at lunch at the time but the resident signed off on my mammogram and I was told I could go home and come back in a year.  They assured me the attending doctor would look at it when she returned from lunch.  They should have never let me leave the office that day.  I was on my way home when I received a phone call from the imaging services asking me to return and that the radiologist would like to speak to me.  My hands got clammy as I gripped the steering wheel as I feared what was coming next.  My husband was out of the country on business at the time so I was alone.  I walked into the radiologist room and she told me the news.  She saw what she highly suspected to be a malignant tumor in my right breast.  I stared at her in disbelief.  My heart was pounding.  I have been a teacher and lifelong educator and the first thing I told her while choking back tears was, “Please, please talk to your resident.”  She looked at me and said, “I already have.”  I really needed to know this was going to be a huge learning day for that young man.  She was a kind, compassionate woman who subsequently performed three separate biopsies on me over the next week because it was also found in a breast MRI that I had a mass in my left breast as well.  I prepared myself for a double mastectomy. 

My breast surgeon ordered that breast MRI to determine the best surgical options.  The breast MRI showed lesions on my spine and now they wanted to do a thoracic MRI.  That MRI revealed lesions at three different places on my spine and on April 17th with my husband back in the country, we sat in the doctor’s office together to hear the results of the thoracic MRI and heard, “I am so sorry.  You are stage IV metastatic.”  It was the single, darkest day of my life.  They comforted me by saying that they would do subsequent tests, a PET/CT and a bone scan to study the lesions further.  That was little comfort while waiting the week to schedule both of those tests.  Telling our two sons, my daughter-in-law, my parents, two sisters and nieces and nephews and friends was nothing short of exhausting.  I have always said that cancer is an ugly vortex.  It does not just suck you into it but everyone else you love and care about goes down with you. 

I have always lived a fairly active life.  Yes, middle-child, tom-boy of a family of three girls.  You get the picture.  I continued to play hard even as an adult.  This has bearing on my story because I have taken some significant falls, once on a horse, twice on the ski slopes and once on my bicycle.  After undergoing the above mentioned scans and viewing reports of those lesions from seven years ago it was inconclusive that they were cancer.  They had not changed in size from seven years ago and it was discussed and I believe that they could possibly be a result of those falls.   Without doing a bone biopsy, which is very difficult, we would continue to revisit and monitor them through subsequent scans.  I cautiously exited from the stage IV metastatic category and marched on to a double mastectomy to remove the tumors in both breasts. 

Before my surgery date my surgeon patiently walked me through the process.  She was an amazing woman and gifted surgeon in my books and I had great confidence in her skill.  Through her, I learned for the first time about DIEP flap surgery.  She said it was the preferred method of reconstruction but there was only one surgeon in the town I live in who did the surgery.  He had been trained through a fellowship by one of the best doctors in the country but the surgeon in my town worked alone.  She said it was an option for me to consider but I needed to get through the mastectomy first and additionally decide if any adjunctive therapy was in my future.  They wanted to make sure they got clear margins, there was no lymph node involvement and that I wouldn’t need radiation or chemo before I decided on reconstruction.  I was feeling relieved that I was no longer considered stage IV metastatic and having my husband and oldest son with me, we went out to celebrate.  The surgeon jokingly told me to go out and work on my belly fat and have some beer in case I decided on reconstruction later.  That we did.  That conversation with her about DIEP flap roused my curiosity but would have to wait for me to research at a later date.  One step at a time….

On May 14th, my surgeon removed my breasts.  I became “an amputee with hidden wounds”.  I felt so strong and ready the morning of my surgery.  I only stayed in hospital for one night and went home less than twenty-four hours after my double mastectomy.  I felt this was a true testament to my skilled surgeon.  Added to that, the tests came back with positive news.  They got clear margins and I had no lymph node involvement.  I was out walking the neighborhood with drains in tow within a few days of having my surgery.  I only cried one day post surgery after returning home.  I looked in the mirror one morning to examine my incisions and drains.  I walked out to the room my oldest son was sitting in and clearly stated, “I think I’m just now mourning the loss of “the girls”.  My youngest sister, a nurse, flew in to visit me the week I got my prosthetic bra.  We injected humor into the experience by trying to come up with a name for my prosthesis.  Ethel and Lucy?  Thelma and Louise?  We finally came up with Sheila and Rita.  That is another story for another day.  I felt better wearing it but over time I personally grew tired of preparing it to wear, adjusting it and the weight and warmth of it.  Additionally, I had to adjust my wardrobe.  No more v-neck t’s or anything that was much below my neckline.  I had some pretty significant “divots” in my chest, as I called them.

I was ready to do something about those divots and in the weeks to follow I began voraciously researching DIEP flap reconstruction.  I think that research class I took for my M.Ed. was paying off.  I was looking at abstracts, journal articles and papers that outlined the successes and benefits of the surgery.  The curious thing to me was that each time I searched for information on DIEP flap surgeons on the internet up popped PRMA in San Antonio.  Who is this group and what makes them the top search result for this procedure among all the plastic surgeons in the country?

The months to follow from June through October had ups and downs.  More tests to determine if I was a candidate for chemo, tumor markers and a revisit of the bone scan to see if everything was stabilized.  Each time I waited for results it was personally nerve-wracking, to say the least.  And each time I had a test, my family marked it on their calendar.  Phone calls, texts, emails…. “How ya’ doin’ Momma?”  My parents and extended family would call.  Again, an exhaustive road of explanations and why I made the decisions I did.  They deserved to know but I think they most wanted to hear, “I’m going to be OK based on these decisions I’m making.”  It’s all part of the process and when you have the love and support I have had through both of my diagnoses there is no other choice than to let them know what you find out and why you think it’s the best choice for your health.  I had the best support team ever in my family and friends!

September 4, 2014, I saw my oncologist and my surgeon.  My blood work was all normal as were the tumor markers so I was given the thumbs up for reconstruction.  At this point I had already had several conversations with Courtney, the patient liaison at PRMA.  What an integral part of this team!  She experienced the many ups and downs that I went through since my first phone call to her in mid-summer.  The day I could finally call Courtney and tell her I had medical approval on my end to move forward with reconstruction she worked her magic.  I had already uploaded my photos and medical information so she asked me which doctor I would prefer to see.  I honestly felt like I could have chosen any doctor at PRMA and been pleased but I think my viewing of videos on the web page and careful study of curriculum vitae lead me to Dr. Chrysopoulo.  Probably just that British accent!

My consult at PRMA was scheduled for Friday, October 3rd at 9 am.  I was called by the nurse the day before we left to review my medical history and records.  We flew to San Antonio the day before my appointment and scheduled our flight home for Saturday.  It was going to be a quick but very life altering trip.  It was breast cancer awareness month and there were pink pumpkins adorning the front office at PRMA when we walked in.  The nurses who took my husband and me back were light-hearted but professional and thorough.  I donned my gown and shortly afterwards Dr. C walked in.  I was sitting in the examining chair and he said to me, “Don’t sit in that chair.  It’s too clinical.  Come sit over here,” tapping the chair just in front of and opposite from where he would be talking to me.  My husband looked at him and asked, “Then why do you have it?”  Dr. C. very quickly responded, “Because we’re a doctor’s office.  I have to have it.”

Humor!  It worked for both my husband and me.  We were off to a good start.  Then Dr. C. got very serious, pulled his chair up right in front of me, looked me straight in the eyes and said, “You’ve been through a lot, haven’t you?”  I replied with a simple, “Yes.”  Then he said, “But you look really good.”  Again, affirmation of why I was there.  All the research that I had done viewing the PRMA website was unfolding before my eyes.  Compassion, caring, expertise, confidence and the team work I witnessed as the nurse also became an integral part of the process was evident in this consult.  Dr. C. asked me how I found PRMA.  My curious and voracious appetite for research was my answer.  I told him that I had vetted them carefully but honestly was already 95% sure of my decision to have the procedure done by Dr. C before this one-on-one consult.  I explained to him that meeting him personally was the other 5%.  He more than fulfilled that requirement.  Now I just had to wait for his assessment of my scars, incisions and body make up to see if I was a candidate for DIEP flap surgery.

After a thorough exam, an honest and confident explanation of my options and expected results we were on board.  I insisted on meeting Courtney before I left because of the care and compassion she always exhibited in all of our phone conversations.  She gave me a big hug, my pink PRMA goodie bag and we left the PRMA office.  For the first time that year, my husband and I walked out of PRMA that day with a sense of hope.  From that day forward my own sense of purpose and for that matter my sense of humor began to return. 

In just a few short days the insurance liaison began putting my paperwork together and before I knew it I had a surgery date, December 1, 2014.  I told Dr. C it would be my birthday present since my birthday is December 15.  He looked at me, grinned and said I was a bit crazy and mildly masochistic for spending my birthday in reconstruction recovery.  I respectfully disagreed!  And yes, as you might guess, my friends and family began calling them my “birthday boobs”.  Gotta love it.

I began following PRMA and Dr. C on my Twitter account to absorb all the information I could but in reality, it made me feel like I was now part of the team.  I also joined the Pink Ladies group via the internet to share valuable information including meeting a recent DIEP flap patient who was able to give me some first-hand insight into the process of recovery.  It was so uplifting to hear her positive words regarding her results and experience at PRMA.  Flights were booked, car rental reserved and our post surgical place to stay was all in place.

I contacted Courtney and told her I was interested in becoming a patient liaison because I felt it important to share my experience of traveling to have this procedure done.  It did seem like a logistical challenge before I started making all of the travel arrangements but it was also empowering and a very integral part of the process.  I want others to know that if you don’t live in San Antonio this is completely do-able and the place to come for this procedure. 

We left for San Antonio the day after Thanksgiving, 2014.  My husband had one week of vacation left after our hectic and difficult year so he would be with me the week of surgery and my stay in the hospital.  My best friend would then fly in from Seattle to stay with me the week after I was dismissed from the hospital so that I might continue recovery and to have my follow-up appointment with Dr. Chrysopoulo. 

We settled into our vacation rental that I found on line just five minutes from the Medical Center.  We spent the next two days finding our way around and knowing just where to park and check in the morning of surgery to avoid any unexpected surprises.  We also managed to spend an afternoon shopping and walking around the The Shops at La Cantera.  It was a good distraction especially with all the holiday shoppers and Christmas decorations lining the beautiful outdoor mall.  There are natural feelings of fear, excitement and a sense of just wanting to be done and to move on with the healing process.  Staying busy and preparing definitely helped ease those fears and anxious feelings.

I texted the ladies that I had met via the PRMA Patient Liaison Face book page and the Pink Ladies group to let them know I was in town.  They were so supportive and encouraging and it helped to know that all was going to be well from those who had walked the walk before me.  Another lady brought me a shower chair to use while I was in town and a couple of them promised to come visit me in the hospital.  That was very special and comforting as we didn’t know anyone in San Antonio.  It also made my family back home feel very good that someone would be there wishing me well and checking up on me and offering to help my husband out if need be.

6:30 am Monday morning…. It’s time to just get on with it.  My husband and I arrived at the hospital for surgery.  After check in and prepping they wheeled me into the pre-op room.  Wow!  It was a hub of activity.  My husband and I looked at each other wide-eyed and I think we were both thinking there might be a bit of a wait.  That was not the case.  I first met with a nurse who started IV’s.  Then the amazing and kind anesthesiologist walked in.  She was a tall, slender woman with a broad, warm smile, a beautiful shirt on.  She assured me that I was “all hers” that day and that she was going to make sure I woke up without nausea.  Thank you Dr. Allen because that was the case!  She even managed to play a song on her play list at my request, “End of the Line” by the traveling Wilburys, right before they put me under.  So we were rocking out to tunes before my long, winter’s nap. 

Another nurse walked in and told us she would be with Dr. C all day in the room and would be keeping my husband updated throughout the day.  The best thing she did for me before they wheeled me back was take care of my husband.  I was very concerned about him waiting at the hospital that day.  I couldn’t imagine how difficult that was going to be although he never once complained about it.  She looked at him so compassionately and said, “Where are you staying?  There is absolutely no need for you to hang around this hospital today.  Go back to your rental apartment and we will call you with updates.”  That statement in and of itself helped to relax me.

Dr. Chrysopoulo walked to my bedside in his usual, calm manner with a big grin on his face.  He chatted with my husband and then took out the marking pen and began to describe what he planned to do.  Because I had radiation on my left side twelve years ago he was very honest and realistic about what he would have to do.  He told me that he would need to put a larger flap in that area to accommodate making the breast mound.  But, in his quick, skillful eye he also told me how he would strategically place it on the underside of my breast so that it wouldn’t be noticeable when I wore clothing.  I remember him quietly looking at it after he marked it and saying, “Yes, I’m happy with that.”  That’s all I needed to hear.  Those final results after I woke up were absolutely amazing.  He explained that he had to remove a lot of scar tissue.  For me, just to touch that breast and feel how soft and warm it was even under my arm pit was a true testament to his skill.  I haven’t felt that feeling for twelve years.

My husband reminded me several times how “goofy” I was when I woke up.  I must have been entertaining to the nurses.  I just remember waking up in my room, seeing my husband in the corner as he watched the nurses tend to me.  IV’s, lines, oxygen, a pole with the different bags of saline, medication and that oh so wonderful Doppler….. THAT was the best sound ever.  They checked it regularly to make sure the perforators were alive and surging.  It got stronger and stronger as the week went along.  I loved hearing that sound and each time the nurses came in to check it they would nod their heads and smile.

The next five days in the hospital was a blur.  I want to wrap up by saying this.  This is not a cake walk.  You will need a dear friend or family member to be at home or to stay with you if you come from out of town.  They will have to help you shower; get up with you in the middle of the night to help you out of bed when you use the restroom.  Remember, this is huge surgery and you will need huge, patient help.  I am so blessed and grateful I had that.  Having said all that, the time also goes by quicker than you will realize.  The support at the hospital and in particular at PRMA is outstanding.  They are comforting, encouraging and there to help you with any needs you might have.  The day I went to see Dr. Chyrsopoulo post surgery to remove drains and stitches is just worth whatever you had to go through for this reconstruction surgery.  I am so happy with my results and I haven’t even had stage two revision as I write this story.  Dr. C and his nurse Denise gave me a big warm hug that day when I left. We laughed, smiled and wrapped up a most amazing step one to a journey of reconstruction.

I have absolutely no regrets that this was the right decision.  I am happy to talk to anyone who is interested in this process.  Contact Courtney if you are interested in sharing your questions and concerns and she will give you my contact information.  It is the strong women that I connected with who have been through this before me that helped me get through this process.  I am happy to pay it forward.

Thank you Dr. Chrysopoulo and PRMA.  Now I can just get on with it!


Béa Richards, California - DIEP Flap Reconstruction

I just completed the 2nd stage of a prophylactic double mastectomy with DIEP flap reconstruction, and I couldn’t be happier with my results or with quality of the care that I received during this entire process.  This was by far the hardest decision I’ve ever made, but finding the right doctor for me made all the difference; Dr. Chrysopoulo is the complete package, possessing top notch surgical expertise, emotional intelligence, and a deep humanity that is immediately evident.

I learned that I had the BRCA1 gene 11 years ago, 6 months after both my son Jonah was born, and my mother was diagnosed with breast cancer.  It was the happiest time in my life, as I basked blissfully in new motherhood, as well the darkest time, my days being etched with grief and anxiety. Two years later my beloved mother and 49-year old sister both passed away from breast cancer. These words are hollow reflections of all that transpired.

I knew that I had an 85% lifetime risk for breast cancer, but some part of me couldn’t reconcile that awareness with the self that I knew myself to be: young, strong, healthy, and boundlessly energetic.  I teetered on a seesaw between the belief that I would and could stay healthy, and my terror of going though major surgery and (possibly) no longer being at home in my own body.

After meeting with a couple of genetic counselors, I decided at that time that I would follow the least invasive course of action by having yearly MRIs and Mammograms.  I also paid a great deal of attention to my diet and lifestyle in an attempt to “prevent cancer.” While it felt good to be taking such great care of myself, there was always a sense of dread ticking in the background, since the reality was that I didn’t want to “catch it early,” I wanted to avoid it at all costs!

I mustered the courage to get an oophorectomy 5 years later when I knew that I wouldn’t be having more children. Even though I was monitoring my CA125, I knew there wasn’t adequate means of early detection for ovarian cancer and my risk was close to 50%.  I was relieved after the surgery, but still couldn’t wrap my head around the idea of breast surgery.

Fast-forward to a year ago. I’m turning 49, and my nurse has just told me that she thinks she has “felt something.” Internal alarm bells go off. She refers me to one of the top breast surgeons here who tells me it’s “nothing,” but she reminds me how aggressive and “nasty” BRCA1 cancers tend to be. In the same month my aunt tells me that she was 49 when she was first diagnosed with breast cancer, as was my grandmother.  The loss of my mother and sister 9 years prior still feels fresh - I don’t need to look beyond my own family to see the ravages of breast cancer. There is a convergence happening that I can’t ignore – I am open to whatever the universe is telling me.

I had actually researched my options many years before, but this time I am in a different place.  I feel fortunate to have had a good run with these breasts that I’ve always loved, but I am aware that time is not on my side, and I don’t want to be blindsided by breast cancer.

I live in the Bay Area, so I began my research here. I wanted to explore the possibility of the “one-step” with implants and the DIEP flap. I had a few referrals from my breast doctor, and I started by meeting with one plastic surgeon about a DIEP who tells me that I don’t have enough fat to be more than an “A” cup, and that if end up unhappy with my size, I could always get implants down the road!  When I asked to see more pictures (because I didn’t like the ones on the website) I was told that we were out of time and that I would need to schedule another appointment. Next!

Then I began researching online for the “one-step” (because I didn’t know of anyone local), which is how I found PRMA. I had never heard of PRMA, but I called and was referred to Dr. Chrysopoulo.  Upon my request I was also given some contact info for a few women who had had either implants or the DIEP flap with Dr. C.  I have spoken with many women over the years that have had reconstruction, but the conversations that I had with these women were unique: they were extremely pleased with their results and they raved about Dr. Chrysopoulo!

I was able to schedule a Skype consultation with Dr. C, and this was a pivotal experience for me.  We spoke about both options – the “one-step” as well as the DIEP flap, and he described the pros and cons of each, and strived to set realistic expectations for each. He answered every question I had thoroughly; he was kind, listened deeply, was compassionate, highly professional, and had a delightful sense of humor. My husband was also impressed with him – not just as a doctor, but as a human being.  In a parallel universe, he was someone we would want to hang out with over dinner and a good bottle of wine!

I had started the call leaning towards the “one-step,” because it seemed like an easier procedure – I wouldn’t need expanders or a second surgery, and the women that I had spoken with had been so happy with their results.  

I think that when, as human beings, we feel really seen and really heard, there is a deep relaxation that occurs in which new possibilities can arise – and by the end of the call, I was convinced that I wanted the DIEP flap.  Dr. C made it clear that it was considerably more difficult on the front end – it was a longer and more involved surgery, plus it was not one, but two surgeries, involving both the breast and the tummy, and there would be a much longer recovery – but I knew (and I believe he knew) that I would be happier in the long run.  I would have breasts that looked and felt natural, which was the most important thing to me – and I wouldn’t ever be faced with the potential complications involving implants. 

I decided to fly down to San Antonio to meet Dr. C in person, because I wanted to make sure that he felt comfortable doing a DIEP flap on me, since at 4’10 and 105 lbs I wasn’t the “ideal candidate,” given the (relatively) small amount of tummy fat I had. He said that I probably wouldn’t be thrilled after the first stage, but that by the second stage I would be happy with my results.  (He actually set my expectations quite low so in fact I was really pleased after the first stage!).

My comfort and trust in Dr. Chrysopoulo gave me the courage that I needed to say “yes” to a surgery that just a few short months ago was inconceivable to me! He also helped me to adopt the right attitude and expectations. It felt good to know that he was one of only 40 surgeons in the US that perform this highly specialized surgery routinely –I was definitely in expert hands!

At this point, I committed to the DIEP, and with the wheels in motion, I felt completely taken care of every step of the way. From multiple calls and emails with Dr. C’s nurse, Denise, to their help with insurance approval, to all my travel questions answered by their patient advocate, Courtney, I was thoroughly held and prepared through this process.

I just want to mention that in a perfect world, I wouldn’t have had to travel for this surgery.  San Antonio definitely wasn’t on my bucket list, and it was also a logistical feat. At the time my son Jonah was 11, we had never been away from him, and we had no family in the area.  But there was no doubt in my mind that this was the absolute best decision for me, and one that would afford me the best possible outcome. My aunt generously flew in from NY to be with Jonah so his life/routine wasn’t disrupted, and my husband took 2 weeks off work to come and be with me.  

The hardest part of the first stage was the first 8 days.  As I write this, I think of what a miniscule amount of time 8 days is in the scope of things.  I don’t say this to diminish the discomfort of waking up and feeling like you’ve been hit by a truck, or how scary it is to not be able to move your legs (because they feel like they weigh 100 pounds each) or how my back was killing me from having to walk all hunched over, or how I wanted to rip the drains out because they were uncomfortable and the binder kept riding up every time I sat down.  But the reality is that actually, my worst fears never came to pass: I did not wake up with half empty, droopy breasts (yes, that was a fear!), and, I had no pain.  Modern medicine has that one covered – I was able to push the little morphine pump whenever I needed it, and once I was out of the hospital I was off the pain meds within 2 days.

Prior to my first surgery, there were two things that helped me tremendously. One was an insight, and one was a tool.  I thought back to when I was pregnant, which was one of the happiest times in my life.  I felt so excited, vibrant, happy – and yet, I was really worried about giving birth.  I imagined the birth experience as a scary, painful, terrifying, rollercoaster ride that I would be trapped on until the very end! Here’s what happened when the time came: it was a long, 36-hour, challenging, labor with 3 hours of pushing – but I got through it, one breathe at a time.  I have a cellular memory of this wisdom now – that we have the capacity to be with anything if we are in the present, one moment at a time. Oftentimes my mind is my worst enemy, mocking up far worse outcomes than the universe provides!

This was absolutely how it unfolded for me with respect to both surgeries. There were challenging moments, but nothing that I couldn’t be with. The second thing that helped me was that I listened to some meditation tapes prior to the first surgery by Belleruth Naparstek that were created to prepare you for surgery (there are many studies that show the multiple benefits of these by the way).

I was so excited when it was time for my second stage surgery – - the completion of a long, difficult chapter.  As I write this, exactly one week post-surgery, I have just today had my drains removed (yippee!) and am looking at 6-8 weeks of “recovery,” which as I’ve learned simply means “take it easy,” i.e. no heavy lifting, get plenty of rest, give up control of the kitchen, get used to sleeping on my back, no chaturangas or mountain climbing, and get used to wearing a girdle (I’m glad that it’s now winter and I don’t mind all the extra layers – something to consider!). I have no pain or discomfort in my breasts, just some tightness and weird sensations in my tummy that will subside as the nerves regenerate.

I look down at these beautiful, symmetrical new breasts and my flat stomach (definitely an added perk), and am enjoying my newfound sense of peace; I had no idea the burden that I had been shouldering.

I am incredibly in awe of Dr. Chrysopoulo.  He is a gifted artist who really knows how to tune into what will serve his patients best. These scars will soften and fade with time, but my deep gratitude will always remain.


Debbie Calvert, San Antonio, Texas - DIEP Flap Reconstruction

Watch Debbie's Video Testimonial

I was 38 years old when I had my first mammogram, a good baseline to start with.

In June 2011 my family relocated to San Antonio. Not knowing a single person and trying to get the family settled, I skipped my mammogram that year.  But, in October 2011, my mom delivered the news that she had been diagnosed with breast cancer, DCIS, and would undergo a lumpectomy and radiation.

It wasn’t until July 2012 that I finally dragged myself to the doctor and was given a referral for a mammogram. However, because it was summertime and we were traveling, I again chose to wait. Even though my mom had just finished breast cancer treatment, it was not even on my radar.

On October 3, 2012, I remember very clearly heading to my mammogram appointment. I was in and out in 30 minutes. Then the next day I got a phone call to come back for an ultrasound. When I pressed for more information, the nurse at the doctor’s office said, “It’s showing irregular and that is concerning.” After the ultrasound, they asked me to come back for a needle biopsy, which was scheduled for the following week.

October 22, 2012, I was 42 years old when I received my diagnosis of Invasive Ductal Carcinoma, on my daughter’s 9th birthday. When my doctor called with the news, she said she was sorry and then preceded to give me a list of physicians. Some were surgeons; others were oncologists. I began feeling frustrated and lost with this “list” of names. At the end of our 30-minute conversation (while I sat in my bedroom closet so my daughter wouldn’t overhear), I remember thinking, “Do I see an oncologist first?”  “A surgeon?”  “What kind of surgeon?”  More than anything, I just wanted to see a doctor -- someone who understood cancer. I was scared. I had a family that I wanted to be around for.  I quickly pulled myself together so I could properly celebrate my daughter’s birthday.

At the end of a day filled with celebration, and tucking my daughter into bed, I finally allowed the emotions of the day to take over. I had to call my sister and my mom; I needed to find a doctor. My world was spinning. 

A week later I was meeting with my surgical oncologist, Dr. Kahlenberg; going over pathology reports and treatment options (I would later learn I was Stage 1, ER+, PR+ and HER2+ and would need chemotherapy). We decided that my best option was a bi-lateral mastectomy with reconstruction, and I was referred to Dr. Chrysopoulo.

When my husband and I walked through the doors of PRMA, I was certain that I would have implants. My mind was made up. Then we started watching the video that they had playing in the lobby. I will say while my husband was intent on watching the video and listening to all the information, I was not. My mind wandered. At the end of the of video he lend over to me and said, “I think you should have the DIEP flap procedure.” What!? I was still set on implants.

We were called back and settled in a room.  A few minutes later Dr. Chrysopoulo walked in. From the moment he came in the room I was at peace. He sat right next to me, asked how I was doing and spent the next hour and a half talking with us. As we started talking about options, and the pros and cons, I started crying.  It was surreal sitting there talking about reconstruction because I had cancer. Was this really happening? Dr. Chrysopoulo was incredibly compassionate, understanding, and had a heart full of patience.

At the end of our time, I had decided on the DIEP flap procedure. Crazy how you go in thinking one thing and then completely change your mind once you have all the information.

I had my surgery, several weeks later, and woke up in my hospital room around 6:00 p.m. I vividly remember my husband being in the room, it was dark, and my nurse was standing at my bedside. The first thing I said was, “how do they look?”

When I think about the knowledge and expertise that’s required to perform this type of surgery, I’m left speechless. The surgeons at PRMA are essentially “rebuilding” their patients.  It is simply amazing the talent they have.

Dr. Chrysopoulo has been one of the most compassionate and gifted physicians I’ve had. I feel so blessed that he walked this path with me. Having reconstruction has had a profound impact on my life. There are never the right words to adequately express my gratitude for what he was able to give back to me.

Having the DIEP flap has been the best decision I’ve made, and I would not change anything. I am awestruck with the results.

Breast reconstruction is a long process, but one that is worth it. When I accepted that time was part of the process, I was able to relax into the journey…knowing I would be stronger for having walked this path.

Thank you PRMA, the staff, Denise, and Dr. Chrysopoulo!


Lisa, Austin, Texas - DIEP flap reconstruction

I found out about DIEP Flap from a friend and at the time she went through it in February, I never dreamed I would be dealing with a decision about breast reconstruction. I just assumed that if I ever needed to deal with it that I could choose to have the natural reconstruction that DIEP flap provides. I had a wonderful general surgeon here in Austin. She knew about my pending decisions and said that knowing what she knew, she would not recommend DIEP flap to me. She said that she would not do it for herself either, as she is a higher BMI woman. She told me how much easier getting implants would be, but I have never wanted implants. In fact that was the only options she told me about, until I asked about DIEP Flap.  Implants are good if that is the only option, but for me, I wanted that choice only as a last option.

The second doctor I spoke to was actually a top plastic surgeon out of Seattle. He is a personal friend of my nephew, so my nephew hooked us up. We eventually spoke over the telephone and he got copies of my "before" photos. In our discussion, he asked my weight and my height and calculated my BMI, which is 37. He point blank told me I am not a candidate in his mind for DIEP flap and that he would not touch me unless I was a BMI 25. It was about this time I found PRMA and I wrote to find out if your doctors would even touch me, as I was beginning to assume, I might be too heavy to have  a choice. I was relieved to hear you would consider me for a candidate and you got the photos and I came in for a consult and it was determined that I was a good candidate.

So here I am, post surgery and all is looking good. I am thankful to PRMA, because you gave me a choice. I can now have the body I want and I've been trying to get that word out not only about DIEP flap but also about PRMA. PRMA has the training and expertise to help women have the choice as to what type of reconstruction they want. I think that is important when all of us facing these options did not have a choice in getting cancer.


Linda Frost, Rulo, Nebraska - DIEP flap reconstruction

In 1979 at the age of 28 I received 2nd and 3rd degree burns to 37% of my body.  For months we had been tearing down old wooden fence around the cattle lot and were waiting for a calm day without winds to burn the piles.  The weather was just right.  I had on shorts and a nylon short sleeved shirt with an underwire bra which caught fire as I attempted to light the wood pile.  My upper torso sustained severe burns while attempting to roll and put the fire out.  My hands and fingers were burned trying to pull off the melting bra.  I prayed to God to help me get the fire out.  Long story short, I spent two months in the burn unit at St Elizabeth’s Hospital in Lincoln, NE.  I could see my husband daily if he were able to make the two hour drive up to Lincoln but saw my 13 month old and 3 ½ year old sons only twice in two months...very hard. Because of the chance of infection, I couldn’t have visitors…everything had to be very sterile.  It was a very challenging time of my life going through surgeries for debriding of dead skin and grafting and then nearly a year of physical therapy but I was very determined to get well and live and do things the doctors said I would probably never do again.

I always have an annual pap test and mammogram.  In January, 2012, it was time to make those appointments for my fall visit.  I decided the tests had always been fine and maybe I wouldn’t go this year…it was a day away from work and to the city two hours away.  In June, I thought maybe I should make that appointment but again declined.  September came and I had a gut feeling that I really should make the appointment so I did and on November 28, 2012 I saw my gynecologist for the pap test and then because the mammography machine was not working properly at his office I went to Advanced Medical Imaging, also in Lincoln, for the mammogram.

I knew something was wrong, when I was told to leave the gown on and wait in a small room with two other women.  I was called back in for more pictures three times.  Afterwards, I met with a Dr. who told me there were abnormal findings that needed further tests for more thorough evaluation.  I was scheduled to return two weeks later on December 11th, for a sterotactic needle biopsy of the left breast.

The following day, December 12th, I received a call from my local physician, followed by a phone call from my OBGYN doctor with the dreaded news…the results of the biopsy…Ductal Carcinoma In Situ, high grade in the left breast…CANCER!

Following recommendations by my OBGYN doc, I met with two surgeons.  The initial option was to remove the affected area, taking part of the left breast, followed by radiation.  However, after consulting with the second surgeon it was determined that radiation would not be an option because of the burns sustained years ago to the chest.  Now the option was to have the left breast completely removed or to have a bilateral mastectomy followed by reconstructive surgery with implants.  As I have a family history of various cancers on both my mother and father’s side, I opted for the bilateral mastectomy and reconstruction.

January 10th, 2013, I underwent a sentinel node biopsy on the left side followed by bilateral mastectomy and implants.

Approximately three weeks later the implants were removed due to the grafted skin breaking down due to the inelasticity of the burned skin.  The Dr. told me had done all he could do for me.

After the skin healed, I was fitted with prosthesis bras.  They were heavy and hot.  I looked better in my clothes but was depressed and felt like half a woman.

At a visit to my oncologist, I learned of another person who had gone through the same thing I had.  Her implants had failed for some reason, but she had found a Dr. in Louisiana who performed a surgery using her own fat, skin and blood vessels.  I came home that day and began to research the internet for that type of reconstruction.

I came across PRMA.  The site was impressive.  I watched the videos of patients telling their stories.  I watched the videos of the Drs. Talk about the procedures used.  I thought maybe there was hope for me.  I emailed a request to Brandy at PRMA for more information.  I called my local doctor and asked her to check out PRMA in San Antonio.  She had a friend who is a registered nurse in San Antonio who was familiar with PRMA.  She reported it to be world renowned, having patients from all over the US and other countries.

I read more in depth about the doctors at PRMA and decided to set up a consultation with Dr. Chrysopoulo, better known, as Dr. C.  I chose him because he had previously worked with burn victims at the Shriners Burn Hospital in Galveston and I felt he would be familiar with burned-grafted skin.

In June, 2012, we flew from our home in southeast Nebraska to San Antonio.  I found Dr. C to be a very caring, compassionate man who is straight forward and honest.  He told me like it was.  He said I didn’t have enough “junk” in the right places, and that if I could put some weight on, my results would be better.  I followed his advice and gained nearly 20 lbs. eating a lot of potatoes, pizzas, and breads.

On September 4, 2012, I underwent the DIEP Flap reconstruction.  The results are better than I’d expected.  I feel good about myself, especially knowing that it’s all me.  No artificial implants.  I like to say that PRMA gave me back what Cancer stole from me.


Michelle Coben, San Antonio, Texas - Nipple-Sparing Mastectomies and Immediate Single-Stage Reconstruction with Implants (Alloderm One-Step)

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My name is Michelle and my story begins 20 years ago. My mother was diagnosed with breast cancer in 1992. When she was diagnosed again with breast cancer less than five years later I asked her to take the BRCA Test with me.

I worked for the Cancer Care Center at Cedars Sinai in Los Angeles. They were offering free genetic testing to Jewish mothers and daughters during a clinical trial. My mother refused to participate stating that nobody had ever had cancer in our family before her.

My mother developed cancer every five years after her first diagnoses in 1992. She passed away in 2010 from metastaic lung cancer. It took me one year after her death to get tested. Her oncologist said to me “you will not be BRCA positive” after all your mother was the only one in your family to have cancer. Six weeks after testing the oncologist calls, Michelle, your BRCA positive. Now what?......

I spent several months researching prophylactic mastectomies.

Was I really going to this? What would I look like? Who voluntarily does this I thought to myself…. I do!! This is to save my life. To not repeat history and to lower my percentage rate of getting cancer. I do! So, that I get to see my children grow up and I get to grow old and love every wrinkle that may come my way. I do! So, that I can grow old with my husband and see my grandchildren. I do! So, that I can reach out and save another woman from having to go through this alone.

I found PRMA and Dr. Chrysopoulo. My reconstruction is fabulous. I do not have any visible scars. He is an artist. PRMA is one of the few practices that perform the one step procedure with immediate reconstruction. Thank you to PRMA and your entire staff.


Jo Kenney, San Antonio, Texas - DIEP flap reconstruction

Even under the best of circumstances 2013 was going to be a challenging year.  I was working full time and working on my dissertation, but I never dreamed that I would be educator, student, and patient.  However, back in January I really wasn't worried, denial seemed to be the word of the day.  I'll get a dissertation proposal figured out, and that strange thing I feel in my breast, that's nothing to worry about.

During my annual wellness exam in February,  I asked my doctor to take a look at my breast. She immediately had me set up an appointment for a mammogram and ultrasound. Even as I sat waiting for my ultrasound results I was sure it was nothing serious. Finally I got called in to see the radiologist. He was very forward as he pointed out a mass in my left breast and said the word malignant. A lump that needed to be biopsied as soon as possible.  I am still not sure how I managed to drive home.

It was hard to sit around and wait for the test results. Once I got the biopsy results there was no more denial, I had stage two breast cancer. I decided to go with chemo first, as I really wanted to save my breast.  At this point I did not want to think about a mastectomy. As the process went on, and more information became available to me, I started to rethink that decision.  By the time I had completed chemo I had decided to do a bi-lateral mastectomy.

Based on my oncology surgeon’s recommendation I went to PRMA and met with Dr. Arishita and his nurse Heather. This was a tough visit; probably the closest I'd come to tears since the whole process began. I had done some research on their website and had already decided that I wanted to pursue a DIEP flap, and was hopeful that Dr Arishita would concur.  At 40, I was interested in having a natural looking outcome with minimal upkeep. He took his time to go over all the options, risks, and possible outcomes, and in the end we agreed a DIEP flap would give me the outcome I was looking for.

A week after I turned 41, I want into the hospital for a bi-lateral mastectomy with lymph node biopsy (ended up with complete extraction on the left side) and reconstruction. I am glad Heather had explained everything so well, so I was prepared for the recovery. Everything went as expected and in January I completed the second stage of reconstruction. I feel at peace with all my decisions this last year and am grateful I found a team of caring and competent professionals who saw me through this journey.  I am defending my dissertation soon and know that part of the reason I feel strong and confident is due to the excellent care I have received.


Paula Lindsey, San Antonio, Texas - DIEP flap reconstruction

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My name is Paula Lindsey and I am a patient of Dr. Chrysopoulo’s. I was diagnosed with breast cancer in April of 2013 and have learned that no two cases of breast cancer are alike and each woman has a very unique story. Mine is unique because I also suffer from a chronic autoimmune disease called lupus. Read more about lupus here.

I was shocked when I was diagnosed. I had gone for my annual mammogram and received a letter from the imaging center in the mail. I opened it as usual, expecting to file it away, but this time was different as my eyes were drawn to the words, “area of concern.”

And so it began. I remember the oncologist called me in to his office and showed me an image of my breast. He pointed to a thin, squiggly white line and explained that this was what they were concerned about. He described it as tiny, sand-like micro-calcifications that may be cancerous. After more testing, it was confirmed, I had breast cancer.

After meeting with my oncologist it was determined that I would have to have a mastectomy to remove the cancer. The doctor said he wanted me to see a doctor at PRMA for a consultation about reconstruction options and I remember thinking, ‘why bother.’ I couldn’t have implants since it was too risky with my lupus. He explained though that there were other ways of doing the reconstruction.

And so May of 2013, I walked into the PRMA office for the first time with my husband. I sat down in the new patient chairs and began to watch the videos where other women share their stories about breast cancer and reconstruction. This is where I shed my first tear since being diagnosed. It all became so real and now I was “one of them.” The reality of it was all finally sinking in and I was very shaken by the time I saw Dr. Chrysopoulo and his nurse, Denise.

I will never forget that appointment. We went through the basic introductions and discussions about my diagnosis and medical history, but then Dr. Chrysopoulo pulled up his chair close to mine and looked me in the eyes and said, “How are you doing with all of this?” He had such compassion in his voice and eyes and I knew that I was in the right place. I felt important. He took serious note of the fact that I had lupus and understood my concern about undergoing such a complicated surgical process with the DIEP flap.

He had me get some blood tests done and I felt safe, like I could trust him.

On June 17th I had my DIEP flap reconstruction. I was in the hospital for a week and was given the intensive care that I needed and didn’t have any complications. Even though the recovery process was tough, I have no regrets. I think having a positive attitude is crucial when dealing with any form of cancer.

I had phase II of my surgery in December and that too has gone well. I will complete phase III of my reconstruction in March of 2014 when I will graduate from PRMA and proudly take my ‘after photos.’ I hope my story and photos will help other women trying to make the decision about breast reconstruction after mastectomy.

Everyone here at PRMA has been wonderful and as many other patients will tell you, they feel like family. I look forward to the Pink Ladies support group meetings every month and am now proud to call myself ‘one of them.’


Melanie, Los Angeles, California - Nipple-Sparing Mastectomies and Immediate Single-Stage Reconstruction with Implants (Alloderm One-Step)

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My name is Melanie and I am writing this two weeks after surgery with Dr. Chrysopoulo at PRMA.  Like so many others, I feel so grateful to Dr. Chrysopoulo.  I’m so glad I came to San Antonio to do this surgery.  I feel great, and once my incisions heal, I’ll have no visible scars.  I love how I look, like myself, only better/”perkier."

I have known since 1997 that I have the BRCA1 gene that predisposes me to both breast and ovarian cancer.  I was 33 years old when I did that genetic testing.  I was young, healthy and single.  Despite lots of cancer in my family (my Mom has had breast cancer three times and ovarian cancer once, and she’s alive!  My Dad died of renal cancer when he was 50), I honestly thought, despite “having the gene,” it wouldn’t happen to me.  I also couldn’t contemplate “cutting off my breasts,” when I was so healthy and single.  Because I knew I was BRCA1+ though, I kept up with my mammograms and breast sonograms, pelvic sonograms and CA-125 tests.

In April 2012, when I was 48 years old, my CA-125 was elevated.  I remember I was out riding my bike when I got the call.  I started to shake when my doctor told me my CA-125 was 164.   It had always been around 14 before.  My urine had been smelling strange for a couple of months, but I couldn’t figure out why.  I had no other symptoms.  Within the week, I went to a gynecological oncologist.  He said, “That’s not a very high number.  High is 900, or 3000.”  He examined me and said, “I doubt it’s cancer.  But you know what they say with BRCA1, you’ve got to get it out.”  My husband and I agreed to go out to lunch, come back to the emergency room, I’d get admitted and have a total robotic hysterectomy the next day. 

The surgery went well and I recovered easily, but within a few days learned I did have cancer—transitional cell carcinoma in my left fallopian tube.  It was just starting to spread to my left ovary.  Because that’s an unusual kind of cancer, and because of my genetic status, and because no one had expected to find cancer, so I hadn’t been staged during surgery, we all agreed I should do chemo, but weren’t sure which drugs would be effective.  My husband and I went for a second opinion to MD Anderson in Houston.

That visit was wonderful and affected the course of my treatment.  While there, I met with a geneticist who said, “When you’re done with treatment, you really ought to consider prophylactic mastectomies and reconstruction.”  She said the surgery is “evolving rapidly,” and there are now “new options that didn’t exist even five years ago.”  She told me about FORCE (Facing Our Risk of Cancer Empowered, and there I saw an ad for PRMA.

When I first looked at the pictures on the PRMA website, I could see both from the photos and the tone of the website, that the doctors at PRMA were not simply out to save the woman’s life, but to help her regain a sense of herself.   The other sites showed scars and results of surgeries that to me looked barbaric and cruel.  Having watched my mother go through mastectomies and reconstruction and having seen friends’ scars, I kept feeling like, “I don’t want to put myself through that.”

The issue came to a head when I began to really consider the surgery.  Having cancer was so hard!  Chemo and then second-look surgery 6 months ago were both very challenging for me physically and emotionally.  I can write that sentence now, but if you’ve been through it, you know that one sentence summarizes months of feeling bad, not at all like your true self.  My feeling completely changed from, “I don’t want to put myself through mastectomies prophylactically,” to “I don’t want to go through cancer ever again if I can help it.”  I knew by having the hysterectomy my risk of breast cancer had decreased, but doctors were saying it was still somewhere between 70-85% chance I’d get breast cancer, too.

I'd like to live a long life.  I have work to do.  I love my husband very much and want to live a long time.  He reassured me that he “wants decades” with me (that felt so good!) and that me having implants would not affect his feelings for me.  He said he’d prefer me alive.  Me, too.

I met with two teams of surgeons at top hospitals in Los Angeles, and they said things like, “It can’t be done,” (in one surgery).  “They’re just telling you what you want to hear.”  I began to doubt my decision.  They insisted on doing the surgery with skin from my thighs, stomach or back, with expanders, then swapping the expanders for implants, then tattooing the areola and maybe making a “nipple” somewhere down the road.  They pushed for a sentinel node biopsy, which I didn’t want because I’m already learning to cope with lymphedema in my legs and didn’t expect to find breast cancer.

I did more research online and saw that PRMA and Dr. Chrysopoulo kept being mentioned by many, many women who’ve traveled to San Antonio to do various kinds of breast reconstruction.  Everyone had a positive experience.  This reassured me. 

At that point, I flew down to San Antonio and met in person with Dr. Chrysopoulo.  He had already taken a lot of time to answer all my questions by phone.  When I met with him in person, he was so warm.  Brilliant and an excellent listener, he was able to explain exactly how he’d do the surgery.  He kept saying, “Nope, you don’t need several procedures.”  “Nope,” he could keep my skin, areolas and nipples alive and connected to their blood supplies, and this despite a scar from a prior biopsy which other surgeons had said would make skin-sparing impossible.  “Nope,” I didn’t need to have any visible scarring, and he’d make the incision “just a smidge,” above the inframammary fold, so if I chose to wear a bikini in the future, and the bathing suit rode up a little, no scar would show.  “Nope,” I didn’t need to do a sentinel node biopsy; we could always go in and do that later through my armpit if the pathology came back and happened to unexpectedly show cancer.  None of the other doctors had talked this way.  I felt profoundly like Dr. Chrysopoulo was able to put himself in my shoes and sense how I’d want to live and look after the surgery. 

I was delighted.

His empathy is profound.  His emotional intelligence is off the charts.  He was confident, but not even remotely arrogant.  I felt he was part of my healing team, not an expert who would swoop down, wreak havoc on my body using the latest techniques, and yes, maybe save my life, but leave me with ongoing consequences.  On the contrary, I felt he is a deep human being who has taken his years of training in several areas (not only breast surgery but burn treatment and hand surgery, too) and integrated all his learning with a very real sense of the impact of his work on our bodies and our lives.  You can probably hear that this is high praise coming from me!

Dr. Chrysopoulo and the whole process of this surgery has exceeded my hopes.  His nurse Denise is wonderfully compassionate as well.  All the nurses at the hospital were attentive and kind.  Everyone at PRMA has been great.

Like so many others, I’m very happy I chose Dr. Chrysopoulo and PRMA to do the surgery.


Amanda Gawlik, San Antonio, Texas - Tissue Expanders and Implant Breast Reconstruction

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I am 25 years old and was diagnosed with stage I invasive ductal carcinoma on February 14, 2013. I didn't have a lump, but had nipple discharge which alerted me to go to the doctor. After deciding to have a double mastectomy I began to research my reconstruction options. I went to PRMA because many of my doctors and a family friend referred me there. After meeting with Dr. Chrysopoulo and further discussing my options in detail, it was best for me to go with the tissue expander reconstruction with implants to be placed later. I have to say that going to PRMA makes me feel at ease. Dr. Chrysopoulo explained everything that he would be doing and made sure that I understood everything. I am confident in Dr. Chrysopoulo that I will have the best cosmetic outcome possible. The staff at PRMA has also been a big help during this difficult journey. Dr. Chrysopoulo's nurse Denise is always available to answer any of my questions or concerns.

I had my double mastectomy on March 29, 2013. I had my surgery first because they didn't think I would need chemotherapy due to the stage and size of the tumor. After surgery we found out that I was HER2+ which then prompted me to start chemo on May 16, 2013. The thought of chemo didn't scare me as much as the thought of losing my long dark hair! We had a family friend that went through breast cancer two years ago and she used Penguin Cold-Caps to save her hair during chemo. I immediately knew I wanted to save my hair too, so I ordered the caps. The caps are kept in the freezer and on the day of chemo we would get 100lbs of dry ice and stick the caps in ice chests with the dry ice and take them to the chemo center. I put a cap on at least 45 minutes before the chemo begins and leave them on at least an hour after chemo. The caps freeze the scalp which then prevents the chemo from reaching the scalp and hair follicles. Yes, the caps are cold and hurt for about a minute or two but after that I couldn't really feel them. I have completed 6 rounds of chemo and still have a full head of hair. I want more women to know that this option is available. I couldn't imagine going through all this without my hair! By saving my hair I was able to maintain a sense of normalcy and keep a positive attitutude. I am now a month out from chemo and will be getting my permanent implants on October 14th!


Christina Bowers, Georgetown, Texas - Bilateral DIEP Flap with Lymph Node Transfer

I came to PRMA seeking delayed reconstruction following chemotherapy, bilateral mastectomy and 33 radiation treatments. As a consequence of my treatments and the loss of 27 lymph nodes, I spent significant effort managing the early stages of lymphedema.  I had constant relentless pain which radiated down my arm and swelling most notably in the truncal region. In addition to wearing compression sleeves, I worked with a physical therapist and used a Flexitouch pump daily to manage my symptoms.

The first thing my husband and I felt upon coming to PRMA was the passion these doctors have for helping women in my circumstance to feel whole and healed. There was such compassion and caring and no sense of feeling rushed. Following the early visits and throughout my recovery our nurse was easily accessible to answer questions.

Unlike other clinics we had visited, at PRMA we felt we had a clear understanding of what we could expect with the reconstruction--and the expectations went beyond what we thought possible.  At our first visit, Dr. Pisano told us that the clinic was beginning to transfer lymph nodes during the DIEP flap reconstruction. I was eager to give this a try.

Upon waking from surgery, despite the expected discomfort, I noticed immediately a reduction in pain in my arm. I am now 6 months out from surgery and my arm has gone down a whole sleeve size.  I no longer experience truncal swelling and my overall range of motion is vastly improved. While I have continued to work with a physical therapist during recovery to manage the effects of scar tissue and to keep ahead of possible changes, lymphedema no longer dominates my every day. I wear a sleeve when I exercise or fly as precautionary measure and I continue to do self massage for lymphatic drainage. I still measure my arm weekly to monitor changes. But my measurements have gone down and the pain in my arm has not returned.

Initially I did not intend to undergo reconstruction. I felt that getting rid of the cancer was enough. Living with the tightness of the scars and the swelling and pain in my arm compelled to seek other options and I am so grateful that I did. I would encourage any woman in my situation to visit PRMA for a consultation.


Yvette Watson, Corpus Christi, Texas - DIEP Flap Breast Reconstruction

Just a small note to thank Dr. Oscar Ochoa and his staff for making my surgery and healing process so easy! Everyone was always so kind to me and my family during this great adventure! I drive from Corpus Christi, Texas and I was always promptly taken care of. You guys gave me back my confidence, which had somewhat depleted. I was always positive but the hurt was still there, and Dr. Ochoa took that away! I'm now 4 years cancer free and about to participate for the fourth time in 'Making Strides For Breast Cancer Walk.' Thanks to you guys I can continue to walk with my head held high! May God continue to bless you and your practice!


Fran Clark, Fredericksburg, Virginia - DIEP Flap Breast Reconstruction

Some people think I was crazy for flying all the way from Virgnia to Texas for my breast reconstruction. I had my initial mastectomy at Sloan Kettering in NYC. I was not treated well, my pain wasn't controlled and as a nurse of 20 years I know how things should be while in the hospital. My nurse at Sloan told me at 3am that "nurses make the worst patients."

When I was at Methodist Hospital in San Antonio and under Dr. Arishita's care, I was relieved to find excellent care. Dr. Arishita gave me back what breast cancer took away. I woke up laughing from my surgery and spent 5 days at Methodist. I was always treated with kindness and respect. My pain was controlled. I feel the staff monitored me to keep me safe from complications. I have nothing but good things to say about PRMA and Methodist Hospital. A special thanks to Dr. Arishita's nurse, Heather!


Rhonda Manee, Grand Junction, Colorado - DIEP Flap Reconstruction

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"I just donated my prosthetic!" - Rhonda's Inspirational Letter

In 2011 I had two car accidents and three surgeries. The last surgery being a mastectomy to cure me of breast cancer. Because I had radiation treatments and a bleeding disorder, it was recommended that I wait to have reconstruction and just get through the healing process. It had been a nightmare of a year and I was exhausted. I had a huge hole in my chest and it felt like I had a hole in my heart as well.

I celebrated because I survived the cancer. However, I felt I was just alive, not living. I had survived, but I wasn’t thriving.

I began to look for options for reconstruction. I wanted reconstruction but due to the radiation treatments, I had few options. Only tissue transfer would work and I have a bleeding disorder. Most surgeons that I met with did not want to take the risk. I needed experts, but had become too tired to keep searching.

Prosthetics were very helpful and certainly made me feel better when I was dressed, however sometimes they were heavy and I had to inch one side higher. They caused me to be hot in warmer weather and made me sweat underneath the prosthetic. They were sometimes visible when I bent down. I was always pinning something or adding lace so something would not show. Getting dressed everyday was a major drag. I became depressed. I wanted to feel whole again but was so tired from the stress of the last few years.

One day while I was at the local hospital for follow-up care, I was crying to my physical therapist about how I felt.  She said she knew of a woman who had reconstruction by a group of experts in Texas.  She said she would call her and see if she might be willing to meet with me. On our way out of the building the woman walked in.  The therapist introduced us and told the woman what I was going through. She was willing to help immediately. She told me about PRMA and was even willing to go to the ladies room and show me her results after only stage one of her surgery. She was four months recovered and had scheduled her stage two surgery. I was very impressed with what I saw.  It did not look like blobs, but rather breasts without nipples and I thought to myself, I could live with that. If we could just deal with my bleeding disorder then this could be my answer. I found that people from all over the country go to see this team of plastic surgeons because they are experts.

I called PRMA and spoke with Brandy, the patient liaison. She was wonderful. She gave my name to Dr. Chrysopoulo and he called me back. We discussed my medical issues and he ordered blood work to determine if I was a candidate for the DIEP flap surgery, which he thought would be the best choice for me. In the meantime, Brandy helped me find answers to my insurance questions, travel questions and everything I needed to know. I was beginning to think, with this team of experts, I could be restored. The blood tests came back and Dr. Chrysopoulo, along with the team of surgeons, evaluated them. They felt with the right precautions I could have the surgery safely.

Shortly after this, my husband left. My heart had been so broken and I had been through so much the last few years, I did not know what to do from here. I still had insurance through my husband’s work, but could not afford the deductible.  I knew I could not get the surgery on my own.  One of my nurses suggested a car wash to pay the deductible.  Much of the community showed up to help and to make donations.  My local church helped raise much of the money.  A friend of mine who was a nurse offered to travel with my daughter and me if we could pay her travel. My church answered the call again and arranged for her flight and paid for her airline ticket.  My community seemed to understand that I needed this.

When I arrived in San Antonio, we had planned to stay at a certain hotel, but it was not the nicest. It was a place for “long term guests” to stay. I called Brandy and told her what had happened and that we needed a place to stay. She arranged for a night at the Towne Place Suites on Prue.  It was wonderful. They gave us the PRMA medical discount, so we reserved the room for our entire stay. The room was clean and the service was incredible. I was ready for surgery on Monday morning.

When I woke up from surgery, it seemed we had conquered the bleeding issues, I was so grateful.  I looked down and saw what looked like a breast again. What a gift.  Perhaps having that deficit so long made me more grateful than ever.  To have something real and alive back in that space, it made me feel whole again.

It was a big surgery, but the nursing staff at the Methodist Hospital and the surgeons at PRMA monitored my progress carefully.  They kept a careful watch to make sure the bleeding or bruising was within normal limits.  The surgery was somewhat painful and it involved quite the healing process, but I am grateful I had the best team on board to take me through it.  I found the experts at PRMA.

I will always have a special place in my heart for Dr. Chrysopoulo.  This surgery gave me my life back.  I can get up every day and take a shower, get dressed and be grateful.

Along this difficult journey, I was able to experience miracle after miracle.  I experienced love in abundance from my children, from my friends, from my church family, from the nurses at Methodist Hospital and from the wonderful team at PRMA.  It was a life changing, lifesaving surgery.  

I look forward to going back to San Antonio for stage 2 of my surgery, where I know I am in good hands. 

If you have had breast cancer and you need reconstruction.  I am confident you will find what you need at PRMA.  Trust the experts!  I am glad I did.


Zoe, Mexico - Reconstruccion del Seno Usando el Musculo Latissimus Dorsi

Ayer es historia y Dios siempre tiene su plan...

No quiero hablar del pasado porque finalmente es solo eso, por doloroso, difícil y traumatizante que haya sido, la vida continúa mientras Dios nos siga despertando cada mañana con un nuevo sol.

Prefiero comenzar por dar gracias infinitas a EL, por su inmensidad y bondad, por mi segunda oportunidad. A mi familia y amigos incondicionales y llenos de amor. Mi hijo y mi hija que son mi motor y mi oxígeno y a una persona muy especial que desde el mes de marzo se ha hecho cargo de la reconstrucción de mi seno de una manera por demás profesional y cuidadosa, hablo del Dr. Oscar Ochoa.

Cuando hice cita con el no tenía ni idea de quien era, solo tuve claro que la clínica PRMA es bien reconocida y que llegue a ella por una “casualidad” de esas que Dios nos pone enfrente en el momento exacto; tampoco le investigué ni pedí referencias, me gustan los retos y lo impredecible. Así fue como llegué al día tan largamente anhelado y me encontré con un médico joven, experto y educado hablándome en español; me bastó su trato y su forma de desenvolverse para saber que después de más de dos años en la búsqueda de un magnifico micro cirujano finalmente lo tenía frente a mí y no me equivoqué. La cirugia quedo programada un mes después.

Hoy, tres meses después de mi primer cirugía y en vísperas de programar la segunda me siento muy bendecida por todo lo sucedido; tanto mi cirujano como todo el staff han sido muy profesionales y amables en su trato y me siento como en casa. Sé que aún estamos en el camino pero voy tranquila y confiada porque estoy en las mejores manos y sé también que el resultado será tal cual lo soñé tantas veces, sé que la pesadilla que a tantas mujeres nos ha tocado vivir queda atrás, actitud y fe son lo primordial, ahora solo me toca quererme mucho más, cuidar y respetar mi cuerpo como el templo que es.

No tengo ningún resentimiento, ningún reproche, no hay amargura por lo sucedido en 2010, porque todo, absolutamente todo en esta vida tiene su recompensa y Dios me permitió volver a nacer a los 41.


Sharon Pira, Monterey, California - DIEP Flap Reconstruction

Watch Sharon's video

My name is Sharon Pira and I am from Monterey, California. I was diagnosed with breast cancer in September 2011 and underwent the whole routine of chemo-therapy, radiation and a full mastectomy of my left breast in March 2012. After all of my treatment was complete I began looking into my options for breast reconstruction.  My local doctor advised against an implant (because of the effect of radiation on the area) so he suggested the TRAM-Flap as the best option for me which I agreed. In May 2012 I attended a women's conference in Scottsdale, AZ which was life-changing in itself, however I had no idea just how incredible this trip was going to turn out. On Sunday I got on a shuttle to the Phoenix airport along with another woman and as the driver pulled away I turned to her and asked, "Were you here for the women's conference?"  She said, No, I am a breast cancer surgeon from San Antonio, TX and was here for a breast cancer symposium. I removed the hat I was wearing to reveal my still very bald head and she proceeded to ask me questions about my treatment. She asked what kind of reconstruction I was having and I told her about the Tram-Flap. She asked if I knew about the DIEP Flap? I explained that I had a friend in San Jose who was having the DIEP Flap operation but that no one in my area performed this procedure. She gave me her card with the info about PRMA Medical Clinic and said I should at least check out their website. We hugged at the airport and I thanked her for the info!

When I returned home I went online to the PRMA website and was amazed by the before and after pictures and actually found a picture of a woman who looked just like me and I could not get over how great she looked one year later. So I called the clinic and scheduled an appointment with Dr. Peter Ledoux in June. I traveled to San Antonio by myself and Dr. Ledoux was kind enough to let me tape the interview so I could share the information with my husband, John. After sending my paperwork for insurance approval I was able to schedule my surgery for August. Everything from beginning to end went incredibly smooth and I am so grateful to the staff of PRMA for their amazing support and care during my hospital stay and my follow up appointments. I feel so blessed to have found Dr. Ledoux with his expertise, talent, and dedication to his patients and am thrilled with my results! It feels so good to have my new breast created from my very own body and my friends are all jealous of my incredible tummy tuck - Wow, what a bonus!

God Bless you all and I look forward to seeing you in January!


Heidi Hogan, Ketchum, Idaho - Delayed DIEP Flap Reconstruction

I am feeling stronger and better every day! Three weeks today. The hardest part for me is trying not to do too much because I am feeling good. I want to hike, bike, and enjoy summer in Idaho! I am so grateful to Dr. C and Dr. Ledoux for their artistry, expertise, passion for what they do and compassion for the women they care for. Everyone at PRMA has been amazing!


Erika Russell, Sidney, Maine - Bilateral prophylactic mastectomy and Immediate DIEP flap breast reconstruction

Not sure where to begin...I am lying here in a San Antonio hotel recovering on day 5 and in awe of this journey. Dr C, all staff, and the nurses and team at Methodist have exceeded all expectations, and I assure you that I have high standards. Trying to always be on top of my game and providing gold service to my clients is a must for me, and I have to accept defeat from Dr C;) I have read other women's blogs about their recovery (having had diep performed by other surgeons) and the difficulties that they endured. I feel so blessed that I have been provided with a totally different experience. Having traveled from Maine to Texas in pursuit of the best, I can say that God led me straight to Dr. Chrysopoulo.


Lisa Layton, Jacksonville, Florida - Delayed DIEP Flap Reconstruction

Watch Lisa's Video

After just spending 3 hours in a (non-cancer/surgery related) doctor's office, of which there was 8 minutes to see the assistant and 4 minutes to see the doctor, AND nothing came of the appointment, now I know why I flew 1500 miles to find the best. You look for the best doctors and you go there - simple as that. Find the best and go to the best! Go Dr C!! Go PRMA!!


Sue, New York, New York - Bilateral DIEP flap breast reconstruction

For me, arriving at the decision to do a DIEP flap reconstruction was simple. The key was finding the perfect surgeon for the task. Being from New York, I was concentrating at first, on the surgeons in my area, until I learned that it was the PRMA group who performed the majority of this type of reconstruction in the US. I knew that this was the group I wanted to perform my second mastectomy, remove my silicone implant and do a bilateral DIEP flap reconstruction; someone who sees this and does this every day. That was all fine; however there was a logistics issue. PRMA was in San Antonio and I was a wife and a mother of 4 children living in New York. “How could I make this work?” I asked. How could I ever recuperate in San Antonio, away from the people who could help me, and where would I convalesce? Well, I didn't even have to try and figure any of that out. The PRMA staff did the work for me and found the perfect place for me to stay after being released from the hospital. My husband and I felt so comfortable with the post-op arrangements that it only made sense that he return to NY to take care of the children and go back to work while I recuperated comfortably with the help of everyone from PRMA and the staff of the assisted living. (I almost felt like I was on vacation.)

This facility offered me 3 meals a day, room service, 24 hour nursing care, a private studio apartment with handicapped bathroom and the opportunity to meet some great people. All of my post-op doctor visits took place in the privacy of my room at the assisted living facility. Now, that is service and the best care you could ask for!

During my stay in San Antonio, I never felt alone. I was cared for by the staff of PRMA. I received phone calls and visits. Someone was always checking up on me. After 13 days (actual days may vary) total in San Antonio, it was time to return to New York. I was really able to gain my strength back and focus on myself and the healing of my body and soul. Boarding the flight back to NY, I knew that the decision to travel to San Antonio for my DIEP flap surgery was the perfect decision for me. I am now a very thankful 48 year old woman with a lot of living to look forward to.

I always say, “You can make it work.” Thanks to all of you at PRMA for helping me make it work. I am forever grateful.


Stanlie Murray, San Antonio, Texas - Bilateral Mastectomy with Immediate DIEP flap breast reconstruction

Watch Stanlie's Video Testimonial

Many ask me how I found out about the cancer, because I was not old enough to start mammogram screenings. I really found out by mistake, I had no symptoms, felt no lumps…nothing. My insurance offered this wellness benefit that allowed mammograms starting at age 37, so the year prior I took advantage of the benefit…after all I was paying for it. That test came back normal, so the next year I was going to skip the screening since I thought I did not need it, but some of my female colleagues were on this wellness kick and we decided to screen then go out for drinks. A week later, I started to get a barge of calls, but I was so busy with work I did not return them. The following week I get a letter from the boutique where I had the screening telling me my test results were abnormal - ahh that is why the doctor was calling.

I contacted the boutique on May 16 and they scheduled me to come in to have another mammogram and an ultrasound that day. I was a little concerned, but not really, I figured it was just a precaution. Therefore, I arrived for the appointment had the mammogram and ultrasound, just when I think I am going to leave, the radiologist emerges from this dark room and says, “We need to talk." He takes me to a room and says, “We see a mass on your left breast." I respond “ok, you sure it is not nothing?” He says “no, it’s not nothing” and schedules the biopsy for the next day. The pace at which everything was moving made me take pause, but I still had little concern. I have no family history, no risk factors, never smoked a day in my life - I cannot possibly have breast cancer.

On May 18, 2012, I was diagnosed with invasive ductal carcinoma breast cancer; I was 38 and a single mom. My life changed that day. I was in disbelief, sad, scared and I did not know if I would live to see my son turn 18, see him graduate from high school, or even get married.   I immediately went into research mode. A friend provided resources that helped me put together a great healthcare team.

I made PRMA part of my healthcare team because of their proven record of accomplishment, reputation in the community and the plethora of information provided on their website. I looked at every picture, watched every video, and read every bio on their website. That gave me the hope and confidence I needed to move forward. I knew emotionally I could not wake up without breast and I wanted the “best” to work on me. PRMA is the best, from the very first appointment my doctor, Oscar Ochoa was awesome. He was kind, patient, gentle, understanding, and very thorough he answered my questions, my family’s questions, my friend’s questions, and he was always compassionate, optimistic, and forthright. An excellent bedside manner and that is so important when you are so scared.

I underwent a bilateral mastectomy and immediate breast reconstruction on July 10, 2012; my first surgery was 14 hours. Recovery was long, hard, painful, and I initially felt like Frankenstein’s protégé, but after a few weeks that passed. Dr. Ochoa and his nursing staff supported me throughout my recovery; they educated me on my home care, answered my questions whether via phone or email, and made sure I knew I was not alone. On March 1, 2013, I underwent phase two of my reconstruction that surgery was six hours, by this time I was a pro, so recovery went by fast and I followed all of Dr. Ochoa’s directions to make sure I had the best possible outcome. I am thrilled, content, and amazed with my results. I could not have imagined anything better. I cannot wait to have the micro pigmentation done and see everything come full circle.

All of the doctors, nurses, and staff at PRMA are true gems; they understand the emotional turmoil a breast cancer diagnosis causes and they work very hard to help you cope.


Luzy Ziegler, San Antonio, Texas - Bilateral DIEP flap breast reconstruction

My one word for all of this is BIZARRE.

When I was told I had breast cancer, I was transported to a different planet. I went from wife, daughter, sister, counselor and friend to double mastectomy and plastic surgery patient and ultimately, breast cancer survivor.

I had no hesitation about the double mastectomy - it was cancer, I wanted it out and I wanted to prevent any chance of recurrence in the other breast - but i was scared.

Luckily, my oncologist guided me through the process of increasingly invasive procedures. He described the two-step surgery: he would do his part and then step out of the operating room so that the plastic surgeon could come in to do the immediate reconstruction. He then asked if I had a preference in plastic surgeons. 

I looked at my husband and he looked at me. Neither of us had any experience with plastic surgery. My oncologist then suggested that I meet with one of the surgeons at PRMA. At 3 pm that same day, I met with Dr. Ochoa. 

He was calm, cool and collected. He listened to me even though I realize now that I often didn't know what I was saying (believe me, emotions get in the way). Dr. Ochoa and the staff at PRMA listened to and heard my fears, my concerns and my mistaken beliefs. They patiently reminded me that my wounds needed time to heal and that revisions were a part of this whole bizarre process. 

I am a licensed professional counselor. The ability to listen and really hear what my clients are saying is critical in my work. And that's one of the many things that impressed me about Dr. Ochoa and the PRMA staff. They heard my voice even when I couldn't remember using it. They helped me survive the best I could, by listening. So thank you Dr. Ochoa and PRMA, for listening, for hearing, for everything. I am whole again.


Gail, Washington - Bilateral DIEP flap breast reconstruction

I am not quite sure where to begin with my story.

Getting breast cancer is not usually considered a gift, but may be getting the right treatment for it is a unique kind of gift.

It is with deep gratitude, owed to Dr. Peter Ledoux, his staff, the Methodist Hospital staff, Dr. Rosenthal and my brother, Dr. Gary Unzeitig that this letter is sent.

The news came on November 29, 2004. This was the same day my mother died of stomach cancer at age 43, when I was five years old. My first emotions were that of sheer fright and then sadness. “What will happen with my husband and children?”

Though I live in Washington State, my ties to my brother Gary are tight. Now, more than ever, I thank God that I was blessed with such a wonderful brother. Gary's first advice was of course to come to Texas so we can take care of you. Worried about my husband and my sons, I wanted to seek medical care in the Spokane and Seattle areas. My brother was by my side every step of the way, literally and spiritually, accompanying me to specialists visits in my area. After, dragging him across the country twice, I finally decided to concede to his recommendation for getting the best treatment available.

In early 2005, we visited Dr. Peter Ledoux. Fortunately, our first exposure to PRMA was Sharon who graciously made me feel as if I was having coffee with a friend. Nonetheless, I was quite nervous upon meeting Dr. Ledoux. With his kind smile and soft nature, it did not take long for me to feel at ease. My procedure entailed a DIEP flap mastectomy, nipple sparing on the left breast.

Pre-op, my surgical team of Drs. Ledoux, Rosenthal, Unzeitig and the anesthesiologist all made contact with me. Another physician who stopped by said, “you are in the hands of the A team.” Surely, I was. Thanks to their skill, my surgery was a complete success. As the Oncotype DX test was favorable, no chemotherapy followed.

In June of 2005 I returned to San Antonio for additional reconstruction by Dr. Ledoux and now, no one can tell that I had breast cancer. Cosmetically, Dr. Ledoux has done a tremendous reconstruction. There have been moments in the coffee shop restrooms with other women when I proudly share my results. They all think it is phenomenal and tell me “I will certainly go to Texas if I am ever diagnosed with breast cancer.”

I believe God places gifts in our lives, my gift was the “A Team”.


Catherine Lutz, Corpus Christi, Texas - DIEP flap reconstruction

Watch Catherine's Video

The summer of 2010 begin like any other summer; registering the kids for summer camps, planning weekend getaways and having fun. Little did I know this would be the summer that changed my life forever!

At 39, I had a routine mammogram and was told another mammogram was needed and when that confirmed suspicious spots on the right breast a needle biopsy was scheduled.  I never felt a lump, in fact, there was no lump. It was fine sand like spots that could only been seen microscopically.  A needle biopsy was done on my right breast and on August 19, 2010, I received the call-  YOU HAVE BREAST CANCER! The immediate devastation took my breath away as the end of my life flashed before my eyes. That’s what I envisioned: my death and leaving my two children Matthew and Alyssa without a mother and my husband Richard without a wife. In the middle of the storm it was my kids and husband that gave me the strength to fight this battle. 

After an unsuccessful lumpectomy, I was told the dreaded news, you need to have a mastectomy on the right breast. The thought of removing my breast was devastating! I quickly “googled” everything I could on breast cancer and reconstruction. Given that I lived in a smaller city, Corpus Christi, Texas, I knew I would look elsewhere to have the surgeries performed but was still searching for the BEST doctors. I received several recommendations on a General Surgeon in San Antonio, Texas so the next step was to find a Plastic Surgeon and Oncologist in the same city. After much research I had made the decision to have breast implants and had selected the Plastic Surgeon and but was still searching for an Oncologist.  Then I received a phone call from a friend who said her friend worked for an Oncologist in San Antonio and highly recommended this particular doctor. I took the lead and called the friend and somewhere in the middle of our conversation she asked me, “What type of reconstructive surgery do you plan to have?” Confident of my decision and all the research, I quickly responded with my decision to have implants and the reputable Plastic Surgeon’s name.  That’s when she shared PRMA with me and the success story her friend had with the transfer of natural tissue. I’d never heard of PRMA and was shocked that my long hours of research did not reveal this place or Dr. Ledoux she recommended.  I immediately “googled” PRMA and started to read about TRAM FLAP, DIEP etc and wanted to find out more about the procedures and the doctors. While I was excited about this new information I was concerned that I could not get an appointment within 72 hours as I had scheduled appointments with the General Surgeon, Oncologist all on the same day. Disappointed that Dr. Ledoux did not have an opening, the friendly receptionist told me that Dr. Pisano did have an opening and could see me. Who is Dr. Pisano?  My anxiety increased as I knew nothing about Dr. Pisano and was going off a referral from a friend of a friend despite all the long hours of research I had already did via the internet. I prayed about it and told myself, what harm would it cause to visit PRMA and see what Dr. Pisano had to say?

Until my visit with Dr. Pisano, most doctors suggested I only remove the right breast as the left breast did not show suspicious spots. In fact, a few doctors were disappointed I would even consider removing the left breast “that was perfectly okay." Some of the things I thought were, “Perfectly okay to who?” Could anyone tell me with absolutely certainty the “fine like sand” cancer was not in the left breast?

In September 2010, I visited PRMA and met Dr. Pisano. I can’t recall everything he said but I’ll never forget how he made me feel. He spent a long time talking to me about all my options. He was authentic, genuine and forth coming with my diagnosis, age, and challenged me to think of everything. I needed that, because when you’re told you have CANCER all you think about is living and removing the CANCER. But I’ll never forget his words, “At some point you will care how your breast look” and I want to make sure I give you all the information to help you make your decision. He was very honest about the left breast and the possibility of CANCER reoccurring if kept. He did not treat me like a statistic but a person who was on a quest to find as much information possible so I could make the decision on what to do. At the time, I thought the decision to remove both or only the right breast was the hardest decision, but looking back, it was the easiest and best decision!

So on October 18, 2010, I had bilateral mastectomy and the DIEP initial reconstructive surgery on both breasts. Fortunately, I did not need Chemo or Radiation and was able to proceed with the additional reconstructive surgery. I’m amazed with my breast and thrilled I do not have horrible scars on them that would be a constant reminder I had breast cancer. Yes, I have the tummy tuck scar but that itself does not represent Breast Cancer as scars on breast would.

Yes, I’ve experienced dark, lonely days, and having my breast removed have at times made me feel, unworthy, undesired and incomplete.  If you let it CANCER will invade your identity. But even on my worst days I still feel more beautiful with my new breasts and battle wound scar.

I decided not to hide behind this illness and begin to share my story with others. It’s been challenging but I always said, “if I can help one person it’s worth all my tears”. This has been the biggest lesson learned, when I think I’m helping others they’re really helping me. “I refuse to become powerless over breast cancer”!

When death is knocking at your door, your life changes, mine did. Sometimes it takes death to put things into perspective. At the end of the day, it’s still faith, family and friends that matters! My life was saved and now it’s my job to make sure my life is worth saving.   Catherine F. Lutz


Holly, Austin, Texas - GAP flap breast reconstruction

I will never be able to thank Dr. Ledoux, his partners, and his staff enough; they made an extremely difficult time in my life much easier for me and my family.

In January of 2009 I found a lump in my left breast which turned out to be breast cancer. It had not shown up on my annual mammogram and, in fact, never showed up on any mammogram. (Ladies, do your self-exams!) This began a very frightening time for me and my family. It was a time of much stress, many unknowns, and massive amounts of information gathering. I was figuring out that I preferred a flap procedure to implants, and that I would likely need the gap flap procedure because I had more excess fat on my bottom than tummy. However, the plastic surgeons that I spoke with in Houston and Austin were not comfortable performing free flap procedures. In Austin, one particular appointment left me in tears because the surgeon was so negative about flap procedures. While I was concerned with aesthetics during this time, I was also going through the agony of the unknown as far as what my prognosis would be. At my very first appointment with Dr. Ledoux, I remember a feeling of relief come over me as the tight hold of worry and fear began to loosen. It was quite obvious to me and to my discerning friend, who had come to take notes for me, that we were in good and extremely competent hands. With great relief, I realized that my decision was made and the big part of my work was done. All I had to do was to put myself in the hands of this doctor, who I believe was an answer to my prayers, and do what he told me to do. That is exactly what I did!

Dr. Ledoux and his partners and staff as well as the nursing staff at the Methodist hospital shepherded me and my family through, what for me, turned out to be a lengthy process. I had a mastectomy with the gap flap procedure on my right breast in 2009 and then was diagnosed again and had the gap flap procedure on my left breast in 2010. I am thrilled with my results. My new physique is lovely; I do not even have to wear a bra! Plus I got a bottom reduction and thigh lift out of the deal!

The doctors at PRMA are unbelievably skilled and talented. These guys are serious rock stars in the breast reconstruction world, and they are incredibly unassuming about their amazing gifts and talent. Faith is a big part of their practice. Each time we went into surgery, Dr. Ledoux would pray with my family and friends. I love that whenever I try to compliment Dr. Ledoux he always defers and "gives all the glory to God who guides his hands."

I would recommend the PRMA group to anyone who finds herself needing breast reconstruction. I am eternally grateful to them for carrying me through this time in my life and for bringing some levity, making it not so scary and giving me a sense of normalcy and hope.


Carrie Scott, San Antonio, Texas - Tissue Expanders and Implant Breast Reconstruction

Dr. Chrysopoulo, your superior attributes of class and grace to PRMA Plastic Surgery and each life you touch is truly amazing. I personally have been blessed with your expertise, perfection and phenomenal bedside manner.

My story started in September 2012 with family history of breast cancer, multiple mammograms, several biopsies, genetic counseling and my maternal aunt's life taken at the hands of breast cancer. I decided to pursue a prophylactic double mastectomy with immediate breast reconstruction.

It was definitely a huge decision but worth each drain, stitch, tissue expander, sleepless night and tear. With your keen eye for perfection, optimistic outcome and charming British accent, I had no doubt I had the best of the best and was placed in great hands. You are truly a first class plastic surgeon.

Your genuine compassion for your work is outstanding. A gift and blessing to present and future patients and their families. Your honorable demeanor reflects in your nurse, Denise. She has been amazing, simply a treasure and quite knowledgeable.

With my final surgery behind me, my mind at ease and an awesome pair of reconstructed breasts, I thank you!


Wendy Shepherd, Edmond, Oklahoma - Nipple-Sparing Mastectomies and Immediate Single-Stage Reconstruction with Implants (Alloderm One-Step)

I had my One-Step with Alloderm in November 2012 with Dr. Chrysopoulo. I traveled from Oklahoma City. His bedside manner is amazing and his staff is also incredible. He is a perfectionist and does absolutely beautiful work! He made me feel at ease and I have already referred two people to him that also traveled. I highly recommend Dr. C and PRMA!


Linda, Fort Worth, Texas - Bilateral DIEP flap breast reconstruction

"I knew insurance would cover my reconstruction anywhere, and anything I wanted, so, for me, the outcome was the only criteria. I interviewed the only local plastic surgeon who would do a Tram flap (nobody would perform a DIEP), but I was unimpressed with his photos. His nurse said the aim was to look good in clothes. That wasn't good enough for me. I wanted to look good naked. After all, I have to look at myself every time I get out of the shower for the rest of my life. I didn't want to see the effects of cancer on my body forever. Since insurance was covering it 100 percent, the costs of traveling wasn't a real issue. PRMA's photos were the most natural I found online. I decided that I finally needed to put myself first for once. Yes, it was inconvenient, but I was worth it. I would only have one opportunity to get it right, and the results would be life-long. My ob-gyn said my scars "lie". They tell him I've had a breast reduction and a tummy tuck instead of bilateral mastectomy and reconstruction."


Sandra, Fredricksburg, Texas - Unilateral DIEP Flap Breast Reconstruction

In the past nine months, you were an inspiration in my fight against breast cancer. Thank you!! You were professional, thoughtful and explained all procedures very well and in detail. I could not have asked for a better plastic surgeons to handle my case. When everything seemed extremely bad, something good came out of it, this was you the PRMA group.

My mastectomy, reconstruction and lipo could not have been handled or done any better that it was. Due to you PRMA, I have lost weight, lowered my blood pressure, and everyone that sees me now tells me how much better I kook now, than I ever have and I feel extremely good. Thanks to you!!!!

Your staff (nurses, receptionists and bookkeepers) all are professional, caring and understanding. Thank you again for being there in my fight against breast cancer. You made my breast cancer, so much easier to deal with and BEAT!!!!


Anna Boggess, San Antonio, Texas - GAP flap breast reconstruction

I had a bad feeling the day my mammogram session went longer than usual. And sure enough, I ultimately got the diagnosis that the doctors had found cancer, again. I had been cancer-free for nearly 20 years after having a lumpectomy in 1992. Believe me, the news wasn’t any less scary this time around. The good news was that the advancements in imaging technology allowed my doctors to find this small speck of cancer very early. The bad news was since I already had my limit on radiation and chemotherapy earlier in my life, a mastectomy was what I needed to do this time around.  After praying about the challenge and talking things through with my doctors, family and close friends, I decided to have a double mastectomy.

One of the comforting pieces of information I had to work with was that Dr. Peter Ledoux would be handling the reconstruction surgery.  The surgeons at PRMA helped me before and I knew I’d be in the hands of a true surgical master.

I had the GAP flap breast reconstruction on the right side in November 2011 and the left breast surgery performed in April 2012.  There is still one more short session later this year to complete the whole process, but I was very happy with Dr. Ledoux’s work and gentle care for me and my family.

To those of you who may be reading these stories and facing the same diagnosis as I and other women on this page have confronted, have faith in God’s healing powers through the work of His faithful servants like Dr. Ledoux. Dr. Ledoux’s prayers just before my surgeries comforted me and my husband.  His surgical expertise gives me a reason to be a confident woman for the rest of my life.


Debbie, Karnes City, Texas - Unilateral DIEP flap breast reconstruction

I want to thank you for all you did to keep me “whole” after my breast cancer diagnosis. I was very fortunate in so many ways after being diagnosed…. first being referred to you and then having all the cancer removed during surgery and not have to undergo chemotherapy or radiation.

Your skill and ability are gifts from God that blessed my life and others. I had no idea of what my options were until meeting with you. You took the time and care to explain how the DIEP Flap procedure worked. You laid everything out and helped make my decision a little easier. From the moment I met you, Dr Chrysopoulo, I knew I was in the most capable hands.


Jamie Greene, Amarillo, Texas - Delayed DIEP flap breast reconstruction

PRMA treated me like a person, actually a Queen, instead of a patient! My cancer surgeon and first plastic surgeon left me with a botched breast lift, an extremely huge mastectomy scar and an unnecessary hole in my arm pit. I had a second opinion and was still not satisfied with his answers. Dr. Chet Nastala was my third opinion and he was very kind, compassionate and professional. I finally felt safe! He performed a DIEP on June 4 and now I finally feel normal! I'm so excited to finish the breast reconstruction with the staff at PRMA!


Lisa, Spring Branch, Texas - Bilateral mastectomy with DIEP flap breast reconstruction

Even before the shock of being told I had breast cancer was over I was scheduled for an appointment with Dr Nastala at PRMA. He and the office staff were so kind and understanding and answered all of my crazy questions. I chose to have the DIEP procedure and also to have both breasts removed even though only one was affected. The staff at Methodist Hospital were knowledgeable, kind, and always available during my post op recovery.  I have never regretted my decisions for surgery and my sweet husband says I look better than ever! He would like to encourage husbands to accompany their wives to appointments and procedures. A direct quote from my husband Charley – “At first I thought going with you was just for encouragement but it was way beyond that.”

We can never thank Dr. Nastala, his partners and the entire PRMA staff enough – they have a lot of heart for their patients and obvious passion for what they do. Thank you for keeping me whole!!!


Patricia, Austin, Texas - Bilateral mastectomy with DIEP flap breast reconstruction

I was diagnosed with DCIS in my right breast in August of 2010. My mother had breast cancer, so I always kind of expected it, but nothing prepared me for actually hearing the words. I was given the option to have a lumpectomy and radiation, but I knew that I would always worry about cancer coming back, and I had seen the damage that radiation could do. I began looking at other options, but didn't like any of them. I didn't know what to do, so I finally talked to a plastic surgeon friend and he directed me to the PRMA website. When I saw the DIEP flap procedure, I knew that it was the right choice for me. I live in Austin, TX, but I have a wonderful husband/caregiver, so the travel was not a problem. I had my bilateral mastectomy and immediate DIEP flap the day before my birthday in September of 2010. I told the hospital staff that this was my birthday present; getting rid of cancer, getting a breast reduction and getting a tummy tuck. I thought I would be terrified, but everyone had told me how great Dr. Ledoux was and how wonderful the hospital staff was, so after Dr. Ledoux prayed with me, I was ready to go. I won't say that recovery was easy, but it wasn't near as bad as I thought it could be. They do everything they can to reduce the pain. There was more discomfort from the drain than pain. By the second day, I was off the pain meds. I went back to Austin after 4 days and was back to work in 4 weeks.

Prior to the revision surgery, Dr. Ledoux was concerned about my overall health. I was quite a bit overweight and he encouraged me to lose about 50 lbs before the revisions. He suggested I go to Medi-Weightloss here in Austin, so my husband and I started the program.  I lost the weight and was able to get off all of my medications.  I had been diabetic and had high blood pressure. On the day of my revision surgery, Dr. Ledoux had to take a double take and didn't even recognize my husband.  I spent one night in the hospital after the revisions, but never took any pain meds. I went back to work the following week. Three months later I had my nipples done and 3 months after that I got tattooed. Thanks to Dr. Ledoux and the staff at PRMA, I not only got rid of cancer, got a breast reduction and a tummy tuck, but I am also no longer diabetic, my blood pressure is normal, my cholesterol is normal and I am healthier that I have ever been. They saved my live in so many ways.


Nancie - Breast reconstruction with DIEP flap

I can't believe a year has gone by since I was diagnosed with breast cancer. I was only 36 with three kids. I thought my life was over, but I was told it was in the early stage. All I needed to do was have a mastectomy. What about my body? Yes, I was vain. I was too young to wake up with a scar across my chest. After talking with the doctor and looking at pictures, I thought well, maybe it would be okay. July 17, 1997 I had a mastectomy with reconstruction. To my surprise I have a beautiful breast. I'm still a woman. A special thanks to you and your staff for your patience, kind words, and prayers. It made such a difference. You really do care about us. It's a very scary feeling to hear the words, "you have cancer," but you took time with me. Thank you very much. People have asked me do I ever ask God, why me? Not really, because through it all I have met some exceptionally wonderful women who have all gone through this. We have a special bond that no one else can have. See, we understand true friendship. We don't take normal for granted. Life is really too short, so we value our time together. I wouldn't change a thing. I'm so lucky. A year has gone by since I went through surgery and chemo. I MADE IT! My life goes on - Thank God!


Antoinette - Breast reconstruction with DIEP flap

I felt compelled to write and let you and your staff know how very pleased I was with the care I have received since last February.I was totally shocked to learn that I had cancer and was so relieved to learn that you were highly recommended, as I know your wife Debbie, I felt more comfortable consulting with you on my condition.Upon our first meeting, I knew I was going to receive excellent care. From the initial consultation, the office visits, my hospitalization, to the many telephone calls I made to your office, you and your most capable and compassionate staff members addressed each and every concern.The tragic impact of losing a breast is devastating, so as I awoke with the partial reconstruction, I was immediately pleased with the results. I would also like you to know that there are people who have no idea that I had breast cancer and would never be able to detect the fact that I had breast reconstructive surgery.


Deborah - Breast reconstruction with DIEP flap

I would like to express my deepest gratitude for all your dedication, hard work, and sincerity you provided for me as your patient. When I was diagnosed with breast cancer in September of 2001 I was devastated and didn't know if I was going to fight for my life or die. However, I was fortunate and blessed with many family members and friends who prayed for me and for my doctors under my care.Therefore, having you as my doctor was God's work and a blessing. My faith in the Lord has carried me through out my life. I have faced many storms, but this one (breast cancer) has been one of the biggest storms for me to battle. However, thanks to the abundance of faith the good Lord has blessed me with, I was able to go through my surgeries and chemotherapy treatments with grace. On one of my routine doctor visits with you in your office, I noticed the cross around your neck. Seeing that cross only ensured me that you were a doctor who really cared and was sent from heaven. You gave me advice and ensured me that the final outcome of my plastic surgery was going to be fine. I remember looking at pictures from different books and feeling miserable because the scars that were left from a modified radical mastectomy and reconstruction of the breast. My surgery for the revisions was completed on June 21, 2002. after the post surgery doctor's visit, I left your office with tears of joy. My scars were nothing like I saw in that book. In fact, my scars were minimal and I couldn't believe it! I had always prayed for God to help me work through chemo, to help me care for Katelyn, my 6 month old baby, to help me transport my daughter, Jacqueline, to all her softball practices and games, and to help me guide my 22 year old son, Benny. Well, the good Lord definitely answered those prayers and more. God planned for you to be my doctor and perform such a miraculous job on my revisions from the reconstruction surgery. No one would ever guess what my body has been through. I've sent a picture of me in my bikini to prove it. This picture was taken approximately 1 month after my last surgery on June 21, 2002. Once again, THANK YOU for your devotion as a doctor.


Barbara - Breast reconstruction with DIEP flap

Let me take this opportunity to "thank you" for giving me a new perspective on life. I never though I would be as happy as I am now after hearing the words "you have breast cancer."Being single, I thought having breast cancer would put an abrupt end to my social life. If a man heard I had cancer, I though he'd run to the nearest door. How shocked I've been to discover that the exact opposite is true. They have been kinder, warmer and some have even contributed financially to a charity fundraiser I was involved in for breast cancer research.The biggest change in my life since this experience is my attitude towards work & play. I have slowed down to "smell the roses." I don't spend as much time at work - life is too much fun and I want to enjoy it!I am up early to exercise at the gym by 6 a.m., play golf every weekend and sometimes during the week if I'm lucky. I have taken skeet shooting lessons and go dancing Sunday evenings with friends. I have a very active social calendar and surround myself with people I love and cherish that I have met through work, golf, and dating.I worship the special relationships I have with the many women I have me who have also had breast cancer. We have a special bond that will always keep us together and we will strive to be there for each other.


Kathy Friedrichsen - Breast reconstruction with Latissimus Dorsi Flap

Watch Kathy's video.

I would like to express my gratitude and appreciation to Dr. Gary Arishita, Heather Waggoner and the PRMA staff. What a pleasure to be associated with them as a breast reconstruction patient.

After diagnosis, I went through chemotherapy, a single mastectomy then radiation. At every turn I was overwhelmed and so blessed by the level of care and compassion my various medical teams bestowed upon me.

Fortunately, my general surgeon recommended I consult with PRMA. In April of 2012 I underwent another mastectomy plus double reconstruction with a Latissumus Dorsi Flap surgery. From the start, Dr. Arishita and Heather have been so very informative and caring. I was totally mentally and emotionally prepared for surgery.

My rapid recovery from this procedure is unbelievable to me! After a few short months the scar on my back is fading quickly and I have resumed my swim workout ranging 1-2 miles a day, holding forth with the two piece I wore before surgery! I was worried about the latissimus transplant weakening my left side, but actually there is no difference! All of this and I feel great.

Post-surgical appointments are always something I look forward to. The incredible "pain free" expertise continues. My scars are healing, I’m exercising, I feel good and if I do say so myself, I look great. I’m proud to say I owe it all to Dr. Arishita, Heather and staff! I am so blessed, life is good.


Louise Parker - Breast Reconstruction with Latissimus Flap

I am writing to express my gratitude to you and your staff for taking such good care of me during the course of my illness. It was quite the journey! For a long time I blamed myself for what I went through because it was my decision to have cosmetic surgery on healthy breasts, but I learned to let the blame go and believe that things happen for a reason. Thinking back I realize how blessed I am to have met so many wonderful people who cared for me during my illness from my doctors and nurses to the nice pharmacist at CVS (he knew me by name!). Yes, while not the results that I originally expected when we first met, I am so grateful you stuck with me throughout the months determined to get me to a healthier place!

A health update from me is that the surgery was a success! It's been over 4 months post-op and no signs of infection or inflammation on the breast or donor site! I was able to get back into the activities that I so love (gardening and yoga) with very slight limitation on the right side. And yes, I also started back shotgun target shooting with my husband, although I am tackling this activity at a slower pace. I've even ventured into the hot tub - which I was so deathly afraid of, and stayed away from, fearful that any type of bacteria in the water would somehow find a way into my body! 

Again, thank you very much for your compassion, kindness and excellent care. As it is hard to forget one of the best, so I will never forget you, Dr. Pisano! God bless you always.


Rebecca - Breast reconstruction with muscle-sparing free TRAM flap

In May of 1998 I felt I was on the road to recovery, after my divorce. I was being recognized in "People Magazine" for being beautiful, of all things! My excitement was short lived, unfortunately. On Memorial Day 1998, I went water-skiing and became quite sore. I then noticed a large lump in my right breast. After a series of nightmarish exams, biopsies, watching people horrified expressions of me having cancer, I had a mastectomy with reconstructive surgery, a muscle-sparing free TRAM FLAP, as it would be called. I was blessed with having you as my Plastic Surgeon. Your staff was ever so patient and kind, and your gift and artistry of re-creating my breast out of my stomach was miraculous. It's not so much for vanity sake that I had reconstructive surgery, but it's that I wanted to be "ME" again and you gave that to me.


Oleata - Breast reconstruction with Latissimus Dorsi flap

In April 2003 I came to visit you having received a 12-24 month terminal diagnosis of Metastatic Breast Cancer to the Lymphatics of the skin. Due to my health and immune system problems the military had refused to perform the surgery recommended my MD Anderson Cancer Center. The military told me I would never survive the extensive surgery to remove the cancer in lymphatics of the skin and replace the skin with a skin graft from my back. And, in their opinion, if I survive the surgery then I would never heal with my impaired immune system. I told you their concerns and I had been denied my right to surgery. You never hesitated. You simply agreed to perform my surgery. And in doing so, you literally saved my life, cured my cancer and gave me my life back. I can never thank you enough.

Your stitches were so precise, tiny and beautiful. Other doctors marvel at how you chose to perform the surgery and the beautiful, almost invisible and ingenious outcome of your masterpiece and surgical work under the worst of cancer and surgical conditions. Five years later, I am so pleased with your work. Most of all, I have treasured the past five years watching our family grow through our children's marriages and the births of grandchildren. Thank you for giving me the gift of life and the gift of becoming a Nana to six wonderful grandchildren and, especially, the gift of time to make wonderful memories with them.


"DIEP Flap Diaries":

Tammy's Journey

Leslie's Diary


Barb, Madison, Wisconsin - Abdominoplasty (tummy tuck)

I just wanted to thank you again Dr C for all you have done for me. I hope you take my before-and-after photos with you; although they don't show how happy I am, they do show your great work. My daughter's wedding is in 2 weeks and I can't wait to wear that beautiful dress she picked out for me. I won't have to try to suck in my tummy all night either! It was a pleasure to have met you. You have changed my views about plastic surgery - it is for us "ordinary" women too. I'm sorry to see you leave, but wish you the best. Thank you so much!


Marlis, Madison, Wisconsin - Body lift

Thank you for some of the most terrifying and yet elating moments in my life! It wasn't easy, as you promised, but without your concern, not so gentle prodding and ability to make me laugh when I wanted to scream, I wouldn't have made it through as easy as I did.

From a patient's standpoint, well at least this patient, having a doctor who remembers he's human and not afraid to laugh make going through surgery and follow-up all the easier. I hope that you grace your other patients with the same kind of "tough care." I've been fortunate with my docs and I have recommended you to many who wish plastic surgery. Thank you for everything Dr Chrysopoulo.


Neelima, Madison, Wisconsin - Abdominoplasty (tummy tuck)

I do not know how to begin to thank you Dr C for all that you have done for me. You said during our first meeting that you would take care of me and know doubt you stuck to your word. On every visit, I was impressed with your gentleness, expertise and professionalism. Your artistic abilities are evident to me in the results that I see everyday. You have really changed my life in that I am so much more confident and happy. I will miss your expert care. I wish you and your family the best in the future.