Prophylactic Nipple-Sparing Mastectomy with Direct to Implant Breast Reconstruction
My story begins well before my surgery date. In 1966, my grandmother went through a double mastectomy, without the option of breast reconstruction at the time. She survived her journey, beating breast cancer, unlike her own mother who passed many years before. Knowing her own daughter came from a family prone to breast cancer, my grandmother recounts the struggle my mother went through, “she asked her doctor if she could undergo a prophylactic mastectomy--a procedure where the breast tissue is removed and replaced with implants to lessen cancer risk. She was discouraged from taking that radical step.” LATimes Sadly, in 1989, my mother was diagnosed with breast cancer after discovering a lump at the age of 40. She went through two years of harsh treatments, but the cancer spread, taking her life in the end. In 2005, I tested positive for the BRCA gene. The pattern of family history was bound to continue.
After years and years of MRIs, mammograms, surgical consults, doctor research and inevitably never having time for preventive surgery, I had my first scare in November 2014 at the age of 38, when a cyst was detected. Two years before my own mother was diagnosed with cancer, I was dealing with the “what if.” Calling my husband and telling him they were going to complete the scans a second time to investigate a spot on the mammogram was the hardest call I’ve ever had to make. There I sat in the waiting room, with two of my children, trying to keep a brave face and hold back the tears. I was sent from the radiology department straight to an oncology consult. You know it’s serious when a doctor gets you in right away. I then sat through thirty minutes of reasons why I should or should not get a mastectomy, how they could cut it out if it was cancer and what the treatments would be. At that point, I was done trying to stay one step ahead of cancer, I didn’t want to “deal with it if it was cancer.” I was ready for surgery. Take them off.
Because I had already done a lot of research on breast surgeons, with the hopes of getting surgery sooner than later, I knew who I was going to trust my life to for this. I flew 9,996 miles, from Singapore to Houston, and then drove to PRMA in San Antonio. Yes, you can travel a long distance for the right surgery and the right surgeon. I had been in contact with Courtney, the patient liaison, and Denise, my nurse, for weeks prior to actually arriving in Texas. They were vital in keeping me calm and informed. They were my long-distance support. They made the process easy and comfortable.
I chose to have a Nipple-Sparing Prophylactic Mastectomy and Immediate Single-Stage Reconstruction with Implants (Alloderm One-Step) in June 2015 under Dr. Chrysopoulo’s care. I chose implant surgery due to the long distance travel required and short window of recovery time available. I’m also a mom to three young children…I needed to be back on my feet as soon as possible. My husband was fully supportive of implant surgery, not minding that my breasts might not feel as soft as some of the other amazing tissue-using surgeries PRMA offers, such as DIEP.
So there we were, the entire family in San Antonio, ready to put my own life back into my own hands. We met Dr. Chrysopoulo, in person, two days before my surgery, only previously speaking via Skype. I knew I had chosen well from our Skype conversation, but meeting someone in person puts things in a whole different perspective. This is when and where I truly understood the words, “I can’t thank you enough.” I simply can’t. Dr. Chrysopoulo greeted me with a hug, provided a warm and friendly smile, and sat down with my husband and I to discuss the surgery for the next hour. There was no clock watching, no agitation at all of our questions, never a sense of “lady, I do this all the time, lets get on with it.” He was there for us, and only us, in that consult. He provided assurance, comfort and had solidified our trust in our decision. I found myself repeatedly saying, “I trust you, whatever you think is best,” to many of the questions he had for me. He was more concerned with making sure I was happy and would be pleased with results after surgery, and all I wanted was for him to free me of my fears. My nurse Denise was there too, providing the reassuring smile you hope to see from your caretaker. When we were finished talking, we left his room, noticing many of the lights were off and the front office had gone home. But there was Courtney, waiting for me with a smile, just to say hi in person.
Dr. Chrysopoulo was comforting and upbeat the day of surgery (I later learned it was his birthday) keeping me in my “it’s a walk in the park” mentality I was working on for calming my nerves. He marked me with his “medical grade Sharpie” and we were off. Next thing I knew, I was waking up and realizing that it was all over. I was free from fear. I had done it. I stayed two nights in the hospital with the greatest of staff members you could ask for. They kept me in minimal pain, I was Facebooking immediately upon returning to my recovery room and blogging 12 hours after surgery, they were attentive to my husband’s needs and they kept me supplied with plenty of jello for the achy throat. It was even more wonderful to see Courtney and Dr. C stop by to check in on me.
I’m pleased to say that after my surgery, although several cysts were actually found, my pathology report was clear. You think you let out that huge sigh of relief once the surgery is over, but when you get that paper in your hand to say you were free from cancer…you can’t beat that moment. You also can’t fake genuine concern and care. Denise, Courtney and Dr. Chrysopoulo were there for me before, during and now, well after my surgery. They truly care about you and your journey…it doesn’t end when you walk out the door after your last follow up appointment. See, I can’t thank them enough because there are no words that truly encompass what your heart feels. You just know it, you try to communicate it and you hope they get it.
Here we are now, I’m four weeks post surgery, back in Singapore and finally living each day without fear. My recovery is going well. The drains came out on days 6 and 11. My surgical tape came off this week and my incisions and scars look amazing. They are so well placed, right above the inframmamary fold, which no one would know unless I showed them. My muscles are sore, but they are healing each day through gentle stretching exercises. Overall, my breasts are beautiful and I couldn’t be more pleased with my results. Today, I’m simply a mother to three beautiful children, who I get to look at with hope that I’ll be able to watch them grow up. I’m free from fear. Thank you PRMA and Dr. Chrysopoulo.