After testing positive for the BRCA2 gene mutation, Emily chose to undergo prophylactic mastectomy with immediate DIEP flap breast reconstruction at PRMA Plastic Surgery in San Antonio, Texas

My name is Emily. I live in Midland, Texas. I received a phone call in October 2016 that my paternal grandmother along with her sister underwent genetic testing. They both tested positive for the BRCA 2 mutation. Their doctor suggested that any grandchildren and children have genetic testing done as well. I had the testing done. A few weeks later my gynecologist met with me to tell me that I had in fact tested positive for the BRCA 2 mutation too. I was shocked. I was scared. I was emotional. I did not know anything about the BRCA 2 mutation.

My doctor proceeded to explain to me the statistics that being positive for the BRCA 2 mutation meant my chance of breast and or ovarian cancer was high. I was devastated to learn just how much being BRCA 2 positive raised my chances for these cancers. My doctor told me that the best thing I could do for my health was to have a total hysterectomy as well as bilateral mastectomies.

My biological mother passed away from a rare form of ovarian cancer at age 55. So, now knowing I carried this gene mutation I could not schedule my hysterectomy fast enough. For some reason the word mastectomy scared me to death. I struggled with myself why I had no trouble losing my ovaries and all female organs but I had SO much trouble getting my mind to a good place about losing my breasts.

My husband and I met with two different plastic surgeons in and around Midland, TX. Both surgeons, while nice people, made me feel like a number… just another woman coming through their practice looking for a boob job. I felt like they rushed the appointments. They were unwilling to hear my concerns and fears. They said have your mastectomy then heal and come back and we can then talk about what type of implants would be best. I left so disappointed and frustrated. I was not seeking cosmetic surgery. I needed them to acknowledge that. I was going to go through these surgeries for medical reasons. I cried as soon as I got into my car after both appointments.

I began obsessively researching breast reconstruction online. This is when I came across a type of breast reconstruction that I had never heard of, and did not know it existed, called the DIEP flap. It is a type of breast reconstruction where your new breasts are constructed from your very own body and tissue and fat. One of the things I was worried about with implants is the fact I would be putting something “foreign” inside my body.  (I was told that since I was only 38 yrs old I would likely need to have implants replaced up to three times in my life time. Additional surgeries throughout my life was not appealing.

I then began researching anything and everything I could find out about DIEP flap reconstruction. This is when I found the PRMA website. Their website was full of information, patient stories, pictures, patient videos as well as videos from the surgeons themselves. I spent several days going through every inch of PRMA’s website. Everything I read and heard was positive. Their office happened to be 5 1/2 hrs away from my home. That was hard for me to get past, leaving my kids to go so far away for this procedure.

My husband and I traveled to San Antonio to meet with PRMA. We were paired with Dr. Chet Nastala and his nurse Amy. They spent over an hour with us. They were so so kind, honest, and patient. They were willing to sit with me and to hear all my concerns and my fears and to address each and every one of them .They really made me feel like they understood why I was there, not to try and look better but for medical reasons to do everything in my power to hopefully prevent breast cancer. They acknowledged my BRCA 2 mutation . My husband and I left this appointment certain that this is where I needed to be.

I had my bilateral mastectomy with immediate DIEP flap breast reconstruction in April 2017. I was SO scared going into this surgery and recovery. Was this journey easy everyday? No, there were bad days and frustrating days BUT nothing I could not handle or did not handle. Dr. Nastala and Amy were always in my corner cheering me on and encouraging me. They were always caring and honest and calming and I respect that about them so much. It did not matter if I asked the same question a hundred times, they were right there beside me this entire journey and they will never know just how much that meant to me.

I have zero regrets about choosing DIEP flap reconstruction. I have zero regrets traveling all the way to PRMA. This group is amazing! From the front desk help to the nurses to the surgeons to the person in charge of helping get insurance lined out to the PR person… every single person I came in contact with at PRMA was just amazing. PRMA will always hold a special place in my heart and I will always hold them in such high respect and I will recommend them to every woman I might meet that needs to undergo breast reconstruction.

Finding out I was BRCA 2 positive and facing these medical procedures was not easy. Being BRCA 2 positive is not a guarantee that I will have breast cancer but I will tell you going from a 75% chance to a 5% chance after surgery truly did take a weight off my shoulders. I do not feel like a ticking time bomb anymore. The DIEP flap might have a more lengthy recovery than implants BUT its a one time thing. Once you get through phase 1 and phase 2 your done! My breasts are warm and soft and I DO have some feeling/sensation in both which is so awesome. My DIEP breasts will “age” with me , they will fluctuate as my body weight goes up and down. And yes, my tummy area looks better than it has in years!

I am so so glad and honestly feel blessed to have been able to have my reconstruction with PRMA and Dr Nastala and Amy. If you are reading my story, please call them. It is so worth the call and travel to go meet with them. This group sees us as individual women with individual needs and concerns and worries, they do not see us as just another woman coming through with all the same “cookie cutter” issues and concerns.

To Dr. Nastala, I say THANK YOU sir, from the bottom of my heart! You are so much more than a plastic surgeon but an artist! I thank you for the amazing job you did on me. To Amy I say THANK YOU you are such a sweetheart and your willingness to be in my corner and support me through this process just meant SO much and is SO appreciated. Your knowledge and your skill of these surgeries and recoveries is awesome. Thank you for all your help!



After testing positive for the BRCA2 gene mutation, Emily chose to undergo prophylactic mastectomy with immediate DIEP flap breast reconstruction

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