Before Breast Reconstruction: How Elle Decided on a PAP Flap | Part 1
Elle had already had breast cancer, a single mastectomy and DIEP flap reconstruction.
More than three years later, she was preparing for revision surgery to improve balance between her reconstructed breast and her remaining natural breast. Then a breast cancer diagnosis in her family prompted updated genetic testing.
The result revealed that Elle had a CHEK2 gene mutation and changed the decision in front of her.
Instead of preparing for revision surgery, she was now considering a risk-reducing mastectomy on her remaining breast and what, if anything, would come next.
What breast reconstruction options remain after DIEP?
Once Elle decided to have a risk-reducing mastectomy, another question followed. Would she remain flat, have implant reconstruction or undergo another own-tissue reconstruction?
Elle had already used abdominal tissue for her DIEP flap, so she couldn’t have that surgery again.
Her surgeon considered her body shape and the importance of returning to gymnastics without using muscle where possible.
Was choosing another major reconstruction selfish?
The mastectomy decision became relatively clear for Elle. The harder decision was what should follow it.
She knew that another own-tissue reconstruction would be a major operation with a demanding recovery. It would ask a great deal of her body again. It would also affect the people around her.
That led Elle to question whether choosing another reconstruction was selfish.
She had already been through DIEP flap reconstruction and understood the physical impact. At the same time, that earlier surgery had changed how she viewed her body.
She had seen what it could recover from, how it could rehabilitate and what it remained capable of doing.
Finding peace with a personal decision
This time, Elle wasn’t being guided towards surgery because cancer had already been found in the breast. The decision sat with her.
She used counselling to examine whether she was reacting automatically, whether she felt responsible for choosing the easiest option and whether another reconstruction was truly what she wanted.
Her choice is based on her own priorities, body, work, movement and feelings about reconstruction.
Part 1 of Elle’s story is about how she reached that decision.
Listen next
In Part 2, Elle shares how she is preparing for PAP flap reconstruction, including the uncertainty of waiting, time away from work, recovery planning and the support she’ll need at home.
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Listen to this episode
Links:
Learn more about the CHEK2 genetic mutation and breast cancer risk in Australia
Patient information from eviQ about what a CHEK2 genetic variant may meanfor individuals and families.Listen to breast reconstruction options when DIEP flap reconstruction isn’t available
Reconstructive plastic surgeon A/Prof Bish Soliman explains alternative autologous own-tissue flap options, including PAP flap reconstruction.Follow Elle on Instagram
Connect with Luan:
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If you’ve found any of the content upsetting, please reach out and get help. Breast Cancer Network Australia has a free confidential helpline – 1800 500 258. Beyond Blue has a range of free resources online, or you can call them 24/7 on 1300 224 636.
