PAP Reconstruction -Have you had; how did it go?

Hi Mel,

We're sure you'll be having some advice coming in soon from others.

In the meantime, you may want to check out the main Breastcancer.org site's pages on PAP Flap Reconstruction, including tips on what to expect and risks related to this type of reconstruction.

We hope this helps!

--The Mods

Hi Mel, I was a solid C cup before, and I'm probably a touch smaller now, but I can still wear all of my old bras, and I think I actually fill them out better because my original breasts had started to sag, and my new breasts are much more "perky". Does that make sense?By the way, I also purchased a device so you can stand up and pee -- like a guy (LOL!). I used it in the hospital mostly. Here's a link to the one I purchased on Amazon, but there are many on the market, and I'm sure you will find one you like ...

Bestpriceam® Potable Female Traval Outdoor Soft Siliconeurination Device Stand up & Pee

I actually bought a couple different varieties of these, as they are very cheap, but I liked this one the best because of the shape, and it was soft, which you will find to be very important. As far as how my legs look.... I would say better than before because I no longer have cellulite in the back (I am thin, but still had plenty of cellulite!), and my thighs have a better contour. My scars are beneath my panty line, and they are still visible, but they are fading with time. If you want to see a good example of what your legs might look like, check out my doctor's website...www.diepflap.com, and look under the "News" topic, and read the story "Libby Haan is Alive" reprinted from Harper's Bazaar. She has some great photos of herself in a bathing suit. I think my leg scars are actually quite a bit lighter than hers, but it's a good depiction of where the scars are. I wore board shorts to swim in last summer because I didn't want to expose the scars to sun (not good for healing), and I bought a little skirted bikini for this coming season. I still like to keep the scars covered because I'm self conscious, but I'm sure they will fade by the time summer rolls around. I haven't worn a bikini or a two piece in 20 years, but now with younger looking breasts and tighter legs, I feel good!

By the way, I sat in a chair at the hospital -- it was uncomfortable, but as soon as I got out of the hospital, I was able to sit at the table to eat for about 20 minutes at a time. I think I was driving within 3 or 3.5 weeks after my surgery. I spent a good part of my time in a recliner, but I made sure to get up and walk every hour or two. I kept a record of my walking, and I just noticed that 8 days after my surgery, I walked 1.6 miles, and within a month, I was up to 3 miles, and 4 miles at 1.5 months. I think I might have progressed even faster, but I had a terrible cold, ear infection and fever just after I got home.

I don't mean to soft soak this process -- I definitely had some difficult times, but it was tolerable, and much less painful than I had anticipated. In fact about a year before this surgery, I had surgery to repair my shoulder, and that was much more painful!!!

By the way, did you see my two private messages?

I am having bilateral mastectomy in Jan '17 and am trying to decide on reconstruction plan. I have heard so many negatives and disappointing results with implants, I am considering PAP reconstruction . However, nobody in my area provides that and it seems to be difficult to find. I am small frame but have excess fat in my thigh area. I have been flat chested forever, so breast size is not much of a concern for me. Does anyone have any advice in searching for or choosing this procedure? I am having the mastectomy surgery in Houston but have not found a provider of the PAP in the particular hospital I am using. Wonder if there is a way to do the mastectomy in Jan, and then follow later with the PAP in another area where I can locate a provider?

I know this conversation has been quiet for a while, but wanted to share that despite Regatta's regrettably bad experience, I am scheduled to have the PAP flap this July. I'm praying that this will be the right surgery for me as my options for muscle sparing reconstruction are very limited with my body type and radiation damage. If anyone's interested I'll keep you posted. I'd also welcome hearing Pap or Gap, (since the donor site is similar minus the muscle,) experiences.

Hello Mel! Thank you SO much for your thoughtful response. Candygold was enormously helpful to me too. (Thank you Candy! I hope all is well.)I live in NY and will be using Dr. Peter Korn. They take my insurance. He is with the Israeli and Feingold practice. They all have a great reputation but Korn mentioned Pap in his bio. He will be doing the fleur de lis style so there will be a scar down my inner thigh. I had the option of only doing the lateral incision but I preferred not to have the scar as far across the butt as it leaves a noticeable dent. It's a trade-off of course. It's not like I love a scar down the leg, but I think it will be better for my shape. More 'thigh gap' lol! How was yours done? How have your scars healed? Any complications? How long before you were driving? Did they use a wound vac? (My doc does in the hospital to keep even pressue on the closed donor site incisions.) How long before you could exercise? Is your ROM the same as before? And dare I ask: sex? Of course only answer what you are comfortable addressing. Thank you, thank you, thank you!!!

Thank you SOOO MUCH for all your advice. The surgery is July 17th. I think the thigh scar will be approx. 6-7 inches. The Athleta swim shorts wouldn't cover that. But hopefully, eventually the scar will fade enough not to be too noticeable. Fyi, I'm a Long Island 516 number for when you see it on your phone. In the meanwhile thank you very, very much for helping me to prepare.

I've been sort of wondering if I'd almost want TUG for vanity thigh size reasons...I know, I know, not the most important thing, but looking for upsides here. I'll be sure to keep inquiring about scar placement/options on the thighs. Thank you both for sharing. It's insanely helpful.

I know it's been over a year since the last post on this topic, but unlike the DIEP, there are not continual threads about the PAP. Any PAPsters out there who care to offer experiences, tips, support? I had a stacked DIEP in February 2018, and now a stacked PAP for the other breast just two days ago. Peeing standing up is a must, the rest of my time I'm either in a reclining position to distribute my weight off my thighs or standing up walking around like a penguin. Bracing myself for my first BM, when I will have no choice but to sit on a toilet. Love the two drains well positioned on back of my thighs. Any advice to make toileting easier? Planning to take my first shower tomorrow. Unlike with the DIEP, will probably do that standing up. I've been going commando so far since being discharged yesterday....worried about panties rubbing against incisions, which start in my crotch lines and extend down vertically towards the back of my thighs. Speaking of thigh incisions, they look very ripply and puckery, hopefully will be smoothing over time. All in all, it seems I'm recovering quicker with PAP than with DIEP. It was harder to get comfortable and move around in the early days after DIEP. Surprised to be moving about so well 2 days after PAP flap surgery.

CallieGirl:

I hope your surgery went well. I don't know that I have any other advice on PAP recovery other than what has already been posted, but I am a few weeks ahead of you since I had the PAP on 8/6/18. I have also had the DIEP before for my other breast. If you want to talk live and compare notes or ask questions, PM me, and I will give you my phone number. I will tell you that it was quite liberating to finally get the last drain pulled, which was a thigh drain, and the ones that I found to be the most cumbersome and in-the-way of daily life. For me, this occurred last Thursday. After that, recovery just seemed to flow more smoothly. Good luck with your recovery!