On July 22, I met with Dr. Lee, a plastic surgeon at the Queensway Carleton Hospital. This was to be a routine appointment with the surgeon who would assist Dr. Zhang of The Ottawa Hospital in doing my major breast reconstruction surgery. It turned into a discussion of risks, implications and options—all of which have brought me to a new date and a new surgery.

As a reminder, in February, I met with Dr. Zhang to finalize my decision for breast reconstruction following an infection that developed after my bilateral mastectomy in July 2023. I had opted for the bilateral mastectomy to reduce my risk of breast cancer from 50-85% to 5-8% because I carry a BRCA2 gene mutation. In February, Dr. Zhang and I agreed on the reconstruction of two small breasts using tissue from my abdomen. A month ago, I received a surgery date and location: August 20 at the Queensway Carleton Hospital.

However, when I met Dr. Lee on July 22, she noted my prior abdominal surgery for ovarian cancer and the potential risks to my abdomen (bulging, hernia) of additional abdominal surgery. More importantly, she noted that the pelvic radiation I received for my perianal skin cancer may have weakened the blood vessels in my abdomen, increasing the risk of failure of the transplanted tissue. (Subsequent to our meeting, she spoke with my radiation oncologist, Dr. Jin, as well as with Dr. Zhang.)

In our meeting, Dr. Lee offered a new reconstruction option: starting over with two new implants. She proposed this course of action: in a first surgery, remove my one existing breast implant and insert two new expandable implants under my chest muscle; over the subsequent months, gradually gradually inflate the expandable implants until an appropriate size is reached; in a second surgery six to nine months later, replace the temporary implants with more permanent ones.

Though there are risks and potential downsides to any option I might choose, the advantage of following Dr. Lee's recommendation is that it would leave my abdomen untouched, thus avoiding the risk of transplant failure and new abdominal problems. I have decided to follow Dr. Lee's recommendation.

I elected to hold off sharing news of the new surgery until I knew when it would take place. Today, I received my new surgery date: September 12.

I've had many health decisions to make over the past four years. In every case, I made the best choice I could based on the information I had at the time. The same is true this time. Onward.