RE: I'm new-thanks

[Guest guest]

Thank you so much for your message. I have been seeing pain management doctors for the past 2 yrs. and have been on dozens of meds. They help enough to get me to all the other doctors appts. I go to but the pain is always there.

I've been up since 4AM because my pain is worse when I'm lying down. It's so strange to be so tired but not be able to sleep because of the pain. I've been given sleeping pills but can't take them because I have a baby. I'm having an epidural shot today and hope for some relief.

Yes, I am seeing Dr. Hiatt in Phoenix who also was Patty's doctor. The reason that I want to go there is because my in-laws live in Phoenix and can help with the baby while I'm recovering. I would love to have a woman doctor. My parents are deseased and I'm an only child so I don't have much of a support system.

I'm trying not to get my hopes up but I hope that the surgery will help me-I'm so glad that you are feeling better! Thanks for caring, Daryl

[Guest guest]

I don't know if a "lift" and a "mastopexy" are the same thing,

but my daughter had a "mastopexy", anchor style, in 1993 and

one can't see any scars. I can't remember whether she had

drains. . .I don't think so--of course, she didn't have infection either (her joints were turning red and stiff and she had silicone-

filled implants.)

Knowing all I do now, I would insist upon an oral antibiotic

started a day before surgery, drains afterward and in

addition to the path report on the capsule, a lab report

on tissue or fluid from the area. It takes the lab at least

24 hours (usually much longer) to render a bacterial

growth report and of course, the surgery is overwith

by then and it's too late for drains.

I haven't heard of Hiatt -- Shaw

at UCLA has been at this explantation and reconstruction

for years--he and Dr. Feng started at the same time. . he

handled the West Coast and she handled the East Coast--they

both do microvascular work and considerable breast reconstruction.

The doctor who did my daughter's surgery was on his staff

but is now at Cedars of Sinai in LA--he too does great work and

explants--his name is Kendrick Slate.

I've heard of a Dr. Gordon in Nevada--rumors are that there

is a reputation that precedes him, but on the other hand

there are some women who have had excellent results

from him. There's a guy here in my city who also came from

another state for reportedly the same reasons--some people have excellent results from him and some do not. Sometimes we forget--just because a doctor has a reputation

for being good with implants, doesn't mean he does a good

explant and lift/mastopexy. . .it's a procedure in and of itself.

Any of them can remove implants.

Dr. Huang in Denver comes with a good recommendation.

Then in Houston I've heard only good things about Dr. Melmed,

and I think Fabian Worthing is in Houston also--he will video

if there is to be a lawsuit. (I'd ask anyone to do this in these

circumstances)

If there is a lawsuit, a video and a thermogram before explant

are excellent tools to have. And do not ever have the

implants in your possession--they should go directly from

the hospital facility to a pathologist such as Blais--this

can be arranged by a request in writing. (I'd put everything

you request in writing--drains, antibiotics, path reports, etc.--

some docs forget a few things on surgery days.)

It's hard to remember all these details when you are in pain,

but you will regret not doing them later. . .maybe your husband

could see to them ???

My guess is that you do not have an infection, but that a pregnancy

and birth along with the existing stress of implants was more than your

immune system could handle. . .now the system wants to rebound and

can't because the implants are still occupying some of it's time/strength

How sorry I am that this interefered with your very early

motherhood--however, there are wonderful years ahead (actually

better ones) with your son and you will be able to enjoy them after

you get this ordeal behind you.

Bonnie

[Guest guest]

Thank you--wasn't sure . You know, scars, if done well, still

depend on ones' skin as to whether they are going to show or

not. Surprisingly, dark-skinned people seem to have more

problems with scarring than light skinned.

I was talking to -Marie about different procedures and

it seems the anchor is sort of outdated. . .guess my daughter

was lucky to get the surgeon she did. . .and also lucky re

her scars as her skin is thin and fragile. . .the incision scars

aren't visible, but she has stretch marks on breasts and hips ???

I also wonder if age has something to do with all of this--as we age

we not only collect more "toxins" that try to get out through the

skin, but we get more from the outside that affects our skin; daughter

was only 24 when she had to have this procedure.

My skin has continued to reveal all manner of things even since

the rest of me feels ok now--in fact, silicone oil (or whatever) is still escaping at both ends of spine--it leaves scars and it dries out

the area around it. I can track it's path by the numbness of my skin

(which of course is the deepest in the breast area)

Bonnie

[Guest guest]

Patty--I don't know how big your breasts are now, or if they

are on the bottom part of the breast or under it, but scars

can be cut out--and if I'm not mistaken, could fall under the

category of a previous surgical error, as far as the insurance

company is concerned. If nothing else, one can wait a few

years until there is some extra skin from aging, to make up

for that which is removed.

Bonnie

[Guest guest]

Daryl

First of all I can relate to your issues completely. Let me tell you a couple of things that I think are really important, have you talked to Dr Hyatt about drains? I am concerned for you because Dr Hyatt didn't use drains on Patty and his lift method was an anchor, that is very old fashioned, is that what he is going to do? Did you discuss with him that you want to have your implants analyzed? By Dr Blais? I really think you need to do this considering how ill you are. I just worry about women going to the wrong Dr because of logistics. I know it is hard to think of the travel, but in reality, Ohio is not that far, can't someone go with you? In laws, husband? Anyone? The support you would get from the people at Dr Fengs office is so overwhelmingly wonderful, and the pain issue is such a BIG ISSUE, you don't want to look back and be sorry especially when you find that you do get well and have scars that are less than satisfying. Also remember, he needs to use drains! You don't want that fluid stuck in there, it is full of infectious crap who knows what that can do to you.

I don't mean to harp, but really seriously, if you can try to find a way to get to Ohio please really really think about it. I know it seems difficult, I was so ill when I went there, but it all worked out best for me, and my results were wonderful, I don't have ugly anchor scars. If all he will do is an anchor lift, you may want to forget the lift period and do it another time when you are well. Trust me having anchor lift scars will not make you feel better about things. Ask Marie on here about her anchor lift, she has been trying to fix it for years now, you don't want to go through that. Not when there are experts that can do supreme jobs. If there is absolutely no way you can go to Ohio, then I would highly recomend that you discuss with Dr Hyatt his suturing methods, his lift technique, and his explant method as well as what he will do with the capsule, implants, and if he would be willing to use drains on you so you can avoid having that fluid in your body. I know it seems like allot to deal with, but later on Daryl you will be wishing you had done this if you don't now.

I am only trying to help and I hope you don't feel that I am being too pushyl. I just have been there too, and have improved so much that i know you can too, and then you will care about what your breasts look like after all is said and done.

Like I said if your only option is Dr Hyatt, if he cannot do a vertical mastopexy, I would pass on the lift, it is not worth it to have all those uneccesary scars. Any good PS will tell you that.

Other options would be closer such as Denver and Dr Huang, or maybe Texas and Dr Mehlmed, I believe in Dallas you could probably stay with some one that Martha knows, or Martha herself, and he is an awesome PS, the only one that I would trust that is in fact a man!

Try to think about this girl. And remember there is hope. Trust me been there!

----- Original Message -----

From: Daryl

Sent: Thursday, October 03, 2002 10:28 AM

Subject: Re: I'm new-thanks

Thank you so much for your message. I have been seeing pain management doctors for the past 2 yrs. and have been on dozens of meds. They help enough to get me to all the other doctors appts. I go to but the pain is always there.

I've been up since 4AM because my pain is worse when I'm lying down. It's so strange to be so tired but not be able to sleep because of the pain. I've been given sleeping pills but can't take them because I have a baby. I'm having an epidural shot today and hope for some relief.

Yes, I am seeing Dr. Hiatt in Phoenix who also was Patty's doctor. The reason that I want to go there is because my in-laws live in Phoenix and can help with the baby while I'm recovering. I would love to have a woman doctor. My parents are deseased and I'm an only child so I don't have much of a support system.

I'm trying not to get my hopes up but I hope that the surgery will help me-I'm so glad that you are feeling better! Thanks for caring, Daryl

[Guest guest]

Bonnie

Lift and mastopexy are the same thing. An anchor scar if you have big breasts or implants, probably wouldn't be as bad as it is on small explanted breasts. THe biggest problem with it as -Marie and Patty will tell you is that the crease scars don't hide very well in the crease esp with small breasts. THey also don't seem to fade as well as the vertical ones. THe whole thing is simple, the less scars the better, and the vertical lifts are leaving off the crease scars so they really are superior. Dr Kolb apparently is very good at the lifts where no vertical or crease scar is needed and this would be a good option for some women as well.

My concern about Dr Hyatt is that Patty herself is not that thrilled with her scars so I wish Daryl will think hard about this.

Hugs

C

----- Original Message -----

From: Bos@...

Sent: Friday, October 04, 2002 9:06 AM

Subject: Re: I'm new-thanks

I don't know if a "lift" and a "mastopexy" are the same thing, but my daughter had a "mastopexy", anchor style, in 1993 and one can't see any scars. I can't remember whether she had drains. . .I don't think so--of course, she didn't have infection either (her joints were turning red and stiff and she had silicone- filled implants.) Knowing all I do now, I would insist upon an oral antibiotic started a day before surgery, drains afterward and in addition to the path report on the capsule, a lab report on tissue or fluid from the area. It takes the lab at least 24 hours (usually much longer) to render a bacterial growth report and of course, the surgery is overwith by then and it's too late for drains. I haven't heard of Hiatt -- Shaw at UCLA has been at this explantation and reconstruction for years--he and Dr. Feng started at the same time. . he handled the West Coast and she handled the East Coast--they both do microvascular work and considerable breast reconstruction. The doctor who did my daughter's surgery was on his staff but is now at Cedars of Sinai in LA--he too does great work and explants--his name is Kendrick Slate. I've heard of a Dr. Gordon in Nevada--rumors are that there is a reputation that precedes him, but on the other hand there are some women who have had excellent results from him. There's a guy here in my city who also came from another state for reportedly the same reasons--some people have excellent results from him and some do not. Sometimes we forget--just because a doctor has a reputation for being good with implants, doesn't mean he does a good explant and lift/mastopexy. . .it's a procedure in and of itself. Any of them can remove implants. Dr. Huang in Denver comes with a good recommendation. Then in Houston I've heard only good things about Dr. Melmed, and I think Fabian Worthing is in Houston also--he will video if there is to be a lawsuit. (I'd ask anyone to do this in these circumstances) If there is a lawsuit, a video and a thermogram before explant are excellent tools to have. And do not ever have the implants in your possession--they should go directly from the hospital facility to a pathologist such as Blais--this can be arranged by a request in writing. (I'd put everything you request in writing--drains, antibiotics, path reports, etc.-- some docs forget a few things on surgery days.) It's hard to remember all these details when you are in pain, but you will regret not doing them later. . .maybe your husband could see to them ??? My guess is that you do not have an infection, but that a pregnancy and birth along with the existing stress of implants was more than your immune system could handle. . .now the system wants to rebound and can't because the implants are still occupying some of it's time/strength How sorry I am that this interefered with your very early motherhood--however, there are wonderful years ahead (actually better ones) with your son and you will be able to enjoy them after you get this ordeal behind you. Bonnie

[Guest guest]

Of course it all depends on insurance and how the

doc words it, but this is a "repair" and if I remember

correctly, wasn't the explant covered?

Just any plastic surgeon wouldn't do--there are

some who "specialize" in repairing others errors.

Bonnie

[Guest guest]

My scars are strange...the ones around the nipple and vertically are almost gone. You can hardly see them. But the ones in the crease are the worst--they are thick and shiny--not so much red anymore as they were but they are definitely noticeable. There is also a small dent on the end of my left scar, so that the skin doesn't lay exactly right when I lift my arms. I wish SO MUCH that I had had a vertical mastopexy, as I would look near perfect now if I had. At the time that I made the decision to get explanted, I don't think there was much talk about the vertical lift. All I knew was that it had to be done en bloc with a total capsulectomy.

I felt lucky to have Dr. Hiatt close to me and on my insurance--he got the explant covered, which was no small feat! At the time, I felt it was a total blessing, because my situation was not the best! We were just on the verge of going into business, with no income in those initial months. It was precarious. But with hindsight now, I wish I would have had the freedom to find the best doctor who could do the best surgery with the most up to date techniques. I would not have these ugly scars now.

So, my advice to anyone getting explanted--make sure you know how skilled your surgeon is, and don't settle for less than the best if you are in a position to choose! You will have to live with the scars for the rest of your life.

Patty

----- Original Message -----

From: Bos@...

Sent: Friday, October 04, 2002 8:35 AM

Subject: Re: I'm new-thanks

Thank you--wasn't sure . You know, scars, if done well, still depend on ones' skin as to whether they are going to show or not. Surprisingly, dark-skinned people seem to have more problems with scarring than light skinned. I was talking to -Marie about different procedures and it seems the anchor is sort of outdated. . .guess my daughter was lucky to get the surgeon she did. . .and also lucky re her scars as her skin is thin and fragile. . .the incision scars aren't visible, but she has stretch marks on breasts and hips ??? I also wonder if age has something to do with all of this--as we age we not only collect more "toxins" that try to get out through the skin, but we get more from the outside that affects our skin; daughter was only 24 when she had to have this procedure. My skin has continued to reveal all manner of things even since the rest of me feels ok now--in fact, silicone oil (or whatever) is still escaping at both ends of spine--it leaves scars and it dries out the area around it. I can track it's path by the numbness of my skin (which of course is the deepest in the breast area) Bonnie

[Guest guest]

I am so tempted.....

but I steer way clear of plastic surgeons offices these days! Maybe someday when we are rich and don't know how to spend a few thousand dollars, I may look into it, but I think my husband would roll his eyes if I ever approached him with the idea.

Now, if insurance would cover it, well, that would be another story. That would be really nice. I can't even imagine them entertaining the idea though, especially when I know there are other women out there desperate to just get their implants out and can't get covered. Hmmm... Martha, are you still with us? What say you on this idea?

Patty

---- Original Message -----

From: Bos@...

Sent: Friday, October 04, 2002 10:14 AM

Subject: Re: I'm new-thanks

Patty--I don't know how big your breasts are now, or if they are on the bottom part of the breast or under it, but scars can be cut out--and if I'm not mistaken, could fall under the category of a previous surgical error, as far as the insurance company is concerned. If nothing else, one can wait a few years until there is some extra skin from aging, to make up for that which is removed. Bonnie

[Guest guest]

Yes, luckily, Hiatt got my explant covered.

I'd probably just go to Feng and be done with it. Who do you know that specializes in repairs of others goofs, Bonnie?

----- Original Message -----

From: Bos@...

Sent: Friday, October 04, 2002 12:30 PM

Subject: Re: I'm new-thanks

Of course it all depends on insurance and how the doc words it, but this is a "repair" and if I remember correctly, wasn't the explant covered? Just any plastic surgeon wouldn't do--there are some who "specialize" in repairing others errors. Bonnie

[Guest guest]

:

You're so right. As it's very important to be explanted, get it done by a PS who can do it with aesthetically pleasing result. I went to an old -- school -- looser -- of-- a-- PS and I'm paying the price--literally as well as emotionally.

-Marie

[Guest guest]

Lift and mastopexy are the same.

[Guest guest]

Patty:

Hi. Scar revisions can be done--I'm living proof.

Take care,

-Marie

[Guest guest]

Patty:

My PS specializes in fixing botched patients.

I'll e-mail you.

LM

[Guest guest]

An "aesthetically pleasing result" is so relative

--the variables are mindboggling and venture into the

realm of psychology.

Looks seem to come first for many, and for others, even when

health issues are at the forefront re explantation, looks often

replace them in time or if health is regained. This makes perfect

sense to me--looks are the reason one got the implants to begin

with. A minority seem to have made changes in their perceptions

during the implanted period and health wins out--age probably plays a part in some of these women--experiencing these kinds

of illnesses for years can be a real eye-opener for many also. (Amazing to me are those who are not ill, but explant as they

don't wish to take the risk--I have to assume they know an

ill person and can see what happens to their lives)

It is only natural (I think) to want to look the best one can, but

when relying on others to do this/to read one's mind is

unrealistic. It is also unrealistic to think one can discern

the type of plastic surgeon who will give her the results

she expects--she does the best she can with what she's got

to work with--same as the plastic surgeon.

Bonnie

[Guest guest]

Dr. Kolb:

I'm going to sound real stupid here, but there just may be others

who want to know also--is a mastopexy and a lift the same thing?

My thought at present is that a lift is usually done by request after explant

but a mastopexy is done either by itself or after explant if the situation

deems it necessary. ???

I can only relate to my daughter's mastopexy when she went from silicone to saline implants in 1993. She went smaller, her surgery took five to six hours, there were two surgeons, there was a lot of presurgical

chin-to-nipple measuring and photography, it was done in an anchor fashion and the result was beautiful--it took approximately a year for

the scars to fade.

Bonnie

[Guest guest]

There are significant challenges technically with explants especially if there is little breast tissue. We have the same tools and skill sets from our training that we are exposed to. I prefer to look at each case individually and use whatever technique will accomplish the goals for the aesthetic result we want. It confuses me that surgeons only use one technique and state that others are not necessary as I know this is not true if one is to mold the very different skin envelopes into the aestheically pleasing result. But it is equally if not more important to address the immune and infection problems these patients have if one is to not have excessive scarring and infections with possible tissue loss due to complications that could have been prevented. If your surgeon is not willing to treat the complications, you may not only have a prolonged recovery from surgery but also problems from scarring due to infection, retained capsules, pneumothorax, and inadequate matopexy as it did not fit into the surgeon's idea of how to do a mastopexy. I have treated all of these complications from other surgeons and I feel that with a proper pre and postop program they mostly could have been prevented. .

-----Original Message-----From: Bos@... [mailto:Bos@...]Sent: Saturday, October 05, 2002 5:10 PM Subject: Re: I'm new-thanks An "aesthetically pleasing result" is so relative --the variables are mindboggling and venture into the realm of psychology. Looks seem to come first for many, and for others, even when health issues are at the forefront re explantation, looks often replace them in time or if health is regained. This makes perfect sense to me--looks are the reason one got the implants to begin with. A minority seem to have made changes in their perceptions during the implanted period and health wins out--age probably plays a part in some of these women--experiencing these kinds of illnesses for years can be a real eye-opener for many also. (Amazing to me are those who are not ill, but explant as they don't wish to take the risk--I have to assume they know an ill person and can see what happens to their lives) It is only natural (I think) to want to look the best one can, but when relying on others to do this/to read one's mind is unrealistic. It is also unrealistic to think one can discern the type of plastic surgeon who will give her the results she expects--she does the best she can with what she's got to work with--same as the plastic surgeon. Bonnie

[Guest guest]

Dear Bonnie: Mastopexy and lift are the same thing in the breast. Lift, of course, is a generic term which can refer to many parts of the body. .

-----Original Message-----From: Bos@... [mailto:Bos@...]Sent: Saturday, October 05, 2002 9:06 PM Subject: Re: I'm new-thanks Dr. Kolb: I'm going to sound real stupid here, but there just may be others who want to know also--is a mastopexy and a lift the same thing? My thought at present is that a lift is usually done by request after explant but a mastopexy is done either by itself or after explant if the situation deems it necessary. ??? I can only relate to my daughter's mastopexy when she went from silicone to saline implants in 1993. She went smaller, her surgery took five to six hours, there were two surgeons, there was a lot of presurgical chin-to-nipple measuring and photography, it was done in an anchor fashion and the result was beautiful--it took approximately a year for the scars to fade. Bonnie

[Guest guest]

:

Aesthetically pleasing results is not all that subjective when you consider some PS use outdated methods that leave patients with more scarring than necessary and/or use poor suturing techniques that leave railroad track marks. It's not hard to figure out. While mastopexy does not leave a perfect looking breast and there are visible scars, it's not hard to figure out if one looks *botched* and if another looks like a normal mastopexy (taking into consideration what the patient looked like pre-op of course). As you had mentioned to me, there are low rated PS's (like my implanting surgeon), the medium (average) PS, then there are the TOP of the line PS--it's a difference in *style*. Tops use the best techniques.

I wish I had been more educated on PS's in 1998 and I wouldn't have suffered these unfortunate consequences.

LM

[Guest guest]

But it's hard for the average person to know the difference--until

after the surgery. And there are those who are perfectly content

with a result that someone would find unacceptable. . .it's all

in priorities. .

[Guest guest]

I think it may not be a matter of external or internal stiches--

HOW it is stitched can make a difference. Example, when

I was only 22 I had a mole removed from my face and the

surgeon put eleven external stiches in a tiny little space--I can't even

find a scar or the area itself, although I know it has to be there.

He said the more stitches, the fainter the scar.

My ex had an auto accident whereby his neck was ugly with

scars from a barbed-wire fence; when these were removed it

was restitched with over two hundred external stitches and one can barely see the lines (same doctor)

In addition, I would think one's particular skin and pigment

color has something to do with scarring. For instance, I'm

told that darker skinned people show scarring more than lighter skinned people.

Bonnie

I'm still confused re the anchor vs. vertical scarring--

is there not a scar from the nipple down to the bottom

of the breast and then across the bottom in both cases?

Bonnie

[Guest guest]

I have just review the July 2002 Clinics in Plastic Surgery which is on Reduced scar mastopexy and Reduction. The article in this states that inverted T (or anchor) is needed when the sternal to nipple distance is greater than 27 to 30 cm, The verticle limb is indicated when this is greater than 24 and otherwise a periareolar incision is used. So anchor procedures can hardly be considered outdated. As I stated earlier, each patient is an individual and the art of plastic surgery is to match the procedure with the patient. Many excellent plastic surgeons use external sutures so this statement is also incorrect. .

-----Original Message-----From: perlesetlacet@... [mailto:perlesetlacet@...]Sent: Sunday, October 06, 2002 4:28 PM Subject: Re: I'm new-thanks :Aesthetically pleasing results is not all that subjective when you consider some PS use outdated methods that leave patients with more scarring than necessary and/or use poor suturing techniques that leave railroad track marks. It's not hard to figure out. While mastopexy does not leave a perfect looking breast and there are visible scars, it's not hard to figure out if one looks *botched* and if another looks like a normal mastopexy (taking into consideration what the patient looked like pre-op of course). As you had mentioned to me, there are low rated PS's (like my implanting surgeon), the medium (average) PS, then there are the TOP of the line PS--it's a difference in *style*. Tops use the best techniques.I wish I had been more educated on PS's in 1998 and I wouldn't have suffered these unfortunate consequences.LM

[Guest guest]

The most common cause of scar widening is not the type of procedure but is the suture used. For the best results, most of us use a long lasting absorbable suture. Check your op note for the type of suture used. Vicyrl and Dexan cause wide scars in many people. .

-----Original Message-----From: perlesetlacet@... [mailto:perlesetlacet@...]Sent: Sunday, October 06, 2002 4:28 PM Subject: Re: I'm new-thanks :Aesthetically pleasing results is not all that subjective when you consider some PS use outdated methods that leave patients with more scarring than necessary and/or use poor suturing techniques that leave railroad track marks. It's not hard to figure out. While mastopexy does not leave a perfect looking breast and there are visible scars, it's not hard to figure out if one looks *botched* and if another looks like a normal mastopexy (taking into consideration what the patient looked like pre-op of course). As you had mentioned to me, there are low rated PS's (like my implanting surgeon), the medium (average) PS, then there are the TOP of the line PS--it's a difference in *style*. Tops use the best techniques.I wish I had been more educated on PS's in 1998 and I wouldn't have suffered these unfortunate consequences.LM

[Guest guest]

:

Hi. Ditto.

Hugs,

-Marie

[Guest guest]

:

Hi! You're right. I had my appendix taken out and my scar is pretty skinny and both *innies* and *outties* were used (outties came out three days later). That doc who did my belly and your neck were evidently good docs. Thing is, we don't always know how we will scar, so why not play it safe the way my doc and Feng does it. I think that's the point here--my point anyway

I just remember what my PS has recently told me--external stitches ON THE BREAST he does not use and anchor mastopexies are outdated. Yes, they're still used, but if a vertical works, go for the best.

Hugs,

-Marie