RE: I'm new-thanks

[Guest guest]

From what I understand from my current PS, sutures used on the breasts themselves is a different ball of wax from suturing techniques done elsewhere on the body. What's good for the head/scalp for example may not be good on the breasts. I have faith in what he has told me.

LM

[Guest guest]

Dr Kolb

Not to argue here but there are allot of PS that use an anchor lift when it is NOT needed and those are what we are warning about here. Patty did not need an anchor lift, neither did I. I got great results with the vertical lift, so why would anyone want the extra scaring? Also it is simply not true that external stitches work as well as internal ones, I know from personal experience and the internal ones that Feng used were far superior to those ugly external ones that my implanting surgeon used.

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

From: Dr. Kolb

Sent: Sunday, October 06, 2002 4:25 PM

Subject: RE: I'm new-thanks

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 So anchor procedures can hardly be considered outdated.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PM Subject: Re: I'm new-thanks :Aesthetically pleasing results is not all that subjective when you consider some PS use outdated methods that leave patients with more scarring than necessary and/or use poor suturing techniques that leave railroad track marks.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]

Bonnie, You're right in that it really is not a matter of internal dissolvable sutures vs external sutures that makes a scar good or bad. It comes down to technique and expertise, as well as type of suture used. I will say again, that internal dissolvable sutures will almost always have a better aesthetic result than external scars; however, if you get a surgeon who is meticulous in his/her technique, one can have all external sutures and have very faint scars, which fade over time to become barely visible. Since I cannot have dissolvable sutures, (as I found out with my heart surgery), my neurosurgeon was the first surgeon after that debacle to have to find a suture I wasn't allergic to and which would not produce a horrible or even large scar. He is a meticulous surgeon anyway, since he often deals with facial trauma and brain trauma, and has to cut the face and scalp. He used 2-0 PDS running subcuticular sutures on my neck, and my scar is barely visible. And working in a trauma hospital, I have seen multiple traumas come in and their face has essentially been reduced to mush. A ps operates, uses hundreds of sutures, and that persons face is just like new. And on the other hand, I've seen other ps' whose technique sucks and I'm suprised they even have a clientele! So, suturing technique is probably the most important factor in how a scar will turn out. Sure, it's always better to have dissolvable sutures, but if the surgery is too big, or the pt is allergic, or there's another reason they can't be used, external sutures can be used, and a very good, acceptable aesthetic result can be obtained. I am living proof. I also had foot surgery done for a neuroma. This was an orthopedic surgeon, so I figured I'd be butchered, but this man was so meticulous in his suture technique, that you can't even see the scars now, and in fact, I have to actually pull the skin taut to see the scars, otherwise they are invisible. And there are just some areas and surgeries where you can't use dissolvable sutures or subcuticular sutures. e ----- Original Message ----- From: Bos@... Sent: Sunday, October 06, 2002 6:47 PM Subject: Re: I'm new-thanks 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]

Actually, I made a mistake. My neck incision(s) were not closed with running 2-0 PDS sutures. He used running subcuticular 4-0 monofilament nylon sutures. e ----- Original Message ----- From: Bos@... Sent: Sunday, October 06, 2002 6:47 PM Subject: Re: I'm new-thanks 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]

How many explants and mastopexies has he done? Feng and I use the same type of sutures and suturing techniques. .

-----Original Message-----From: perlesetlacet@... [mailto:perlesetlacet@...]Sent: Sunday, October 06, 2002 11:36 PM Subject: Re: I'm new-thanks From what I understand from my current PS, sutures used on the breasts themselves is a different ball of wax from suturing techniques done elsewhere on the body. What's good for the head/scalp for example may not be good on the breasts. I have faith in what he has told me.LM

[Guest guest]

I'm lost again--where does this 3rd scar fit in? Again,

I'm just going by my daughter's anchor mastopexy--her

incision went around the areola, vertically down and about a 1-1/2 ro 2 inch area horizontally under the breast. . .???

I would think that the amount of skin to be removed

would decide the width of the bottom of the

anchor and therefore horizontal incision, but maybe

I have this wrong in my mind. . .i,e. the more to be

removed the longer the horizontal incision. I can't

feature a need for an anchor if there isn't a lot of extra skin,

but in her case, there was--she had very, thin stretchy

skin and of course she cannot be the only one with

this type of skin. There was a time a plastic surgeon

would assess the skin and advise the patient of the potential things that may be encountered as a result of it. . .

Bonnie

Bonnie

Bonnie

[Guest guest]

Feng and I use the exact same internal sutures but sometimes I use some fine external nylons as well. You cannot state that one should never use external sutures. This is misinformation. .

-----Original Message-----From: Heer [mailto:idagirl@...]Sent: Sunday, October 06, 2002 8:45 PM Subject: Re: I'm new-thanks

Dr Kolb

Not to argue here but there are allot of PS that use an anchor lift when it is NOT needed and those are what we are warning about here. Patty did not need an anchor lift, neither did I. I got great results with the vertical lift, so why would anyone want the extra scaring? Also it is simply not true that external stitches work as well as internal ones, I know from personal experience and the internal ones that Feng used were far superior to those ugly external ones that my implanting surgeon used.

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

From: Dr. Kolb

Sent: Sunday, October 06, 2002 4:25 PM

Subject: RE: I'm new-thanks

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]

Most plastic surgeons use internal dissovable and external permanent or paper tape if needed on the breast. Some older plastic surgeons use permanent subcuticular (pull-out) if the patient has reaction to Vicryl or Dexon. Most of the longer lasting dissovable sutures are not going to result in allergic reactions. The worst scars I have are in protein deprived ie bullemic or alcoholic patients so patient factors are often important. .

-----Original Message-----From: e Rene [mailto:e_Rene@...]Sent: Monday, October 07, 2002 12:41 AM Subject: Re: I'm new-thanks

Bonnie,

You're right in that it really is not a matter of internal dissolvable sutures vs external sutures that makes a scar good or bad. It comes down to technique and expertise, as well as type of suture used. I will say again, that internal dissolvable sutures will almost always have a better aesthetic result than external scars; however, if you get a surgeon who is meticulous in his/her technique, one can have all external sutures and have very faint scars, which fade over time to become barely visible. Since I cannot have dissolvable sutures, (as I found out with my heart surgery), my neurosurgeon was the first surgeon after that debacle to have to find a suture I wasn't allergic to and which would not produce a horrible or even large scar. He is a meticulous surgeon anyway, since he often deals with facial trauma and brain trauma, and has to cut the face and scalp. He used 2-0 PDS running subcuticular sutures on my neck, and my scar is barely visible. And working in a trauma hospital, I have seen multiple traumas come in and their face has essentially been reduced to mush. A ps operates, uses hundreds of sutures, and that persons face is just like new. And on the other hand, I've seen other ps' whose technique sucks and I'm suprised they even have a clientele!

So, suturing technique is probably the most important factor in how a scar will turn out. Sure, it's always better to have dissolvable sutures, but if the surgery is too big, or the pt is allergic, or there's another reason they can't be used, external sutures can be used, and a very good, acceptable aesthetic result can be obtained. I am living proof. I also had foot surgery done for a neuroma. This was an orthopedic surgeon, so I figured I'd be butchered, but this man was so meticulous in his suture technique, that you can't even see the scars now, and in fact, I have to actually pull the skin taut to see the scars, otherwise they are invisible. And there are just some areas and surgeries where you can't use dissolvable sutures or subcuticular sutures.

e

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

From: Bos@...

Sent: Sunday, October 06, 2002 6:47 PM

Subject: Re: I'm new-thanks

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]

Patty--logic says your breasts were larger during lactation with

implants. . .just as logic says they were larger

prior to lactation with implants. The skin can stretch

just due to implants without lactation and then lactation

can stretch it even more.

How would one know whether the horizontal scars are the

minimal size? Depends on the way the procedure was done. . as we know, surgeons don't always do the same procedure

the same way. . .

Bonnie

[Guest guest]

--that's what I pictured. . .I'm wondering now if we

are all on the same page. . .are you saying that your

explant was performed entirely between the nipple

and the crease with no horizontal incision? If so,

I haven't ever heard of that. Could it be that your

horizontal incision has faded or is so small as not

to be noticed? It seems you didn't have your implants

very long, so your skin probably didn't give out much.

Where was your incision for implant?

Bonnie

[Guest guest]

Your right and no I never said one shouldn't I just was commenting that I don't think it is usually needed to use external stitching and anchor lifts. anyhow I appreciate your comments as always

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

From: Dr. Kolb

Sent: Monday, October 07, 2002 5:55 AM

Subject: RE: I'm new-thanks

Feng and I use the exact same internal sutures but sometimes I use some fine external nylons as well. You cannot state that one should never use external sutures. This is misinformation. .

-----Original Message-----From: Heer [mailto:idagirl@...]Sent: Sunday, October 06, 2002 8:45 PM Subject: Re: I'm new-thanks

Dr Kolb

Not to argue here but there are allot of PS that use an anchor lift when it is NOT needed and those are what we are warning about here. Patty did not need an anchor lift, neither did I. I got great results with the vertical lift, so why would anyone want the extra scaring? Also it is simply not true that external stitches work as well as internal ones, I know from personal experience and the internal ones that Feng used were far superior to those ugly external ones that my implanting surgeon used.

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

From: Dr. Kolb

Sent: Sunday, October 06, 2002 4:25 PM

Subject: RE: I'm new-thanks

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]

If he did a good job and you like what he has done then that is the bottom line !

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

From: perlesetlacet@...

Sent: Sunday, October 06, 2002 9:35 PM

Subject: Re: I'm new-thanks

From what I understand from my current PS, sutures used on the breasts themselves is a different ball of wax from suturing techniques done elsewhere on the body. What's good for the head/scalp for example may not be good on the breasts. I have faith in what he has told me.LM

[Guest guest]

--had just posted a message re your implant/explant

and see here that your implant was performed through

the nipple rather than through the crease. .. .I'm betting

that has a lot to do with how the explant procedure is

performed--based on the desire of the patient.

In any event, I don't think we are all speaking of exactly

the same thing as the circumstances are different.

Bonnie

[Guest guest]

Feng told me the same thing, she uses all internal suturing on her mastopexies, and that the way she bevel cuts the skin or something makes it lay flatter so you get a flatter, thinner scar. This made sense to me. She also told me and showed me these different incision sites that dr's routinely use, one was the anchor lift, she explained how she does not feel it is ever needed to get a good lift, she said many Dr's are not aware of how to do a good vertical mastopexy without the crease incision.

I think she may use the crease on some explants if there is no lift needed if the patient already had a crease incision with her implants.

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

From: perlesetlacet@...

Sent: Sunday, October 06, 2002 9:32 PM

Subject: Re: I'm new-thanks

: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 anywayI 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

[Guest guest]

There are so many different things that can determine the outcome of a scar. However, in seeking a surgeon for explant, I admit I was totally fascinated by Fengs description of her bevel cut and suturing from the inside. I also felt that her photos and her demeanor were fantastic, the combination won me over!

C

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

From: Bos@...

Sent: Sunday, October 06, 2002 7:44 PM

Subject: Re: I'm new-thanks

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 think that we could argue this point all day, the fact is I guess if you have huge saggy boobs you might need this anchor but if you are just tiny or small and saggy usually I don't think you would need all those incisions and I would run to get a second opinion before I settle with a PS who was set and determined to give me not two but 3 seperate scars!

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

From: Dr. Kolb

Sent: Sunday, October 06, 2002 4:25 PM

Subject: RE: I'm new-thanks

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]

That is what I thought--that you had implants while lactating. . .

So the stretching occurred due to the pregnancies and lactations

(and aging skin) and you filled the "extra" with implants? That's

what a lot of women do. . .

So you thought implants were potentially harmful even when you got them?

My daughter was told (I was there) AFTER implantation, not

to breast feed. . this was in 1989. . .

Bonnie

[Guest guest]

Oh--don't know when you got implants. . .so the controversey

had got underway already. . .it appears to me that you had

a life lesson and learned from it whatever it was you

were supposed to learn. It may not seem so, but I consider

your experience ultimately positive in the whole big

scheme of things--in the words of my attorney's paralegal,

"It could have been worse." It's real doubtful you will need to be

presented with the same lesson again. . .(a personal

philosophy)

Bonnie

[Guest guest]

"I had no idea how bad it was until it actually happened to me"

Wish this could be publicized over and over somehow for all those

women who are taking the risk. . .just so they have this fact well

fixed in their minds.

Bonnie

[Guest guest]

Well you have one scar all the way around the areaola, then you have (with the vertical lift) the one running from the nipple down the breast then with the anchor you have one in the breast crease so in my own opinion that would be 3 scars, although techincally they would all be together, does tha make sense?

Right now I have scars around my areolas and then down the front of each breast, but nothing in the crease. The vertical scar is completely invibible unless I totally look for it, the nipple scar is just a white thin tiny line, that is it!

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

From: Bos@...

Sent: Monday, October 07, 2002 9:48 AM

Subject: Re: I'm new-thanks

I'm lost again--where does this 3rd scar fit in? Again, I'm just going by my daughter's anchor mastopexy--her incision went around the areola, vertically down and about a 1-1/2 ro 2 inch area horizontally under the breast. . .??? I would think that the amount of skin to be removed would decide the width of the bottom of the anchor and therefore horizontal incision, but maybe I have this wrong in my mind. . .i,e. the more to be removed the longer the horizontal incision. I can't feature a need for an anchor if there isn't a lot of extra skin, but in her case, there was--she had very, thin stretchy skin and of course she cannot be the only one with this type of skin. There was a time a plastic surgeon would assess the skin and advise the patient of the potential things that may be encountered as a result of it. . . Bonnie Bonnie Bonnie

[Guest guest]

I was nothing but skin, if you have looked at my photos here on the site you can see I was very saggy and just skin with nipples hanging down before implants. My breasts are not firm at all, they are still smoshy, but they are perky and sit up where they should be

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

From: Bos@...

Sent: Monday, October 07, 2002 9:48 AM

Subject: Re: I'm new-thanks

I'm lost again--where does this 3rd scar fit in? Again, I'm just going by my daughter's anchor mastopexy--her incision went around the areola, vertically down and about a 1-1/2 ro 2 inch area horizontally under the breast. . .??? I would think that the amount of skin to be removed would decide the width of the bottom of the anchor and therefore horizontal incision, but maybe I have this wrong in my mind. . .i,e. the more to be removed the longer the horizontal incision. I can't feature a need for an anchor if there isn't a lot of extra skin, but in her case, there was--she had very, thin stretchy skin and of course she cannot be the only one with this type of skin. There was a time a plastic surgeon would assess the skin and advise the patient of the potential things that may be encountered as a result of it. . . Bonnie Bonnie Bonnie

[Guest guest]

Bonnie: That is correct. The smaller the skin resection, the smaller the horizontal compenent. It is mathemathical. .

-----Original Message-----From: Heer [mailto:idagirl@...]Sent: Monday, October 07, 2002 11:45 AM Subject: Re: I'm new-thanks

I was nothing but skin, if you have looked at my photos here on the site you can see I was very saggy and just skin with nipples hanging down before implants. My breasts are not firm at all, they are still smoshy, but they are perky and sit up where they should be

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

From: Bos@...

Sent: Monday, October 07, 2002 9:48 AM

Subject: Re: I'm new-thanks

I'm lost again--where does this 3rd scar fit in? Again, I'm just going by my daughter's anchor mastopexy--her incision went around the areola, vertically down and about a 1-1/2 ro 2 inch area horizontally under the breast. . .??? I would think that the amount of skin to be removed would decide the width of the bottom of the anchor and therefore horizontal incision, but maybe I have this wrong in my mind. . .i,e. the more to be removed the longer the horizontal incision. I can't feature a need for an anchor if there isn't a lot of extra skin, but in her case, there was--she had very, thin stretchy skin and of course she cannot be the only one with this type of skin. There was a time a plastic surgeon would assess the skin and advise the patient of the potential things that may be encountered as a result of it. . . Bonnie Bonnie Bonnie

[Guest guest]

: I wasn't referring to your comments but to the comments from -Marie's plastic surgeon. .

-----Original Message-----From: Heer [mailto:idagirl@...]Sent: Monday, October 07, 2002 9:19 AM Subject: Re: I'm new-thanks

Your right and no I never said one shouldn't I just was commenting that I don't think it is usually needed to use external stitching and anchor lifts. anyhow I appreciate your comments as always

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

From: Dr. Kolb

Sent: Monday, October 07, 2002 5:55 AM

Subject: RE: I'm new-thanks

Feng and I use the exact same internal sutures but sometimes I use some fine external nylons as well. You cannot state that one should never use external sutures. This is misinformation. .

-----Original Message-----From: Heer [mailto:idagirl@...]Sent: Sunday, October 06, 2002 8:45 PM Subject: Re: I'm new-thanks

Dr Kolb

Not to argue here but there are allot of PS that use an anchor lift when it is NOT needed and those are what we are warning about here. Patty did not need an anchor lift, neither did I. I got great results with the vertical lift, so why would anyone want the extra scaring? Also it is simply not true that external stitches work as well as internal ones, I know from personal experience and the internal ones that Feng used were far superior to those ugly external ones that my implanting surgeon used.

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

From: Dr. Kolb

Sent: Sunday, October 06, 2002 4:25 PM

Subject: RE: I'm new-thanks

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]

Patty: I would have to see your preop photos. .

-----Original Message-----From: ~*Patty*~ [mailto:fdp@...]Sent: Monday, October 07, 2002 12:27 PM Subject: Re: I'm new-thanks

Wow, I just measured my scars underneath. The left one is 5 inches, the right almost 6. But I didn't have that much boob skin to begin with--I did get stretch marks when I got milk in--I went almost to a D cup with milk, then back down to my normal size, an A, but with all that extra skin.

My impression was that the large scars I have now are mostly from the en bloc explant with lift. , (and I know you can't say this for sure, but I'll ask it anyway), do you think these size scars would be normal for an anchor lift if I had never had implants?

Patty

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

From: Dr. Kolb

Sent: Monday, October 07, 2002 8:52 AM

Subject: RE: I'm new-thanks

Bonnie: That is correct. The smaller the skin resection, the smaller the horizontal compenent. It is mathemathical. .

-----Original Message-----From: Heer [mailto:idagirl@...]Sent: Monday, October 07, 2002 11:45 AM Subject: Re: I'm new-thanks

I was nothing but skin, if you have looked at my photos here on the site you can see I was very saggy and just skin with nipples hanging down before implants. My breasts are not firm at all, they are still smoshy, but they are perky and sit up where they should be

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

From: Bos@...

Sent: Monday, October 07, 2002 9:48 AM

Subject: Re: I'm new-thanks

I'm lost again--where does this 3rd scar fit in? Again, I'm just going by my daughter's anchor mastopexy--her incision went around the areola, vertically down and about a 1-1/2 ro 2 inch area horizontally under the breast. . .??? I would think that the amount of skin to be removed would decide the width of the bottom of the anchor and therefore horizontal incision, but maybe I have this wrong in my mind. . .i,e. the more to be removed the longer the horizontal incision. I can't feature a need for an anchor if there isn't a lot of extra skin, but in her case, there was--she had very, thin stretchy skin and of course she cannot be the only one with this type of skin. There was a time a plastic surgeon would assess the skin and advise the patient of the potential things that may be encountered as a result of it. . . Bonnie Bonnie Bonnie

[Guest guest]

:

Hi. My doc has been a PS since 1997. He's younger and new school. He's done MANY mastopexies and reductions (I saw many photos), and reconstructive breast work on women with cancer pediatric plastic surgery, maxillofacial, and burn victims. He does not do as many breast augmentations and explants as there is not as great as a demand in his practice. He is more in the reconstructive side of plastic surgery than just the "cosmetic" side of it.

Take care,

-Marie