RE: I'm new-thanks

[Guest guest]

Hi Dr. ,

Isn't this issue somewhat like 'all masterpiece artists' do not use the same painting techniques? And, afterall, "beauty is in the eyes of the beholder"!

MM

Martha Murdock, DirectorNational Silicone Implant Foundation | Dallas Headquarters"Supporting Survivors of Medical Implant Devices"4416 Willow LaneDallas, TX 75244-7537

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

From: Dr. Kolb

Sent: Sunday, October 06, 2002 5:25 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 So anchor procedures can hardly be considered outdated.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PM Subject: Re: I'm new-thanks :Aesthetically pleasing results is not all that subjective when you consider some PS use outdated methods that leave patients with more scarring than necessary and/or use poor suturing techniques that leave railroad track marks.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]

Dear LM, and all other Ladies (of any age and/or marital status),

The only thing that went well for me was my health immediately improved, and I did 'not' die! My body doesn't look so great, yet my life is wonderful, although I will never have the energy level I need to do all I need to do for all who need me!

I will send you my "Barbie Doll" and "Trophy Wife" story another day this week! Many of you should be able to 'relate' to many of my statements in my story! I've had a marvelous life despite these BI problems, and I thank God each day for allowing me to be here to realize how insignificant my 'stupid boobs' were, in the whole scheme of things!

Thanks for reminding me about 'the quotes', as I have a really great one I have never sent regarding 'Sons'!

Blessings,

MM

Martha Murdock, DirectorNational Silicone Implant Foundation | Dallas Headquarters"Supporting Survivors of Medical Implant Devices"4416 Willow LaneDallas, TX 75244-7537

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

From: perlesetlacet@...

Sent: Tuesday, October 08, 2002 12:30 AM

Subject: Re: I'm new-thanks

Martha:Hi.Are you married? I'm 29 and single and to be quite blunt not very experience with men. I had what many would be considered a lovely body until my PS butchered me putting in/taking out my implants. As good as it was to be explanted, I think it's important to get good results as well. My disfigurement has impacted on my sexuality and self esteem.I agree with . When you're my age (or any age) and unmarried (or married) whatever, you want good results--and your health too.I'm glad things went well for you.Take care and keep those quotes coming.LM

[Guest guest]

It makes sense--sorry, I hadn't considered the submuscular placement that is usually used now--I would guess there

would be very little, if any, skin stretched this way. . .most

of the gals I know had sub-glandular placement.

I would think one could get around the skin-stretching by

placing the implant sub-muscularly.

Bonnie

[Guest guest]

Wierd Dr not to take pre op photos? What about your implant doc did he take preops? You should get them sweetie! Hey by the way how big were the incisions for you implants?

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

From: ~*Patty*~

Sent: Monday, October 07, 2002 10:53 AM

Subject: Re: I'm new-thanks

Oooh, too bad, I don't have any and Hiatt never took any. Oh well, can't change it anyway.

Patty

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

From: Dr. Kolb

Sent: Monday, October 07, 2002 9:09 AM

Subject: RE: I'm new-thanks

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]

BUt I always wondered how the implants really can stretch the breast if they are submuscular cause mine seemed like they were under the muscle and if I bent over the breast sort of hung free of the implant and muscle, so it seemed in reality that they breast was only made bigger by the muscle being stretched, I sometimes thought that the breast was not really any more stretched than before, does this description make any sense or does it sound like I am from outer space ha!

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

From: Bos@...

Sent: Monday, October 07, 2002 11:00 AM

Subject: Re: I'm new-thanks

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]

I HAVE NO HORIZONTAL INCISIONS WHAT SO EVER ! I have pics didn't you see them? Maybe they are not clear enough? I will take more then and show you, my original incision was a tiny one around the areolas only, they were invisible too. Then Feng just did around the nipples and vertical down the breast stopping at the crease, there is NO incision at the crease, in it or anywhere near it , now does it make sense? Hee hee. I do have two tiny little marks that I can barely find anymore from the drain holes just below my breasts.

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

From: Bos@...

Sent: Monday, October 07, 2002 11:07 AM

Subject: Re: I'm new-thanks

--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]

Oh yes I agree because had I had a crease incision who knows what might have happened, however, if you talk to most of the women on explantation.com, there are allot of them that all talk about Fengs vertical lifts, also if you look at her website there is allot of talk about her special suturing methods.

I agree that everyone is individual, I am curious though, is the fact that the scar is horizontal in the crease rather than vertical why it seems that this scar does not fade as much or what is the deal with this? I would love to know.

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

From: Bos@...

Sent: Monday, October 07, 2002 11:36 AM

Subject: Re: I'm new-thanks

--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]

Oops, I made a mistake. My implanting p/s (which was Stuart in Tucson, not Hiatt in Mesa) did not take pre-op photos of me before I had any surgery at all on my breasts. I thought that was what Dr. Kolb was asking for. I don't have any of my own either. But, yes, Dr. Hiatt did take pre-op photos before explant.

My incisions in the crease of the breast for implant only ended up being about an inch or less. You couldn't see them of course under those huge implants!

Patty

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

From: Heer

Sent: Tuesday, October 08, 2002 6:38 AM

Subject: Re: I'm new-thanks

Wierd Dr not to take pre op photos? What about your implant doc did he take preops? You should get them sweetie! Hey by the way how big were the incisions for you implants?

[Guest guest]

All the pics Feng showed me were lifts with a vertical incison and they all looked good, I mean I am sure that she would not lie to me about the fact that anchors are not used by her. When I talk to I am going to talk to her about the tummy t and also going to ask again about the vertical vs anchor lifts

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

From: perlesetlacet@...

Sent: Monday, October 07, 2002 2:57 PM

Subject: Re: I'm new-thanks

My PS lifted big granny-like boobs (D) with a vertical. I suppose for the abnormally sized women.....yikes.LM

[Guest guest]

I guess it is like a beveled edge, where the two pieces of skin fit together for tightly, lay down flat and the end result is a smooth flawless looking thin scar. I am sure this is why my vertical lift scars are invisible ! Maybe not every PS can do this so that is why their vertical lifts result in scars that are visible even many years later, this is why I went to Dr Feng. I will post some new photos of my scars, or rather invisible scars, to prove the point, I also do not believe I am an exception or anything special, just another example of Fengs awesome lifts!

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

From: perlesetlacet@...

Sent: Monday, October 07, 2002 2:52 PM

Subject: Re: I'm new-thanks

:Hi. What is the "Bevel Cut"--it does sound fascinating? I too would have been one over.LM

[Guest guest]

I think so too, I don't think my breasts got worse than they were but they were saggy to begin with, so I needed that lift!

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

From: Bos@...

Sent: Tuesday, October 08, 2002 9:42 AM

Subject: Re: I'm new-thanks

It makes sense--sorry, I hadn't considered the submuscular placement that is usually used now--I would guess there would be very little, if any, skin stretched this way. . .most of the gals I know had sub-glandular placement. I would think one could get around the skin-stretching by placing the implant sub-muscularly. Bonnie

[Guest guest]

Dr. Devi has trained many practioners to do it. I will ask her if there is a website where they are listed. You could search it on a search engine for quicker information. .

-----Original Message-----From: e Rene [mailto:e_Rene@...]Sent: Tuesday, October 08, 2002 7:45 PM Subject: Re: I'm new-thanks

So who does this NAET and where is it done? Do acupuncturists do it? I'd be interested in finding out more, because my list of allergies goes on and on, when prior to my implants, I had NO allergies. All anesthesiologists hate doing my H & P because of my allergies.

e

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

From: Dr. Kolb

Sent: Tuesday, October 08, 2002 4:24 PM

Subject: RE: I'm new-thanks

It is an allergy elimination technique based on the acupuncture meredian system. Dr. Devi has written a book on it. Many patients with difficult allergies such as you have with suture have been helped. The theory is interesting as we may develop allergies when we have a particularly negative state when we are exposed to something. This can be undone energetically. .

-----Original Message-----From: e Rene [mailto:e_Rene@...]Sent: Tuesday, October 08, 2002 12:30 AM Subject: Re: I'm new-thanks

I have had all the tests done that everyone recommends on this site. I don't have any platinum, I don't have yeast. I will ask Dr. Huang what type of sutures she used on me. It was similar to what my neurosurgeon used, but much finer and smaller (he used monofilament nylon). I have not heard of NAET. What is it?

e

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

From: Dr. Kolb

Sent: Monday, October 07, 2002 9:18 PM

Subject: RE: I'm new-thanks

e: I have never had an allergic reaction to PDS or Maxon sutures in any of my patients but I agree it could occur. But remember that my patients are on an immune program prior to surgery so many of their allergies are resolving. If one is not on such a program, I agree that multiple allergies are possible. Prolene is a permanent suture that is similar to nylon so what kind of sutures did Huang use? We will often test patients prior to surgery to determine allergies then use NAET to eliminate them. Have you considered NAET? We are going to be interviewing the doctor who developed this technique on the radio show this month. You might want to read her book. Her name is Dr. Devi. Have you had your platinum levels tested as multiple allergies can be associated with this toxicity and there is a protocol for detoxification of platinum at www.templeofhealth.ws . I believe our clinic is very skilled at the treatment of the multiple chemically sensitive patient as we are trained in holistic medicine. .

-----Original Message-----From: e Rene [mailto:e_Rene@...]Sent: Monday, October 07, 2002 2:43 PM Subject: Re: I'm new-thanks

My allergies are to prolene and vicryl sutures, and because the sutures that were placed in my chest after my open heart surgery caused a SEVERE infection which led to sepsis, my being admitted to the ICU and fighting for my life, I don't know of any doctor who would risk his/her license or reputation by putting dissovable sutures in me. And I wouldn't let them. And the 2 surgeons who operated on me after my heart debacle refused to attempt it, and this was my neurosurgeon and Dr. Huang. She normally doesn't do a subcuticular suture, but after talking to me and reading my med records, she absolutely said she was not going to take a chance with any dissolvable sutures.

I think the statement you made that the much longer lasting dissolvable sutures are not going to result in allergic reactions is incorrect and misinformation. This may be a "blanket" statement for the majority of people, but not everyone. I had titanium placed in my neck for my first surgery. This is supposed to be something that no one reacts to, and yet I did. Plus, in people who do have allergies to sutures, the last thing they need in their body is a longer lasting suture to invite infection and allergic reaction. Plus, once someone has an allergy to a particular kind of suture, they are at higher risk to have hypersensitivity reactions in the future, which you should be taking into account when you do your H & P.

I'd much prefer to go to a MD who will err on the side of caution and not take any risks.

e

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

From: Dr. Kolb

Sent: Monday, October 07, 2002 5:33 AM

Subject: RE: I'm new-thanks

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]

Martha: It is more like the amount of skin resection is scienfically linked to the type of procedure to get the best results. If you only do one kind of lift, then some of your patients will end up with deformities. That is what the articles are about. .

-----Original Message-----From: MARTHA [mailto:MAM-NSIF@...]Sent: Tuesday, October 08, 2002 12:31 AM Subject: Re: I'm new-thanks

Hi Dr. ,

Isn't this issue somewhat like 'all masterpiece artists' do not use the same painting techniques? And, afterall, "beauty is in the eyes of the beholder"!

MM

Martha Murdock, DirectorNational Silicone Implant Foundation | Dallas Headquarters"Supporting Survivors of Medical Implant Devices"4416 Willow LaneDallas, TX 75244-7537

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

From: Dr. Kolb

Sent: Sunday, October 06, 2002 5:25 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]

Hi Dr. ,

I totally agree with your explanation, and I would NEVER refer any woman to any PS who I did not know was extremely skilled in all forms of reconstruction. Yet, for me, I was sooo grateful to realize how much better I was a week after my explantation & felt like I just might live a few more years ....... I could have cared less what my breasts looked like! Since that time my focus has certainly been on more important things in my life!

Thanks immensely for taking so much of your private time to help many of these ladies, and always know you are more than appreciated by most!

Blessings,

MM

Martha Murdock, DirectorNational Silicone Implant Foundation | Dallas Headquarters"Supporting Survivors of Medical Implant Devices"4416 Willow LaneDallas, TX 75244-7537

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

From: Dr. Kolb

Sent: Monday, October 14, 2002 8:04 AM

Subject: RE: I'm new-thanks

Martha: It is more like the amount of skin resection is scienfically linked to the type of procedure to get the best results. If you only do one kind of lift, then some of your patients will end up with deformities. That is what the articles are about. .

-----Original Message-----From: MARTHA [mailto:MAM-NSIF@...]Sent: Tuesday, October 08, 2002 12:31 AM Subject: Re: I'm new-thanks

Hi Dr. ,

Isn't this issue somewhat like 'all masterpiece artists' do not use the same painting techniques? And, afterall, "beauty is in the eyes of the beholder"!

MM

Martha Murdock, DirectorNational Silicone Implant Foundation | Dallas Headquarters"Supporting Survivors of Medical Implant Devices"4416 Willow LaneDallas, TX 75244-7537

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

From: Dr. Kolb

Sent: Sunday, October 06, 2002 5:25 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]

Thanks Martha. .

-----Original Message-----From: MARTHA [mailto:MAM-NSIF@...]Sent: Wednesday, October 16, 2002 12:10 AM Cc: Dr. KolbSubject: Re: I'm new-thanks Importance: High

Hi Dr. ,

I totally agree with your explanation, and I would NEVER refer any woman to any PS who I did not know was extremely skilled in all forms of reconstruction. Yet, for me, I was sooo grateful to realize how much better I was a week after my explantation & felt like I just might live a few more years ....... I could have cared less what my breasts looked like! Since that time my focus has certainly been on more important things in my life!

Thanks immensely for taking so much of your private time to help many of these ladies, and always know you are more than appreciated by most!

Blessings,

MM

Martha Murdock, DirectorNational Silicone Implant Foundation | Dallas Headquarters"Supporting Survivors of Medical Implant Devices"4416 Willow LaneDallas, TX 75244-7537

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

From: Dr. Kolb

Sent: Monday, October 14, 2002 8:04 AM

Subject: RE: I'm new-thanks

Martha: It is more like the amount of skin resection is scienfically linked to the type of procedure to get the best results. If you only do one kind of lift, then some of your patients will end up with deformities. That is what the articles are about. .

-----Original Message-----From: MARTHA [mailto:MAM-NSIF@...]Sent: Tuesday, October 08, 2002 12:31 AM Subject: Re: I'm new-thanks

Hi Dr. ,

Isn't this issue somewhat like 'all masterpiece artists' do not use the same painting techniques? And, afterall, "beauty is in the eyes of the beholder"!

MM

Martha Murdock, DirectorNational Silicone Implant Foundation | Dallas Headquarters"Supporting Survivors of Medical Implant Devices"4416 Willow LaneDallas, TX 75244-7537

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

From: Dr. Kolb

Sent: Sunday, October 06, 2002 5:25 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