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Surgeon says NO vertical incision!!

Surgeon says NO vertical incision!!

Postby cupie2 » Fri Apr 21, 2006 12:39 pm

I was wondering if anyone has had the BR with that type of incision pattern...around the areola and horizontally underneath, but NOT the vertical incision??? if so how's your experience been with that?
Anyone who just knows about that style, can you offer any input as to the the limitations/disadvantages that you've heard of with that? (we know the pros.)

Thanks,

cupes
Last edited by cupie2 on Sat Apr 22, 2006 1:35 pm, edited 1 time in total.
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Postby cupie2 » Fri Apr 21, 2006 6:45 pm

I can't believe I can't seem to find any literature on this method anywhere online. Figures I'd want to find out something so difficult.
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surgeon says NO vertical incision!!

Postby cupie2 » Sat Apr 22, 2006 1:33 pm

Now I'm worried cause no one's heard of it or had it done that way....why is that I wonder if it eliminates the vertical incision.

I ask about this because this surgeon I went to see yesterday said I'm a good candidate for this type of incision but he said this method didn't have a name. I trust I know what he's talking about because he's a professor/chief of the Dept of Plastic Surgery at a University hospital. I plan on asking for more detail about it from him, but I just wondered if anyone has heard of it, or it being done????????????
For those of you who remember I didn't feel terribly comfortable with the first surgeon I went to see a few weeks ago, and as it turns out, he's not comfortable nor confident in his own abilities to handle a patient who might have the potential for complications more so than the average person. So this other one I just saw had no concerns with working with me, and this made me feel comfortable in his expertise.
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Postby LookinUp » Sat Apr 22, 2006 1:38 pm

Did you see that breast lift method that I sent you? I think it is called Bernelli....maybe it is a combo of that and a reduction. You can always ask your PS if he's done that method on anyone else and if it is possible to speak with them (and /or see photos)...That might put your mind at ease some. (I'm the only one on these boards who had Propofol anesthesia as far as I can tell, and it was great--IV only--no mask or intubation---so just because nobody has heard of it doesn't make it bad!)
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Postby cupie2 » Sat Apr 22, 2006 2:20 pm

Yeah, I did look at the link you sent me...they talk about an incision around the areola only though...not underneath too....
I will ask the surgeon about photos..I'm sure he must have done them on others before.
You're right, just because no one's heard of it, or had it done doesn't mean its bad...but I gotta wonder why its not more commonly done if it avoids one incision...I definitely have to find out more about it.
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Postby Jeanenne » Sat Apr 22, 2006 10:32 pm

Lookinup, before I had my surgery, I had read your posts about Propofol and discussed it with my antheseologist. He said it is part of a cocktail, and specifically used to *enduce* general anesthesia and not used by itself. I felt a little embarrassed because when I asked for it, I was told of course, everyone uses this combined with other drugs and it is not used by itself, not an option. I believe you when you say your doctor used it because it seems like I've read all sorts of things and it seems like there are many ways to skin a cat --- or shrink a breast, if you will.

I was intubated and was told this was mandatory for several reasons. One, IV sedation is not deep enough to keep you from reacting to pain and other stimuli. They want you out completely and not moving around when they are cutting. The more they can control, the better they can respond. If you aren't wearing a mask and you are not intubated and you go into shock, not to mention moving all over the place on the table, they have to be able to respond quickly. I never saw the intubation. It was all done after I was sedated. I had no side affects from the intubation and unless someone told me, I would have never known it was done. However, I was terrified of the thought of it. Better off not knowing, me thinks. This really depends on the comfort level of the surgeon and how far out they want the patient.

It is strange, but after talking to several doctors and surgeons, I felt comforted by the intubation and anesthesia as it gives them a lot more control of the situation and how far under you go and how you come out of it. My surgery was done in a surgical suite, which was another fear I had to overcome. Once I got there, I realized why the surgeons preferred it. It was extremely controlled as they owned the building, hired all nurses, staff and anesthesiologists and even the owned the equipment used. Total control and I can't recommned it enough. They said they have never had to overnight a BR patient in the hospital. My doctor says my recovery is typical and I can't tell you how smooth it has been. I had no nausea, no leekage, none of the problems I worried about. I am 5 1/2 weeks PO and I played golf today with absolutely no pain whatsoever except I misplaced my driver and someone apparently decided to take it home.

Back to Cupie. You asked about this new method that I know is not common practice. All the more reason to see photos and talk to patients who have had it done. I would be concerned about shape if there is no vertical scar. Where would all that skin go? I would think it would make the breast very wide, give a large areola or not give much of a lift. If you look at a standard BR, I can see why they do what they do. The vertical scar seems to be the one constant in BL and BR becaues it is what tightens the skin up. The anchor scar is needed when a lot of skin needs to be removed and lifted. Just my two cents and not expert by any means.

I was considered a small reduction with 300 grams per side removed and I had the anchor and vertical. My breasts are so beautiful now that I can't imagine any of these incisions not being done and having the result I have because of the skin that I know that had to be removed.

Jeanenne
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Postby LookinUp » Sun Apr 23, 2006 6:35 am

I had asked about the Propofol....(I knew it was short acting, and thought it an odd choice to use for a surgery that was more than 3 hours long). It is not used by many doctors at this point, and I was given a sedative and pain med (I think fentanyl, but wouldn't swear to it) before the surgery, when I was still awake....then it was pretty much straight propofol the rest of the time. Apparently when properly administered, it will put you out deeply enough to stop movement, etc. It is one of (if not the) most newly developed general anesthetic agent, and many anesthesiologists don't use it or are uncomfortable using it, because it is so new and they'd rather stick with the agents they have experience with. (When everyone else on these boards seemed to be intubated, or masked, I asked about that as well)I was told if need be, you can be intubated in less than 10 seconds, and a mask can be used in about 2 seconds. Some people were catheterized routinely. Before the surgery, I was told to take everything off (including underwear, which I thought was a bit strange)...I asked the assistant (the one who shows you where to change and gives you the gown--not a nurse) why you have to take your underwear off...she gave me a strange look, and said for infection control.
I found out afterwards, when I asked a nurse, that it was just in case you needed to be catheterized quickly--they didn't want to have to start messing with pulling your panties off. Like you said, there definitely is more than one way to skin a cat. Here's some info on Propofol , if anyone is interested, tho....Propofol (Diprivan) is a nonbarbiturate hypnotic agent and the most recently developed intravenous anesthetic. Its rapid induction and short duration of action are identical to thiopental, but recovery occurs more quickly and with much less nausea and vomiting. Also, propofol is rapidly metabolized in the liver and excreted in the urine, so it can be used for long durations of anesthesia, unlike thiopental. Hence, propofol is rapidly replacing thiopental as an intravenous induction agent. It is used for general surgery, cardiac surgery, neurosurgery, and pediatric surgery. (And, you should never be embarrassed asking a physician any question--they went to med school, and you didn't! There are no 'bad' questions...if it is something you want to know, then you shouldn't worry about asking!.)
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Postby cupie2 » Sun Apr 23, 2006 9:37 am

Jeanenne wrote:
You asked about this new method that I know is not common practice. All the more reason to see photos and talk to patients who have had it done. I would be concerned about shape if there is no vertical scar. Where would all that skin go? I would think it would make the breast very wide, give a large areola or not give much of a lift. If you look at a standard BR, I can see why they do what they do. The vertical scar seems to be the one constant in BL and BR becaues it is what tightens the skin up. The anchor scar is needed when a lot of skin needs to be removed and lifted.


Hi Jeanenne,
Yes, I'm concerned about the kind of shape it would be also, if the proper contouring and shaping would work without being left with too much width. He said its because I have enough skin to work with that he can do it that way. I'm thinking its actually the way tissue is cauterized underneath and how its shaped that determines more the shape one is left with, and that the skin is merely an encasing. He would move the nipple up I guess by cutting out a hole on top and lifting the skin up and over the areola after its separated from the tissue under it. I'm figuring.
I plan to find out more information, actually I've emailed a list of questions to them, and I should be hearing something back in a couple of days.

Oh PS: I made it to Nordies to get measured as you suggested. She made me out to be a 36DDD. She told me that when she worked at Victoria's Secrets, they made them measure the width plus 5inches (I guess so since their bras fit so much smaller than the average bra elsewhere), but there they add more like 2inches.
That 36 is really pushing it though, cuz to me that's too tightly uncomfortable to be in all day for sure. They fit my sister in law tighter than she would like also. Anyway, so, I'm more a 38DD in their 'full coverage' bras. But when we get into the skimpier kind of bras which they don't make there really in a double or triple D one has to go up in size. But technically I am a 36DDD but also fit into one of their 38DD, which the girl said were equivalent to one another.
This second surgeon I saw, is not big on specific sizes..he doesn't seem to go by that per say, but I told him I wanted to be a B and showed him pictures of what my vision is. He said that's kind of standard results he gets...which I guess is a good sign. But Its definitely something to discuss again.

cupie
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Postby SomeoneSwipedtheDs » Sun Apr 23, 2006 10:50 am

Hi Cupie,
Another question you might want to ask this PS is How Many of these Un-Named procedure he has done? If it's a low number, that would give me pause.
Also most PSs that have been discussed on this board have discussed cup sizes--even when the were wrong, they still discussed it in terms of cups.
Definitely asks for pictures, and maybe even go a step further and ask to speak to former patients.
Peace,
SSD
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Postby cupie2 » Sun Apr 23, 2006 10:56 am

Thanks SSD. I will ask for all of that.
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Postby LookinUp » Sun Apr 23, 2006 5:14 pm

I think PS's only discuss cup sizes because they feel it is something the patient can relate to. In reality, when they do the surgery, they don't look for a 'cup' size, but for a proportional size...and will take into consideration the patient's wishes (wanting to be left on the larger side or the smaller side.)--hence, patients don't necessarily end up with 'what cup size they ask for'.)...In my practice, people ask what percentage of hearing loss they have. However, there is no such thing as a percentage of hearing loss--there is no such thing as 100% hearing, so what would you base it on? But, since that is what the patient wants to know, I'll call the decibel level of loss a percentage (or the speech reception threshold score if they don't have a flat loss.) This is what the patient wants to hear and what he/she relates to. Same with BRs and cup sizes.
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No Vertical Scar Reduction (Apron Technique?)

Postby mountains2molehills » Mon Apr 24, 2006 9:18 am

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Postby cupie2 » Mon Apr 24, 2006 2:12 pm

M2m,
Thanks you soooooo much for this!!!!!!!!
I found it very helpful, at least to know this technique really does exist and has been done for a number of years. I also found some other articles on it since you opened up the door to it. They call it the apron flap technique. But somewhere else I read it being called the passot technique, develped by a few drs including a dr. John Yousif.
From my readings so far, it confirms i think that one may end up on the fuller side, which I don't want, so I'll definitely have to discuss this further with my PS.
Thank you once again...

cupie
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Re: Surgeon says NO vertical incision!!

Postby Aquagirl42 » Thu Aug 08, 2013 1:50 pm

I know this message is extremely old but wanted to know if you went through with the BR without a vertical incision. I did!! I am so happy that my PS was able to do it this way. I asked him about it and he said he can't do it for everyone.
I can post pics for you if you want, this was 3 years ago and I am still so happy.
I hope you get this!!
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