Need help with list to ask Plastic Surgeon???

Hey LBT buddies I need some advice on what questions to ask Plastic Surgeon on my 1st consult???I haven't made an offical appointment yet! Any advice ,ideas,.....anyone like to share their experience on pros and cons~ pain~time off work????

I'm wanting to look into a Tummy Tuck,Breast lift(or possible implants too)Thinking of getting my arms done also! Any help would be great! I'm just at a loss for knowing what to be concerned about.HELP!!!! :omg:

Also wondering what a good weight or how far from idea weight do I need to be before having PS done.

Hey,
I had a TT, Breast Lift and lipo of the flanks back and arms 4 weeks ago.
I asked my Dr shitloads of questions, and I still emailed nearly daily with more questions to ask him up until the surgery. Jamie, just remember be CLEAR as possible about what you want. Let them know exactly so you both go into the op with the exactly the same ideas of the final results...How tight, muscle repair, sutures or staples, how high for the nipple, extended vs normal TT, lipo etc...ask it all!!!!!!!!!!!
I am trying to find my questions I asked him at my first consult so I can show you...

1.Can you tell how far apart the muscles are before the op?
2.How aggresive are you with muscle repair?
3.How tight do you pull the stomach down?
4.How much longer is my ETT scar going to be vs a normal TT scar?
5.How long for the drains - how long for the binder?
6.How much are you going to take off with lipo in the flanks and back area?
7.Is the ETT going to pull the top of my thighs up and my pinny - Will it lift my butt a little also if the scar goes further around?
8.Will I wake up in pain or is that controlled already?
9.How high do you do the boobs with a lift and what happens with them if I lose more weight, say 15kgs
10.Will you use my ceasar scar? How do you do the scar, long or curved or??
11.How much skin app will be removed with my TT?
12.Will I have a roll when I sit?
13.Does the ETT involve the vertical cut also?
14.How do you do the belly button - looks wise? Can it be pierced later?
15.How long till I am standing straight?
16.Will my body match with a flat tummy and a waist etc but still fat arms and thighs?
17.Will me having a port with the Lap Band effect where you can do the lipo on my flanks?
18.staples, stiches or glue?
19.Do we use Bromelain, Arnica or lymphatic massage afterwards?
20.Is pain levels controlled by a pump after?
21.Will I lose nipple sensation?
22.What kind of cut do you do with the TT and the breasts.
23.What kind of belly button do you create.

These are questions copied from a plastic surgery forum I am a member of :
Muscle Repair

Most women who are seeking a tummy tuck will require some muscle repair. Childbirth, weight gain, and aging all contribute. The fascia which holds the muscles together to form a strong core is actually what is repaired, not the muscles. To understand what the fascia is, think about the gristley part of a steak. The part between the meat and the fat. That is what the PS's sew back together to draw the muscles back in. For those who need MR, it can be what causes the most dramatic changes in appearance. Most women having a FTT will have roughly the same amount of skin removed, the area between the pubic mound to just above the belly button. The main difference between a good TT and a great TT is in the details of the MR and the incisions. Having the muscles pulled in nice and tight is what brings in the waist line and the sides, so as to 'frame' the body that the skin will drape over. So how do you know which Drs do the better job? Here's a few tips.

* First educate yourself by looking at tons of pics. You can find many right here on MMH -Pictures. Compare one persons results with the other. Visit the Tummy Tuck Message Boards, and follow the recoveries of women. Who was standing straight at what point, how do their results compare with others? What was their initial body type in comparison to yours? Learn to look at pictures with a discerning eye, that's how you'll be able to judge the work of the PS when you visit for a consult. I like to compare a good TT with getting a good paint job. If you take an old rusty car to Maaco and get the $199 special, you'll still be thrilled with the results in comparison to the befores. But if you take the same car to the custom shop, and they remove the bumpers and rebadge and do extra body work, you would be able to tell the difference when compared side by side. In PS, surgeons usually charge about the same in a given geographic area, so make sure you're getting the custom job.

* Ask your PS what his philosophy on MR is.. He won't be able to gaurantee you what he'll be able to do for you until he gets into surgery, but he should be able to tell you what he 'usually' does. Is he aggressive? How close - in mm's - will he try and pull them together? How soon can you expect to stand straight? If he tells you, you can stand straight w/i a week, then he either doesn't do aggressive MR, or you didn't need it. Some PS still don't do any MR, and some do only a modest amount. They have their reasons. There's a longer recovery time, more pain for the patient. It also takes them longer in surgery to do a good job, as it usually requires more layers of stitches to do it tighter and have it hold. Discuss your Dr's techniques and his philosophy with him to make sure your expectations are on the same page. Your case may be one where MR is either not required or where he can't be as aggressive for very real reasons. Make sure you have all the info you need to make the right choice.


Sutures and Closure

Most Dr's will use disolvable internal sutures. Where they vary most is in how they close the incision. Here's the most common types:

* Steri-strips or tape. This is placed over the incision to help the 'top' close cleanly. Your Dr will usually advise you not to shower for several days up to a week, to allow the incision to close before exposing to water.

* Glue. If your insicison has been sealed with glue, then you will be able to shower on or about day 2, as the glue will prevent water from touching the incision. Within a week or so, the glue will begin to peel off.

* There are still a few Dr's that use staples. There is some risk that the staples will cause extra scarring, tho alot of women have done just fine. And the staples will have to be removed during the first week.


Scar Placement

As with everything else, this largely is a preference determined by the PS, depending on your body type, the amount of skin to be removed, and the natural fold of the skin. If you get an Extended TT (ETT), then your incision will go all the to the back of your hips. If you have a mini TT (MTT), then your scar will be low and much smaller than most. You may or may not be able to have much say over where the scar is placed, as doing it other than the way the PS recommends could give less than satisfactory results and cause issues such as 'dog ears'.

* Where does he recommend the inisicion be placed?

* Will it be the smiley face shape or a more straight line?

* Can you wear your favorite panties or swim suit to help determine the placement?

* How far back will the inicision go?


Binders

Here in the states most Dr's use a binder for at least some period of time. It helps close the space that was created when seperating the skin/fat from the fascia, which keeps fluid from collecting. This is to help prevent complications such as a seroma or a hematoma. It can also reduce the amount of swelling by compressing the tissue and forcing fluids out. Some Dr's recommend the Stage 1 binder for a week or two, before graduating you up to a stage 2 garment . A stage 2 garment is usually just a high waisted support panty that you can buy in a store. You don't want something that just comes to the waist, as it can pinch the ab muscles and be extremely uncomfortable. Some Dr's will take the binder away from you in a couple of weeks and not have you use anything. And then there are some - especially in Great Britian - who don't use a binder or garment at all.

* Will you wake up in a binder after surgery? If so, what kind? How long will you need to wear this binder?

* If you're to provide your own, what does he recommend?

* If you're having a combination of procedures, such as a "breast augmentation" or liposuction, how will that effect the garment you should wear?

* Can or should you wear a stage 2, and if so, when can you switch from the binder, and how long should you remain in it?


Drains

Almost all Drs use drains of some type. This is because the lymph system has been disrupted with the skin removal and incision. The drains are put in to assist the body in removing the fluids, so as to reduce swelling and prevent a build up that could cause a seroma or a hematoma. There are some new techniques available now, where drains aren't required. One is a procedure where a sort of 'glue' is made from your own blood to seal the pocket, and another is called pregressive tension sutures, which also closes that pockets. Since they're both pretty new at this point, alot of Dr's are taking a wait and see approach before using this technique for themselves.

* Where does the Dr put the entry points for the drains? In the incision directly? Or in the pubis area? Will there be a seperate scar?

* How long does he typically leave the drains in? Will he remove one first and then the other? Does it depend on the amount of fluid being drained?

* Is there a max length of time that he'll leave a drain in? If it extends for longer than anticipated, does he prescribe antibiotics so as to prevent infection?


Time off work

The amount of time for recovery depends alot on the amount of MR, as well as the general health and condition of the patient. It seems that most Dr's will recommend at least 2 weeks before returning to work, depending on the type of work you do. Even with a desk job. Sitting can be harder than standing, because of the pressure it puts on the MR. If you return to work at a desk job, make sure you get up often and move around to prevent the muscles from cramping up. During lunch, I would often go out to my car and lean the seat all the way back, so I could rest the muscles mid-day.

* How long before you can return to work full time?

* How soon before you can resume household duties? I recommend at least 6 months off from this activity. ; )

* How soon before you can take care of small children if you have them?

* How long before you can resume exercise? Walking? Weights?

* How soon can you drive?



Definitions

seroma
A mass or swelling caused by the localized accumulation of serum within a tissue or organ.

hematoma
A localized swelling filled with blood resulting from a break in a blood vessel.

fascia
A sheet or band of fibrous connective tissue enveloping, separating, or binding together muscles, organs, and other soft structures of the body.




As for weight, you will lose about 6 or so kgs if you have a TT. Thats average, some dont lose any. It will also take a while to see it come off because of swelling etc. My Ps said that you can lose another 20 kgs or so after a TT so it doesnt effect the results. I really have to stress that muscle repair is a huge factor of the final results with a TT. It is an absolute must. Make sure you and your PS are both clear that he performs it, because some dont. Also make sure you look at lot of pics of patients they have done with the same procedure.
I think you are a perfect weight now to have it done and will get optimal results being so close to your goal.
Good Luck if want to know anything else just let me know.

Also, make sure you ask lots of questions about the Dr performing the surgery on someone with a band. Have they done it before. Also have them consult with your banding Dr so they know exactly where the port is and how far they can pull before pressure is placed on it. My Dr couldnt pull my tummy down as tight as he would have liked because it was causing alot of pressure on my port.

Here is a link to my post about mine, I am not sure if you have seen it. I havent updated pics there for a while but will do so in the next week or so. I am in major swell hell at the moment and look severly pregnant.
http://lapbandtalk.com/showthread.php?t=16435

Oh Kelly thank you soooooo much for taking the time to post all this awsome information for me... I really felt worried and didn';t know where to start with PS. This helps ALOT. I will deffinatly check out the thread you started about yours...thanks for all your help!!! Its good to know someone that has been through all of this before. I will feel better informed going into something so serious... I now feel I have some info to start with!!!! Thanks again!!
If anybody has anything to add fromtheir experiences I would appreciate the time to respond...the thought of having PS is so scary I need all the help I can get!!!

Kellie,

This is an amazingly detailed list of excellent questions -- a great many of which I've never even thought of !!!! I am definitely going to be asking whatever Dr. I end up choosing most (if not all) of these questions.

I know you posted this a while back, and Texas Becky, a poster in our August 07 group, posted it in our plastic surgery area.

However, I wanted to resurrect this thread in the main plastic surgery part of the board because I am sure many of the people currently considering plastic surgery will find your questions to be very helpful.



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Banded 8/07/07 Dr. Miguel Zapata, Monterrey Mexico