Gonna Travel for Surgery, Two Different Docs?

There is really only one practice that is considered the best & they cost a lot more, on top of that they refuse to do breast augmentation via axilary region and that is the way I want it done. Saw other docs I just didn't have a good feeling about or didn't care for the pics i saw. Minimal scarring and natural appearance is top priority. So now I am venturing to Birmingham. Should I go to two different docs? I found one with nice breast aug. pics via axilary and one with great tummy tuc pics!

Doctor Answers 9

Surgeons and surgery

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Why not have the one surgeon do both procedures?  It certainly be most cost efficient and you can recuperate from both at the same time.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Choosing Plastic Surgeon for Procedures?

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Thank you for the question.

 I would suggest that you meet with a few well experienced board certified plastic surgeons in your area. Ask to see lots of examples of their work  in pictures and in person. I would also suggest that you select your plastic surgeon on the quality  of work that he/she can demonstrate to you,  not on a specific incision or technique. I think you are more likely to be happy with the results of surgery if you approach your decision-making in this fashion.

Best wishes.

Travel, surgery with different surgeons, and patient choice!

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I'm not sure if I ever met a patient for whom natural-appearing results and minimal scarring is not an issue. And even when a patient says "I don't really care about the scar," I certainly do (and they usually DO end up caring LATER)!

You also seem convinced that an axillary incision gives the "best" results. For some surgeons that may indeed be the case, but you should be aware that others use other incisions with equally good (and maybe even better) results! You should be able to find great photos of breast augmentation patients with ANY incision--who is dumb enough to put BAD results out there as representative of their best work?

You should be concentrating not on choosing a surgeon or surgeons who will do your bidding, but one (not two) who listens carefully to your goals, concerns, and preferences, and then discusses the pros and cons of each of them, so that in the end you can decide TOGETHER how best to proceed, or you should try another surgeon.

You should always consider what happens with the rare outcome, or the unsatisfactory result, or the complication that requires re-operation, or how far away you want to be from the surgeon who did the work, but is not nearby, if you have any post-op problems or need more surgery. Uncomfortable questions indeed, but those that should be carefully considered when traveling out of town for elective surgery.

What is your surgeon's re-do or re-operation policy? Who pays for what? Hospital, accredited outpatient surgicenter, accredited office surgical facility, or back room in some bogus-boarded cosmetic surgeon/s office?

Tummy tucks and breast augmentations are extrememly common operations in a busy ABPS-certified plastic surgeon's practice, especially if they perform mostly or exclusively elective cosmetic surgery. You should be able to find one experienced surgeon good at both procedures, which will be safer (one operation instead of two) and less expensive, not to mention better for follow-up and potential revisionary surgery. Meet surgeons in person and then look at their before and after photos. For more information about breast augmentation that might be helpful to you, click on the web reference below. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Scarless breast augmentation at the same time as Tummy Tuck

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Hello, it seems you have concerns about scars as well as need two operations.  Conceptually as you don't have pictures showing, you are the ideal candidate for TABA (Trans Abdominoplasty Breast Augmentation). In this operation, saline or silicone implants may be used under or over the muscle through your tummy tuck scar. This will avoid and breast scarring, one anesthesia and recovery period as well as reduced anesthesia and facility fees. One surgeon doing both is ideal. 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.7 out of 5 stars 112 reviews

Choosing the Right Plastic Surgeon

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A board certification and previous experience are necessary when choosing a plastic surgeon. You should choose the doctor with the best results in the procedures that you are considering, since, for example, a tummy tuck specialist may not perform many breast augmentations. Regarding price, you usually pay more for experience with surgery. The most experienced doctors will charge more than inexperienced ones, but they bring a higher approval rate and have a better understanding of what the patient truly wants. I recommend that you get the opinions of multiple plastic surgeons and choose the one that you are most comfortable with.

Jaime Perez, MD
Breast Augmentation Specialist
Plastic Surgery Center of Tampa

Jaime Perez, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 81 reviews

Minimal scarring with augmentation

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If you want saline implants, then I feel that the inferior periareolar incision leaves the best scar. If you want silicone, you will likely need to use the inframammary approach depending on the size of the implants you choose and the size of your areola.  The transaxillary approach is more difficult to achieve symmetry.  You can not typically reach the inframammary fold from the axilla without the aid of an instrument for dissection.  Through the periareolar and inframammary approaches, the surgeon can count the ribs and fell the sides of the pocket for better symmetry.  This may be why many transaxlillary photos you see are not optimal results.

Todd C. Case, MD
Tucson Plastic Surgeon

Two docs for two procedures

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First, let me address the breast augment. I don't use the axillary approach either because I find it to be less safe than the other approaches and that implant placement is not optimal. I think you need to evaluate not only placement of the scar but the result as a whole. I do not think that you will achieve a natural appearance from this approach. Therefore, I would encourage you to look further and also to focus on communication and recommendations in addition to photographs.

One Procedure, One Surgeon, Equals Savings

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If you want to have both an augmentation and a tummy tuck the operation can be performed in one setting with significant savings, a priority in this economy and one it seems for you.  Minimal scarring is a priority for you as well, again, not uncommon.  Breast implants can be placed through a tummy tuck approach so there is no scar on the breast or the axilla and still give a very natural enhancement.  The only trade-off is the implants have to be saline.  Most ABPS board certified surgeons should be able to do the breast implant approach you want and a tummy tuck.  If not keep looking until you can find one that can do both.

Christopher J. Schaffer, MD
Birmingham Plastic Surgeon

Shop for the best surgeon- not the scar you want

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Hi there-

If someone agreed to give you the scar you think you prefer, but you ended up with funny looking breasts, are you going to be happy?

Similarly, if you had an excellent surgeon perform your procedures, had to accept that the scar would be in a different location, but afterwords felt no regret because the scars healed beautifully and your shape was lovely, how will you feel?

Most women don't realize how the process by which they go about selecting a surgeon and researching their preferences affects their chances of ultimately being happy...

The way you are go gin about this is all wrong, and I am concerned that you are more likely to end up very unhappy and needing revision surgery.

Whether talking about tummy tucks, facelifts, or breast surgery, the best thing you could do is to find the best, most talented surgeon you can and then communicate carefully. This means explaining your goals and preferences, and then LISTENING to their recommendations and the reasons for them. It should be a team effort based on mutual trust and respect- not like a trip through the McDonald's drive through window...

If you choose your surgeon carefully and for the right reasons, and you keel an open mind about the details of the procedure that will be safest and most likely to give you the best outcome, your chances of being safe and happy will be much higher.

The very most unhappy women I meet are those who talked a surgeon somewhere into performing an operation on them that they thought they wanted because of the cute scar or because of the lower cost, etc... only to find afterwords that the outcome was funny looking, weird, or just not what they thought it was going to be. And then they need more expensive revision surgery.

You, and all patients, should be careful to find the best surgeon you can and then trust them to help you do what is the best thing for you. Your preferences are important- but if they are going to compromise your outcome or your safety, you should listen to the professional who you are going to entrust with your safety and satisfaction.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.