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**Pooka1** · 12-01-2012, 11:16 AM

Originally posted by PollensaGirl View Post

But I'm not very happy with my front view. I still have a more prominent left ribcage and when I look in the mirror I still look like I'm slightly rotating and leaning towards the left (this is the side I tended towards before surgery). My Mum and Dad keep on telling me that nobody is perfect but I expected more and I can't help feeling down.

See front view post op:
http://i47.tinypic.com/23tp0u1.jpg

I am worried this is getting/will get worse and that perhaps my spine is fusing in a position that it shouldn't because of the way I'm holding myself?? Is this possible or are the rods too strong to allow this to happen?

Hi. I just had a few potential answers for you but I think the only person who can really answer these questions is your surgeon. Can you email them to him? Our surgeon responded to emails.

I looked at your picture. As far as I can tell, you got a fabulous result. You do have what seems like a slightly lower rib cage on the left but that might not be noticeable to anyone who doesn't know to look for it. If you had a 60* thoracic curve before that was probably quite rotated, your result might be among the best possible outcomes. My one daughter had a 58* highly rotated T curve and the surgeon was very careful to mange our expectations about how much rotation he could correct. You should know that surgeons cannot necessarily correct all rotation on all curves. They can only do what is possible. Our surgeon told us to not expect to see it all removed. But in fact he removed almost all of it though there is still some there. So instead of being disappointed that it all wasn't removed, we were elated that it was de-rotated to the point that nobody would notice it if they didn't know what to look for. That's how I would describe your result also.

You should ask specifically if a costoplasty can help with the specific front rib issue you are concerned about. It may be a lot of pain for little gain.

I am wondering if it is just the position of my left rib cage causing this appearance of leaning. It feels like my ribcage needs tilting forwards more -hard to describe but hope that might make sense?? I also feel like my upper body is naturally trying to twist towards the left.

The lean is separate. You could be correct that any lean is magnifying the issue of the front rib asymmetry. My other daughter had a post-op lean that corrected over about a year. So it is far too early to worry about that. Maybe after a year when the lean corrects it will also correct some remaining asymmetry in the front ribs as you suggest.

You look great and I think you need to discuss with your surgeon whether it is even possible to gain more symmetry at this point (or at any point even during surgery actually). You had large curves and I think you had a great surgeon based on that picture. Surgeons can do amazing things but miracles don't exist and life is unfair.

Good luck.

**titaniumed** · 12-01-2012, 11:52 AM

Vic

I see nothing wrong.....you look great!

Thoracoplasty (US) costoplasty (UK) is something that you really want to avoid and with todays pedicle screw systems addressing the actual rotation, is not really warranted. Scoliosis does deform the ribs some, and coming out perfect shouldn’t be expected. Lets face it, were not perfect, and my belly keeps growing exponentially. LOL It always something.

The main thing is that you nipped this one in the bud, and have come out great.....being pain free, and controlling progression are the main goals. If I would have known, I would have had my surgeries many years ago. I suffered with pain for many years, and it seems that you will dodge that bullet...My 40’s were extremely painful.

These surgeries are serious and procedure shouldn’t be dictated by the layman....(us) We try to influence, but without the extensive training that these guys go through, it really is fruitless....(smiley face) Thoracotomy is the procedure used for thoracoplasty, they go in under your armpit. I have read that it’s the most painful surgery man can endure. Begging for this is like wanting to jump in front of a freight train.

Our soft tissues take a beating after surgical correction. It takes months if not years for the retraining and rebuilding to happen. For right now, just keep doing short walks often through the day, and breathe deep and eat well. Your healing at a fast rate right now, treat your body correctly....

Your hardware will do a good job at holding your construct while you fuse. Try not to bend or rotate, stay erect and no falling! Fusion or healing is happening right now just like a cut on your finger. You don’t want to disrupt this process.

Keep smiling! That’s the one thing that surgeons wont teach you. Its important.

Ed

**Pooka1** · 12-01-2012, 12:14 PM

Ah Ti Ed's answer reminded me of something. You are still fusing and the January appointment is not too late to do something if the surgeon thought there was something more to do. So don't worry about that issue. I seriously doubt he would go back in your your case because, as Ti Ed mentioned, your progression has stopped and you will have no pain it seems. Those are the medical reasons for fusion and I don't think he can ethically go back in or if insurance would pay if he had previously addressed those two things but I don't know that.

The other issue is the point of waiting until curves get large before operating. There is a surgeon here in the US who seems to advocate operating earlier to avoid ancillary damage and to get better corrections. Your valid subjective reaction to what is objectively a really nice result might be a case that supports his position. Generally, If you operate at say 45* on a progressive curve, the result is probably going to be better than on a 60* curve but not all 45* curves will progress so surgeons are reluctant to do it.

Fusion surgery has saved the lives of both my daughters so that is my perspective. Everything is gravy. Your perspective is equally valid but I think your surgeon should have managed expectations better in your case.

**JenniferG** · 12-01-2012, 03:41 PM

Agree with Ed and Pooka but I thought of something else. Did you lose a lot of weight since your surgery? Sometimes weight loss can show up the not-quite-perfect bits but because most of us regain that weight down the track, those imperfections seem to improve or disappear altogether.

As Ed said, you saved yourself a painful bullet by having your surgery now. I think you got brilliant result, you look great. I'm 3.5 years out and have a definite lean to the left. But I have no pain and can do anything I want. I couldn't be happier.

**PollensaGirl** · 12-02-2012, 08:43 AM

Thanks Ed, Pooka, and Jennifer! I know you're all right and I need to realise that what Mr T has achieved is little short of a miracle when you look at what I was like before! It really helps to hear from you guys to get some perspective on things! Thank you for all the lovely comments.

Jennifer - Yes I have lost about half a stone throughout the process so my sticky out bits are sure to be more prominent as a result...good thinking!
Pooka - how fantastic about your twins! I am a twin too but with a boy. Luckily he escaped the scoliosis bit, he's 6'4" tall so not a lot of physical similarities! Blue eyes and blonde hair, that's about it!
Ed - Thank you and you're right, the costoplasty does not sound fun!

xxx

**Pooka1** · 12-02-2012, 09:20 AM

Hi.

I just wanted to say that the set of things others will notice is probably A LOT less than what you notice because they don't know what to look for and you do. For example, there are any number of cases, myself include, who missed even large curves in their children's backs. That's because the brain probably just associates any asymmetry with simply standing funny. The brain can't associate it with scoliosis if the brain is unaware of that condition.

I looked at your picture again and I think your shoulders and hips are level and you say your rib hump on your back is gone. Your result is so good that I would be shocked if anyone not familiar with scoliosis would ever think you were asymmetrical. Even in a bikini. Naive brains simply can't go there. And then when you consider you had two large curves, I am thinking your surgeon must be one of the best. I don't think it gets better than your result.

None of this is meant to downplay your valid feelings about your result. I am just trying to provide an accurate big picture that you might use to place your result in context.

**LindaRacine** · 12-02-2012, 11:17 AM

Hi...

I think this is absolutely a problem of expectations. Unfortunately, you're about as close to perfect as can be expected. Derotating the spine doesn't completely change the rib cage, because it is deformed. Even a costoplasty (thoracoplasty) probably wouldn't make you perfect.

I don't see a lean in your picture, but it wouldn't surprise me if your pelvis is tilted a tiny bit. If that's the case, you can wear a small lift inside your shoe.

Hang in there. The good news is that your curves are likely never get any worse, and the only person that will ever know that you have a slight asymmetry will be you.

Regards,
Linda

**titaniumed** · 12-02-2012, 12:31 PM

Vic

We really are fortunate that the technology has improved in the last 50 years. This is something I think about often seeing all the scoli�s and kypho�s coming out every day.....there are so many of us. The scoli�s that lived before our time or at least before the turn of the last century really paid a price just trying to live and function.

I consider myself quite fortunate. The luckiest person on the planet sometimes. Its great to have that 2nd chance and to come out pain free....and it does change you and your outlook. People panic about things, trivial issues, and I just smile at them.....It helps to be able to relax, which you will be able to do in time....after you heal some more.

I agree with Sharon, people don�t notice and don�t have a clue. And if they do, and have their own mental problem with it, well, they can use some help because its not what we look like outside that matters, its what�s inside that counts.

Having a positive attitude is important in everything we do, and especially in surgical recovery. Sometimes things can be pretty hard, but it seems that these low points always pass, and we turn a fresh page. It doesn�t matter if it�s a surgery, or your home burns down, always expect a brighter day ahead, you know it will happen. Surgical recovery teaches patience because recovery can happen slowly.....we push ourselves and test the limits and create pain, then after time passes, we heal some more. Adaptability is key, I didn�t think I would EVER be able to get my shoes on again, I was wrong. Now, I put ski boots on, one of the ultimate full fusion challenges. I�m a fused contortionist. LOL You stretch to your limits, and make the best of it. Don�t try this for at least a year or more ok?
We can talk about the shoes later....

Accept and adapt to your new self, its going to be challenging but the rewards are so worth it.

You cannot judge your recovery for at LEAST 1 year. Many of us continue healing for years.....

And keep smiling!

Ed

**king14** · 12-02-2012, 10:23 PM

I understand

Hi Vic I completely understand, I WISH I looked like you after my surgery. I am almost 3 months post op and I'm still soooo crooked, high hip, leaning way to the side, go in on only one side of my waist, look wretched! Look way worse tHan before surgery. I have no pain, but you want to look good, normal, after going through something like this - especially after looking different your whole life.... Needless to say I'm not happy. I have been distant from the boards because I don't want to complain about aesthetics when so many are suffering from horrible pain... But the mental anguish is (I believe) equally as bad

you look fantastic!! So don't worry!!!

**mabeckoff** · 12-02-2012, 10:48 PM

Originally posted by king14 View Post

Hi Vic I completely understand, I WISH I looked like you after my surgery. I am almost 3 months post op and I'm still soooo crooked, high hip, leaning way to the side, go in on only one side of my waist, look wretched! Look way worse tHan before surgery. I have no pain, but you want to look good, normal, after going through something like this - especially after looking different your whole life.... Needless to say I'm not happy. I have been distant from the boards because I don't want to complain about aesthetics when so many are suffering from horrible pain... But the mental anguish is (I believe) equally as bad

you look fantastic!! So don't worry!!!

What has Dr Bederman told you about your situation?

**tae_tap** · 12-03-2012, 07:44 AM

Originally posted by king14 View Post

Hi Vic I completely understand, I WISH I looked like you after my surgery. I am almost 3 months post op and I'm still soooo crooked, high hip, leaning way to the side, go in on only one side of my waist, look wretched! Look way worse tHan before surgery. I have no pain, but you want to look good, normal, after going through something like this - especially after looking different your whole life.... Needless to say I'm not happy. I have been distant from the boards because I don't want to complain about aesthetics when so many are suffering from horrible pain... But the mental anguish is (I believe) equally as bad

you look fantastic!! So don't worry!!!

King,

I would give anything to just be out of pain! I am 6 weeks post op and chose to skip the idea of having a straight spine and appearance to retain range of motion and to just have the pain disappear. I will post pics when I have Internet other than my iPad because I have not figured out how to do it from here. I realize it is still early to be out of pain, but the fact that your pain is gone is a miracle! Remember, it is not your outer appearance that people get to know and love. It is who you are. That is how so many of us on these board become so close without even seeing one another. It is because we get to know the person without sight. You have to learn to love the you that God created inside and out. He makes no mistakes and to Him you are perfect. Since the pain is gone (which is the main reason to have this extensive surgery) then love your whole self.

Tamena

**Irina** · 12-03-2012, 12:51 PM

Originally posted by king14 View Post

Hi Vic I completely understand, I WISH I looked like you after my surgery. I am almost 3 months post op and I'm still soooo crooked, high hip, leaning way to the side, go in on only one side of my waist, look wretched! Look way worse tHan before surgery. I have no pain, but you want to look good, normal, after going through something like this - especially after looking different your whole life.... Needless to say I'm not happy. I have been distant from the boards because I don't want to complain about aesthetics when so many are suffering from horrible pain... But the mental anguish is (I believe) equally as bad

you look fantastic!! So don't worry!!!

Hi King,

I am so sorry to hear about your cosmetic result. I won't be a happy camper either... I agree that being out of pain is the most important goal of this surgery, but many of us are looking forward to at least some cosmetic improvement, espeically when we are youngish. I remember that you had a very flexible spine and thought that you'd get good correction... I wonder what your doctor says about it. May be some PT will help? I truly hope that somehow your appearance will improve and you'd be happy with the outcome.

**JenniferG** · 12-03-2012, 02:21 PM

Originally posted by king14 View Post

Hi Vic I completely understand, I WISH I looked like you after my surgery. I am almost 3 months post op and I'm still soooo crooked, high hip, leaning way to the side, go in on only one side of my waist, look wretched! Look way worse tHan before surgery. I have no pain, but you want to look good, normal, after going through something like this - especially after looking different your whole life.... Needless to say I'm not happy. I have been distant from the boards because I don't want to complain about aesthetics when so many are suffering from horrible pain... But the mental anguish is (I believe) equally as bad

you look fantastic!! So don't worry!!!

Hi King, I'm sorry you feel so bad about your appearance. I can't blame you for being disappointed if you look worse than pre-op. It's important to be pain-free but yes, you would want to look better, even if you're not expecting miracles. Don't stay off the forum. All our feelings are valid and there is always someone out there who'll read your post, and think, "I'm not alone."

Our results vary so much. It's great to hear of excellent outcomes but we need to hear about all outcomes.

I'm wondering what your curves were pre op and post op. Did you gain height and how much? Have you lost loads of weight? Are you planning on asking your surgeon about your appearance? We'd all be interested in hearing what he has to say.

**JuliaAnn** · 12-03-2012, 05:29 PM

Vic, you look great! Your shoulders are so straight. And wow, to have little pain at 4 weeks post op is pretty impressive.

While I was in the hospital, Dr Hey told me that the way I looked now would not be my final appearance. He said it takes weeks or months for the ribs to settle into their final position. That makes sense. Three weeks after my surgery, my biggest pain wasn't my multiple drilled bones but rather the stretched and reconfigured ribs, with stretched nerves and muscles. At one point, I even went to the emergency room thinking I broke some ribs or had a gall bladder infection because the pain was so bad. It took a couple weeks with a heating pad for the pain to subside in my ribs. The muscles and nerves are slowly growing to fit the new shape of my rib cage, with which I am very pleased.

I'd give it a little more time if I were you. In the meantime, you really do look terrific.

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