SWEEEEEET!!

I asked Dr. Gelabert about this. Both Gelabert and Angle told me they always go for the transaxillary rib resection with partial scalenectomy as it is a more complete decompression than scalenectomy only. They do the full scalanectomy only if the patient experiences recurrence of symptoms down the road.

Dr. Ahn told me he used to follow this same approach but will now perform scalenectomy only, in some cases. I think Dr. Ahn would have to strongly believe that your problems are due to scalene hypertrophy only to take this approach. He said that even then, he may have to take the rib once he gets you open and sees everything that is going on. I recommend you undergo Ahn's angiogram/angioplasty test to see if you are truly a candidate for scalenectomy only. I was not a candidate as I failed the scalene block so I didn't bother going through with Ahn's angioplasty.

Dr. Angle convinced me to just lose the rib because we don't need it anyway and there was no real advantage to keeping it. Also, women here in LA get the lower ribs removed for cosmetic reasons all the time.

If you really don't want to lose the rib you could go to the neurosurgeons who treat this, Dr. Aaron Filler or Dr. Justin Brown. But, what do these guys do if they open you up and find out you need your rib removed, or have some other vascular complication? I heard Filler sends you back to Ahn for a second surgery. I guess Brown would send you over to a vascular surgeon at UCSD.

The only surgeons I felt comfortable with cutting me were Gelabert and Angle. My surgery was with Angle. Gelabert and Angle told me Ahn is a great surgeon but his bedside manor simply doesn't compare to the other two.