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Dr.
Marialyn Sardo Chat Transcript
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10/24 Dr.
Marialyn Sardo from
LA Jolla, CA
Chat has been edited by Dee for easy reading.
Visitors names have been changed for their
protection.
Note: These answers are the opinions of
the doctor. |
Dr. M Sardo :
Were any of you able to catch the show I did on the learning channel
on BA?
Nikki :
You did a show on
TLC???
Nikki :
I've seen almost all
of those
Dr. M Sardo :
Yes, It aired 10/16 "A Personal Story"
Jac :
I saw the promo on your web page, that was about it
Dr. M Sardo :
I think it will repeat on Nov 30
Nikki :
Well, that is neat.
Did you enjoy making the show?
Chemeke :
Is is running for the
first time?
WebMaiden :
Great, welcome. What is you name, f jac?
Jac :
Faith
Dr. M Sardo :
Yes
Chemeke :
I will definitely look
for the show. What does it cover?
Jac :
so, well, what exactly goes on in these little chats?
Chemeke :
And does it show that
actual surgery?
Dr. M Sardo :
The show covers my patients story about wanting breast implants , then
follows her through the process
Chemeke :
Oh! Sounds great Dr.
S!
Nikki :
Well, Faith, tonight
we have a female Plastic surgeon in the room joining us
Dr. M Sardo :
Daytime TV so not too graphic
WebMaiden :
Dr. S, anytime you do a show, if you let me know the airtime/channel
I can add it to your page & the mainsite.
Jac :
I've noticed heh
Dee :
You can ask questions
and we try to give the doctor a chance to answer
Nikki :
ask her anything you'd
like
Chemeke :
Ah, darn! Daytime?
Dr. M Sardo :
I will update when I know for sure when the repeat is
Chemeke :
<VCR illiterate
Dr. M Sardo :
OK what questions do you have
WebMaiden :
We don't know how to tape shows off of cable either!!! Sad!
Blanck :
thanks Dee! :-)
Dee :
YW
Jac :
a'right... well... I'm just going to go to my *personal* question...
when doing a BA, can you also do a correction for nipple inversion?
Dr. M Sardo :
Yes, there are many techniques depending on the inversion
Dr. M Sardo :
or whether you want to maintain function of the ducts
Nikki :
In your experience
dealing with patients, how long do they normally experience occasional
pains?
Jac :
I was under the impression that most of the time use of the ducts is
eliminated when doing nipple inversion surgery
Dr. M Sardo :
about 3 months for intermittent nerve pain to the breast
Chemeke :
Question: Dr. S, In
your experience, how long does it take for textured unders to fully
drop? (I have tex silicone and they are moving VERY slowly!!!)
Dr. M Sardo :
Yes it does usually scar the ducts
Dr. M Sardo :
I don'
Arella :
(a/k/a Aquarena) Dr. S....how
do you feel about the new Inamed (formerly McGhan) 410 Cohelsil gel impkant??
Dr. M Sardo :
I don't like to think of dropping, but settling. Usually done by 2-3
months
Nikki :
ooohhh! I want those!
Have you done any augmentations using those?
Dr. M Sardo :
I haven't used the new gels yet, still experimental
Arella :
Was wondering if you had seen
them and your thoughts--I am going to be in the study
Dr. M Sardo :
But they should be useful I'm wondering if they will require a larger
incision
Arella :
Hmmm...was going to go through
the areola again...
Jac :
i have no clue what those are... can I get an enlightenment check?
Dr. M Sardo :
The gel is more cohesive so if they rupture the gel will be less likely
to get into the tissues or migrate
Dee :
Aqua, the cohesil
are a thick silicone non-bleed implant. It's made by Inamed (formerly McGhan) and is currently
part of a core study
Dr. M Sardo :
Inamed (formerly McGhan) 410 gels don't flow if you cut a wedge out of them, they are
a thicker gel
Arella :
In your experience....if you
get capsular contrature once...are you likely to get it again???
Chemeke :
They are firmer than
reg silicone, but my PS put 450's (reg) through the areola, Boom
Jac :
thx
Dr. M Sardo :
I have had 2 patients in 14 years who had repeated contracture, But
I know of another woman who had surgery 5 times and has not had cc for
15 years
Arella :
My main concern for my re-do
after 14 years (!) is CC again! I have tennis ball breasts!
Dr. M Sardo :
Are they under the muscle?
Arella :
They aren't now but they will
be...
Dr. M Sardo :
textured or smoothe
Arella :
they are smooth now but will
be textured
Dr. M Sardo :
Sometimes it is hard to get it under the muscle once they have been
on top for a while. Going with textured this time should really lessen
your chances for repeat contracture
Arella :
I'm in Los Angeles and have
seen Dr. Cambre in Bev. Hills and Dr. Teitelbaum in Santa Monica....any
thoughts?
Dr. M Sardo :
You will really enjoy them after the redo
Dr. M Sardo :
I trained in LA but I 'm not sure of the specifics of these doctors
Arella :
Thanks so much...don't want
to HOG the conversation!
Chemeke :
Dr. S- back to my "dropping"
tex under thing.... Mine aren't where I'd like them to be yet. I still
have a lot of upper fullness. Do you think my PS might put me in one
of those horrid straps? LOL (it's been 3 months)
Chemeke :
LOL Nik, NOT I!
Dr. M Sardo :
If you haven't used a compression band, I would try that . But if they
are very high, they might need repositioning
Dr. M Sardo :
What size, Under muscle or not?
Chemeke :
hmmmm, he did lower
my creases... it's just that I never had much breast UNDER the nipple
(450cc's under)
Dr. M Sardo :
sometimes large implants in small breasts take a while to settle
Nikki :
How long do you usually
give them to drop on their own before deciding that another surgery
would be necessary?
Chemeke :
OK- I will TRY and
be patient!
Chemeke :
Good ? Nik!
Dr. M Sardo :
It depends on the person. But if you started with l\very little tissue
under the breast it id difficult to stretch that skin.
Dr. M Sardo :
I like people to wait 6mos to a year (unless I thought they were not
going to get better )
Chemeke :
<small A, stretch
marks underneath from breastfeeding... I was probably a D then... and
have a D now
Chemeke :
Oh, then I am feeling
a LOT better. Thanks, Dr. S
WebMaiden :
So it is the skin that hold them back from "settling" rather than the
muscle, or both?
Dr. M Sardo :
skin in some cases, muscle in others, both in others
Arella :
Is $9,600 fair for a re-do
(incl. surgical center, Implants, anesth.) in Los Angeles? I think it
is but just wanted your opinion since you're in Newport.
Dr. M Sardo :
But frankly, this is a rare issue in my practice
Nikki :
WOW! That sounds like
way too much to me.
Dee :
Dr.S...what is
your preferred incision site?
WebMaiden :
Are there any exercises one can do to better prepare for surgery (such
as stretching the chest muscles?)
Dr. M Sardo :
I'm in La Jolla, which usually less than LA about 1/3 that cost
Arella :
Whew....
Dr. M Sardo :
I do about 50%periareolar, 50%inframmammary --patient preference usually
Jac :
are there any situations (i.e. physical, medical, ect) in which you
would advise an individual not to have a BA?
Dr. M Sardo :
I don't recommend any exercises
Dr. M Sardo :
Yes, there are many medical conditions in which elective surgery would
not be safe
Mo :
hello, all...
Dee :
Hi Mo
Nikki :
Hey girl!
Chemeke :
Hi Mo!
Mo :
sorry i'm late...
Nikki :
what about a heart
murmur?
Crystal :
hiya Monyeen
Jac :
I'm asking because I have a history of breast cancer in my family, and
i was wondering if it would be advisable not to have a BA because of
that
Dr. M Sardo :
An innocent heart murmur is no problem
Arella :
Can't you get a test done
to see if you have the breast cancer gene?
Nikki :
phew...lol. That's
what my PS also said, but I like to hear other opinions. Thanks!
Chemeke :
Dr. S, Have you heard
of the study that showed that implants caused more antibodies to occur
in the breasts and therefore reduced the chance of breast cancer?
Jac :
I honestly wouldn't want to know if I had the breast cancer gene if
there was a test
Chemeke :
I think it was a foreign
study
Mo :
I am 14 weeks post-op
tomorrow (yippee) one question: on my right I have scar tissue about
the size 1" x 1.75".. when should it soften?
Jac :
I honestly don't think there is any solid evidence of that, but that's
just from my research
Dr. M Sardo :
breast ca is so common, but that is not a strong reason not to have
breast augmentation statistics actually show no increased problems with
implants. And usually women with implants tend to find a lump earlier
than others because they are more
Dr. M Sardo :
likely to check their breasts
Jac :
huh, well, that makes sense...
Chemeke :
<feels hers all
the time!
Mo :
we can't keep our
hands off them. lol
WebMaiden :
Cheme-- LOL
Chemeke :
^5 Mo
Dr. M Sardo :
There does seem to be less breast ca in women with implants, I'm not
sure why
Jac :
do you have a reference for that study or just something that you've
come across?
Chemeke :
could it be that because
there's a foreign object in there, there are more antibodies?
Arella :
Can't something be found BEHIND
the implant though?
Jac :
interesting thought cheme
Dr. M Sardo :
No I don't think so
Chemeke :
I saw it on a TV show,
f jac, it was a show on all the studies that have been done post the
Dow thing
Chemeke :
and prior to
Dr. M Sardo :
The tissue is on top of the implant.
Jac :
question for all of you who have implants: are you happier now that
you have them?
Chemeke :
YES!!!!!!!!!
Dee :
ABSOLUTELY :-D
Nikki :
Being that you are
the 1st female PS that we've had a live chat with, I hope you don't
mind me asking, but have you yourself got implants? And if so, how long
have you had them? And have you experienced any problems?
Nikki :
Of course!
Mo :
OH YEAH
Nikki :
I would do it all
over again!
WebMaiden :
YES!
Jac :
was the pain bad?
Dr. M Sardo :
13 years,textured silicone, no problems
Arella :
I have loved them for 14 years
even though I have CC they still look ok and my love LOVES them
Nikki :
WOW!
Dee :
WoooHoooo
Jac :
wow =)
Mo :
Dr. S: I am 14 weeks
post-op tomorrow (yippee) one question: on my right i have scar tissue
about the size 1" x 1.75".. when should it soften? or will it soften?
it even sticks out when I lay down
Dee :
under or over
Dr. S?
Nikki :
^5 Dr. Sardo!
WebMaiden :
The pain depends on many factors, placement, the doc's technique, etc
Dr. M Sardo :
under,
Chemeke :
No, I've had worse
pain for sure
Dee :
cool...
Dr. M Sardo :
I would need to see you Monyeen to know
Mo :
ok. Just wondering.
I was told to apply pressure and it will EVENTUALLY soften.. I'll keep
waiting
Chemeke :
Mo, have you tried
the silicone sheeting or Mederma?
WebMaiden :
Ok, Dr. S & Boom, you need to fill out our implant survey, we don't
get to many with 10+ yrs!!!
Nikki :
Ok....mammogram question.
Does it hurt more before or after breast aug to have a mammogram?
WebMaiden :
I'll post the implant survey link at the end of the chat.
Chemeke :
<scared of the mammo!
Arella :
If you do a lot of lifting
and hold a long boom pole with a microphone on the end....(!) how long
till you can get back to your glamorous job?
Mo :
no... lori, maybe
I should.. We'll chat after dr. s. thanks
Dr. M Sardo :
Is it a skin scar or thickening in the tissue?
Mo :
thanks, Dr. S.
Nikki :
Chem...luckiny I don't
have to go for another 6 years at least!
Nikki :
luckily
Arella :
Sure...I'll do a survey
Mo :
thickening of the
tissue under inside
Dr. M Sardo :
mammogram is much better after aug they don't squeeze as hard
Mo :
like scar tissue...
where he cut the areola, going down towards my crease
Dr. M Sardo :
6 weeks until return to full activity and heavy lifting in my practice
Arella :
Thanks, Dr. Sardo
WebMaiden :
Dr. S, am I correct in saying you got your implants right around the
height of the silicone controversy (right before they were removed from
the market)?
Girlie :
what incision do you do
the most?
Dr. M Sardo :
88, controversy 90-91?
Dr. M Sardo :
half and half areolar, IMC
Arella :
Dr. S...are yours under?
Dr. M Sardo :
yes
Dee :
Candy...that's
1/2 areola and 1/2 crease
Arella :
Great...so glad to hear you
haven't had problems
WebMaiden :
Yes, I was thinking it was 90-91, but I guess that was on 10 yrs ago
(gosh, getting ahead of myself!!!)
Girlie :
ok, thanks
Mo :
dr. S.. do you believe
in massage of smooth, unders?
Arella :
The original doc who did mine
14 years ago I found (from links on this site) that he is under investigation
on more than a few cases!!!
Dr. M Sardo :
Well I mostly use textured, but we tell people with smooth to massage
every day.
WebMaiden :
I'm sorry to hear about your doc, but I am estactic that you found out
from my links!!!
Girlie :
what do you recommend
to improve the appearance of scars?
Mo :
you prefer textured
why?
Arella :
It's such an informative site!
WebMaiden :
Who was your Doc, boom?
Arella :
scary man...Dr. Alexander
Villicana
WebMaiden :
(Reb has always got to get the lowdown on the docs!)
Girlie :
my best friend went to
him too!!!
WebMaiden :
Ok, I don't know him, ever heard of him
Dr. M Sardo :
I have a less than 1% capsular contracture rate.
Girlie :
he was in pasadena at
the time!
Arella :
scary guy...yes and Arcadia
as well
WebMaiden :
Is he cert?
Dr. M Sardo :
But I know that half of the docs feel that under the muscle it probably
doesn't make any difference
Arella :
barely...
Mo :
excellent to hear
your CC rate!!! good work
Girlie :
we'll talk later arella
WebMaiden :
I do think under & tex R the best options for decreasing the chance
of cc
Arella :
absolutely
Dr. M Sardo :
If a patient wants smooth or has very thin skin I use them
Arella :
Have you used the anatomical
salines at all Dr. Sardo?
Dr. M Sardo :
I don't like anatomical because I think they are unnecessary
WebMaiden :
How do you determine thin skin?
Mo :
i wish they had silicone
gel rounds
Dr. M Sardo :
You know the 100 lb woman who has nursed 3 kids for example with stretchmarks
and damaged skin and virtually no breast tissue
Arella :
Hmmm... the 410 Inamed (formerly McGhan) 's I
want are anatomical...what do you mean by "unnecessary?"
Dr. M Sardo :
They are anatomical because the doctor that helped create them is into
anatomical,
WebMaiden :
LOL< I only had to nurse one child and my tiny little boobs sagged!!!
And I was only 21!!!
Girlie :
Have you seen the areola
incision keloid before?
Dr. M Sardo :
They will probably develop round later , but I don't know how firm they
are, to say if there is an issue with them
Arella :
My breasts were saggy and
I have no children!
Arella :
Luck of the draw....but we
can change that!
Dr. M Sardo :
But with saline and regular silicone round looks like a tear drop shape
on x-ray, but no problems with asymmetry if the implant shifts position
and they go flatter with lying down, more natural
Dr. M Sardo :
and most people want more superior fullness these days anyway
Melissa :
Me too, but I think
my sagginess is from weight gain and loss
Blanck :
Dr. S - I am getting textured,
round, unders....will I have any problems breastfeeding when I eventually
decide to have kids?
Crystal :
.
Dr. M Sardo :
I have only seen one areola thicken or hypertrophy but no true keloids
Dr. M Sardo :
it is rare to have problems breast feeding after implants assuming you
were going to be able to breast feed any way ( some people have trouble)
Arella :
Mine probably was too, actually.
Not even big gains or losses either.
Arella :
My friend is still happily
breastfeeding with saline implants
Dr. M Sardo :
If you are very concerned about it you might consider having your scars
place in the crease
Blanck :
ok thank you
WebMaiden :
Boom-they make a medicine treated tape to treat keliods, a friend used
is successfully on her areola after a lift
WebMaiden :
AND the scar was 3 yrs old!
Arella :
My scars on my areola--even
with the orig. scary doc are FABULOUS! You can BARELY see them--hoping
for that again with the re-do
Jac :
*smiles* sorry for going back to the subject... but... you said that
there are many techniques for re-verting an inverted nipples depending
on the inversion... i have an extreme inversion what kind of technique
would that require?
Dr. M Sardo :
there are steroid tapes, injections, silicone sheeting or gels, mederma
cream
Dr. M Sardo :
but you may need the scar surgically revised
Girlie :
same w/ my best friend
, Boom and she's had 3 incisions on the areola
Dr. M Sardo :
if the nipple can be pulled out with a thread and the constricting bands
cut. Or sometimes if there is some projection I cut out the dent and
sew it together
Arella :
I am getting VERY excited
about my re-do, girlies!!!!!!!!!
Mo :
amazing to me!
Jac :
well, there's no projection and it can't be pulled out =(
Girlie :
who are you going to Boom?
Are you still in southern cali?
Dr. M Sardo :
It can still be done but the ducts would most likely be scarred, I would
have to see you to give you accurate advice
Arella :
I think it will be Dr. Steven
Teitelbaum in Santa Monica, girlie
Jac :
*smiles* do i get any special discount for chatting with you here? (I'm
in pt loma)
Nikki :
Dr. S....do you see
a lot of women having re-dos just to go larger?
Dr. M Sardo :
Free consultation?
Jac :
isn't that standard ;-)
Girlie :
Oh, we have to talk later,
I've heard he's great and in the silicone study too
Nikki :
I had to pay for my
consult, Faith
Dr. M Sardo :
No, Most people seem to be happy with the size they are after surgery
Jac :
ooo... ok nikki =)
Nikki :
I had to pay $65.00
consult fee!
Nikki :
But, it got deducted
from the amount of my surgery.
Nikki :
IF I had the surgery
with him
Dr. M Sardo :
I charge 45, and spend 45min to an hour with you. It is deducted from
the surgery fee
Jac :
well yea... so basically they got money either way
Nikki :
lol
Jac :
*would like a consultation*
Dr. M Sardo :
Please call my office to arrange
Jac :
will do =)
Arella :
My consult $$ were all waived
and they all spent 1-1/2 hrs. with me which I must applaud them for
Dr. M Sardo :
that's unusual
Jac :
how many surgeries do you do in an average week?
Arella :
Time is money and I was really
overwhelmed that they waived their fees...probably because of the study
Nikki :
Dr. Sardo...do you
do a lot of reconstructive augments? Like for women that had breast
cancer and had to have a mastectomy?
Dr. M Sardo :
6 general anesthesia, 10 local
Mo :
do you do twilight
or a general for sedation?
WebMaiden :
U go F Jac, Dr. Sardo sounds like a great doc (but I already knew that!!!
;-)
Mo :
answered before I
typed it. Thanks
Mo :
at a hospital or your
own surgery center?
Dr. M Sardo :
I do some reconstructions, I used to do many, but our community leans
to lumpectomy and radiation
Arella :
I had twilight the first time
YUCK! and will have general this time. I woke up the first time--awful!
Nikki :
I've never understood
the difference between Twilight and General. I've had both and both
seemed the same. I was out cold.
Dr. M Sardo :
general anesthesia
Nikki :
well, that's good
that not as many are having to have mastectomies
Arella :
I woke up and felt the pressure
of him stuffing the implant in! UGH.
Nikki :
good
Dr. M Sardo :
general is safer you get less drugs and you have a protected airway,
and you definitely won't be aware of what's going on.
Arella :
You don't need to be part
of a Discovery Channel episode!
Dr. M Sardo :
what do you mean?
Mo :
where do you perform
your surgeries?
Dr. M Sardo :
my office surgericenter
Arella :
I woke up...no pain just felt
this ENORMOUS pressure in my chest...saw everybody in the surgicenter--very
weird
Mo :
thank you
Dr. M Sardo :
Always insist on a board certified MD anesthesiologist
Jac :
this might be a biased question -- but what are your opinions on some
of the other docs in the area?
Arella :
Dr. S....do you think it is
SAFER to do surgery in a surgicenter rather than a hospital? I kinda
think so....I've known too many people who got sick in hospitals
Nikki :
I once woke up during
a surgery to hear the nurses picking on my doctor about his singing....lol.
Luckily I didn't feel anything though! (BTW...this was NOT a BA related
surgery.)
Dr. M Sardo :
Can't really discuss that issue. Many are good and well-trained. Some
just have different philosophies
Jac :
hehe... nice, safe answer =)
Nikki :
lol
Dr. M Sardo :
Make sure the center is accredited. The hospital is OK but more bacteria
running around and usually way more expensive. Free standing surgericenters
are good
Arella :
I'm just thinking Germwise...safer
in a surgical suite than a major hospital
Chemeke :
Dr. S, do you use a
surgical tech AND a nurse in surgery (along with the anesthesiologist
of course) ?
Arella :
It is
Chemeke :
I think so too, Boom
Dr. M Sardo :
Yes
Nikki :
do you think you will
ever have a voluntary re-do or will you just wait until they HAVE to
be replaced, Dr. Sardo?
Mo :
what is your "fill"
procedure? do you overfill at all past specs to decrease rippling?
Jac :
how often (on average) will breast implants have to be replaced?
Dr. M Sardo :
Not sure, I have yearly mammograms so of course if there is any evidence
of rupture I would, but it is probably getting about time for me to
think about it
Nikki :
I know that most girls
I've talked to usually have re-do's to go larger. We don't get to talk
to many people that have had their implants for a long time.
Dr. M Sardo :
I usually over fill just to the manufacturers upper limit
Arella :
I do NOT think larger is better....trust
me!
Chemeke :
What do you consider
a LARGE implant Dr. S?
Nikki :
If you fill above
that it will void the warranty, Correct?
WebMaiden :
The larger they R the more likely they will sag
Dee :
Nicole...the mfg
reserves the RIGHT to void...depending on the day they're having when
the implant hits the lab, J/K
Dr. M Sardo :
most people go larger on a re do, but I am 102 lbs 5'1" and a C cup,
I think I will feel more athletic and youthful by not increasing my
size
Arella :
LOOK BETTER
not RIDICULOUS!
Mo :
Dr. S. how often do
you see rippling? very common?
Dee :
Hey Dr. S...you're
a tiny think like me...LOL
Arella :
Thank you Dr. Sardo!
Dr. M Sardo :
seeing rippling, 5%, feeling the implant closer to 80%
Dee :
oops...tiny thing
Jac :
very tiny =)
Mo :
thanks, Dr. S. i can
only feel mine, thankfully
Nikki :
I have to go everyone.
It was wonderful getting to talk to you Dr. Sardo! Thank you so much!
Dee :
I'm 5'4" 100lbs
Dee :
nite Nicole
Mo :
bye nikki
Nikki :
Nite everyone! Talk
to you all tomorrow:-)
Jac :
bye nikki =)
Arella :
I am 5'7" 130lbs. athletic
and a full C and look HUGE
Dee :
LYLAS
Arella :
Thank you!
Dr. M Sardo :
It is so individual!
Chemeke :
How many cc's do you
have Dr. S? (If you don't mind my asking)
Dr. M Sardo :
I was a strange B before, 240cc
Melissa :
Size is a tough choice...my
pre-op is Monday, so I better decide by then. :-)
Dr. M Sardo :
That is why I don't get obsessed with cc with people, and determine
it intraoperatively
Dee :
Dr. S...is there
a particular implant you use most?
Dr. M Sardo :
Mentor textured saline round
WebMaiden :
Ok, Dr. Sardo has given us an hour of her time. Thank you so much Dr.
Sardo, it has truly been a pleasure!
Dr. M Sardo :
Thank you so much, I have enjoyed it!!!!
Special
thanks to Dee for arranging our chat &
for editing the transcript.
If you are interested in being
a guest speaker/, please contact Rebecca.
Copyright©2006
All About Breast Augmentation
and Breast Implants Plastic Surgery Information by Rebecca.
All Rights Reserved
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