Dr. Marialyn Sardo Chat Transcript

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!!!!

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