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Dr Disaia answers your questions here.....
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drdisaia
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PostPosted: Tue Mar 20, 2007 10:06 am    Post subject: Reply with quote

Boobsnj wrote:
drdisaia wrote:
Boobsnj wrote:
Hi Dr. Disaia,

Thank you so much for responding to all our questions.

I have Mentor Mod + 500 f/t 600. I started out with Tubulor breast and I am 8 months po. I have noticed that over the past few weeks I am getting a burning sensation under my right breast towards my cleavage. It doesn't happen often and I really haven't done anything strenous or out of the ordinary. I did notice that one day when wearing an underwire bra is when it started, apparently the underwire was digging in there. Do you think this actually have done something in there? It is not swollen or red and like i said it happens out of the blue even when i'm not wearing a bra.

Thanks again for your opinion.


It is difficult to know without knowing much about your case, but with silicone I would consider imaging the breast to look. At least have your surgeon take a look.


I don't have silicone, I have Mentor Mod + saline 500 filled to 600, not sure if this should make a difference in your decision. Also, I have noticed that they dropped significally, so maybe that is what the burning is. The implants getting settled.


"Moderate Plus" is a silicone implant series. When you type "Mod +" do you mean "Moderate Plus?" Well if you don't have silicone it might just be mechanical stretching of the muscle. Larger implants can do this.



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PostPosted: Tue Mar 20, 2007 10:09 am    Post subject: Reply with quote

rosebury wrote:
danielle06 wrote:
Hi Dr,

My queston is over time do the implants begin to lower more than in the first few months of having implants? I am asking this because I only have 275cc mod+ implants and I still have a slight sag of my breast tissue on the bottom of my implants. If I pull my nipple up an inch it is not noticable, so is there still a chance that my implants can lower or does it sound as if i may need a lift or bigger implant?? I am 7.5 months post op.

Just wanted you to know I have the exact problem. I have my own tissue sagging at the bottom of the implant and I'm almost a year post op. I hate it!!!
I will be going in some time this summer to get silicone and go larger. I'm hoping going larger will fill it all in so I don't have this problem again. I'll see what PS says. I know he originally wanted me to go 800 cc to fill in all my loose skin. I think I will go around 700 cc this time. I want the bottoms full like if I pinch the side of my boob a bit it looks perfect, otherwise I have the skin hanging slightly underneath.



Consider a lift. It sounds like that might help more than just increasing volume. See what your surgeon says as he can examine you and should therefore have a better idea.
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PostPosted: Tue Mar 20, 2007 11:33 am    Post subject: Reply with quote

Dr Disaia-

Thank you so much for answering all of our questions! It is wonderful to have you here! I am not sure what brand of implants you carry but have you heard anything about when Inamed silicone implants will be available? I am hoping to get gummy bear implants sometime soon for my redo when I go bigger. I know the FDA has approved them but are they available yet?

Thank You!!
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PostPosted: Thu Mar 22, 2007 10:36 am    Post subject: Reply with quote

Hello Dr. Disaia:

I am 4.5 weeks post op and am experiencing some mild pain in my right breast (at the top). In addition, it feels a bit firmer than my left and the crease seems to be higher. This could be due to the fact that my left crease was lowered during surgery but along with the other symptoms, I am worried about Capsular Contracture. I should also mention that I have Silimed silicone cohesive gel textured overs, 485 cc's. Would you mind taking a look at my picture (link below- taken today 3/22/07) and telling me what you think? I spoke to my plastic surgeon's office this morning and they have assured me that it's not CC. What do you think? Thanks so much!!!!

Heather
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PostPosted: Sun Mar 25, 2007 8:35 am    Post subject: New question Reply with quote

Have you ever had a patient that reacted extremely bad after viewing her own body after surgery?
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PostPosted: Sun Mar 25, 2007 2:15 pm    Post subject: Reply with quote

Hi Doctor,
I have what I believe is a pocket problem on one side on the outside. The left is smooth, full and round and the right is dented, straight and deformed with a visible/palpable fold. It's all getting worse and does get sore. Does a PS usually cover costs except anesthesia, etc. for such a redo? If I wanted to get silicone while getting the redo should he just charge me the difference in cost to my salines?
Thanks!
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PostPosted: Wed Mar 28, 2007 9:40 am    Post subject: Re: New question Reply with quote

KSmitha22 wrote:
Have you ever had a patient that reacted extremely bad after viewing her own body after surgery?

I am just curious if you have ever had a patient react so dramatically. If you have, how did you assist the patient in dealing with this? As FYI she is the one who took care of me after I had a benelli lift, augment and major lipo to my abdomen so she was completely aware of what to expect visually and mine was extremely severe in comparison to hers. I am just trying to help her get through this.

Thanks.


Fortunately this has not happened to one of my patients. I talk with my patients quite a while before operating and turn away those that seem to be seeking surgery for the wrong reasons. I show images of benelli wrinkling and its resolution to appropriate patients. That way they can turn me away if they like. LOL.

I think your friend may need some professional help. I would refer her to a local psychologist if she were here. What does her surgeon say?
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PostPosted: Wed Mar 28, 2007 9:47 am    Post subject: Reply with quote

rosebury wrote:
Hi Doctor,
I have what I believe is a pocket problem on one side on the outside. The left is smooth, full and round and the right is dented, straight and deformed with a visible/palpable fold. It's all getting worse and does get sore. Does a PS usually cover costs except anesthesia, etc. for such a redo? If I wanted to get silicone while getting the redo should he just charge me the difference in cost to my salines?
Thanks!


You need to talk to your surgeon on that one. We all handle this kind of stuff differently. I do lotsa stuff for good patients. Those that try to take advantage are shown the door.

They exist believe me.
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KSmitha22
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PostPosted: Wed Mar 28, 2007 11:44 am    Post subject: Re: New question Reply with quote

drdisaia wrote:
KSmitha22 wrote:
Have you ever had a patient that reacted extremely bad after viewing her own body after surgery?

I am just curious if you have ever had a patient react so dramatically. If you have, how did you assist the patient in dealing with this? As FYI she is the one who took care of me after I had a benelli lift, augment and major lipo to my abdomen so she was completely aware of what to expect visually and mine was extremely severe in comparison to hers. I am just trying to help her get through this.

Thanks.


Fortunately this has not happened to one of my patients. I talk with my patients quite a while before operating and turn away those that seem to be seeking surgery for the wrong reasons. I show images of benelli wrinkling and its resolution to appropriate patients. That way they can turn me away if they like. LOL.

I think your friend may need some professional help. I would refer her to a local psychologist if she were here. What does her surgeon say?


She is actually doing extremely better, I think it was a combination of just outright stress (going back to college full time) and the sheer shock of seeing the incision sites on her own body. Trust me - if she continues in any way shape or form I will get her help!
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PostPosted: Thu Apr 05, 2007 9:41 am    Post subject: Reply with quote

A little You Tube video with a few of my redos in it:

<object width="425" height="350"><param name="movie" value="http://www.youtube.com/v/gKy-9m85blA"></param><param name="wmode" value="transparent"></param></object>
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PostPosted: Wed Apr 11, 2007 10:42 pm    Post subject: Reply with quote

Hey That was Great


drdisaia wrote:
A little You Tube video with a few of my redos in it:

<object width="425" height="350"><param name="movie" value="http://www.youtube.com/v/gKy-9m85blA"></param><param name="wmode" value="transparent"></param></object>

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PostPosted: Tue Apr 17, 2007 1:34 am    Post subject: Question about Brest lift and evening out size difference Reply with quote

My SIL is getting a full lift and then saline implants. Her surgeon has said this is so he can over fill one to even out the size difference. I am concerned because I dont think she will be happy with the feel of saline. Plus wont there be a difference in the feel of the two breasts because one is overfilled??? Cant a surgeon just remove more tissue on the larger side during the lift? That way she can get the silicone? Appartently there is up to a cup sixe difference in her breasts.
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PostPosted: Mon Apr 23, 2007 8:54 am    Post subject: Re: Question about Brest lift and evening out size differenc Reply with quote

armychick wrote:
My SIL is getting a full lift and then saline implants. Her surgeon has said this is so he can over fill one to even out the size difference. I am concerned because I dont think she will be happy with the feel of saline. Plus wont there be a difference in the feel of the two breasts because one is overfilled??? Cant a surgeon just remove more tissue on the larger side during the lift? That way she can get the silicone? Appartently there is up to a cup sixe difference in her breasts.


Saline feels OK as long as the soft tissue covering it is thick enough. Silicone contracts (Capsular contracture) under thin soft tissue cover. Removing tissue should be kept to a minimum. There is a size difference between all breasts . It is just a matter of degree.
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PostPosted: Mon Apr 30, 2007 11:17 pm    Post subject: Reply with quote

Hello Doctor!
I had my BA today...and I know swelling is expected...I have pretty minimal swelling at this point, but I notice I am swollen in between my breasts. is this normal?? or is it a "uniboob??
I might just be paranoid!
other then that i love, love, love my new breasts!!!! Thanks for yout input!!

~Sara
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PostPosted: Sun May 06, 2007 6:16 pm    Post subject: Reply with quote

I am 19 days post op (I have 365cc saline over the muscle), and my left breast still lacks a crease. I mean it has NO crease at all. It never has. My right has formed beautifully, but left looks like a cone, and goes lower than the right. I have been clued in taht it could be bottoming out.. is thre anything my PS can do other than another surgery? Also, I noticed today that the whole left seems a lot emptier than right. Could there be a slow leak? It seems to be getting smaller, and emptier. I am totally lost, and my PS doesn't say much at all. HE didn't tell me ANY risks really at all. There isn't much on my paperwork, so I just don't know what to expect.

Please Help...
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PostPosted: Sun May 06, 2007 11:00 pm    Post subject: Reply with quote

liltexasgal wrote:
I am 19 days post op (I have 365cc saline over the muscle), and my left breast still lacks a crease. I mean it has NO crease at all. It never has. My right has formed beautifully, but left looks like a cone, and goes lower than the right. I have been clued in taht it could be bottoming out.. is thre anything my PS can do other than another surgery? Also, I noticed today that the whole left seems a lot emptier than right. Could there be a slow leak? It seems to be getting smaller, and emptier. I am totally lost, and my PS doesn't say much at all. HE didn't tell me ANY risks really at all. There isn't much on my paperwork, so I just don't know what to expect.

Please Help...


You really need to see your surgeon for something this complicated. I have no real idea of where you are here.
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PostPosted: Thu May 10, 2007 5:37 pm    Post subject: Reply with quote

Is there any exceptions for the "22+" rule with silicone implants? I'd like to get my saline replaced with silicone. I would really hate to wait til I'm 22!
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PostPosted: Wed May 23, 2007 5:36 pm    Post subject: Reply with quote

Hello Dr. Disaia:

I'm in need of your opinion, when you have time:

The pocket on my L side is too big (long story), therefore, the implant rests too far laterally causing discomfort and I lack upper pole fullness. My PS is strongly opposed to reducing the pocket with sutures because he's concerned with causing permanent nerve damage/pain. His recommendation is to switch my current smooth silicone implant to a textured silicone implant. He feels that this would reduce the pocket size and reshape the breast. Do you feel that this is a viable option - would it work?

Thank you!

P.S. I'm almost 7 months post-op.
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PostPosted: Thu May 24, 2007 12:52 pm    Post subject: Reply with quote

Hello... curious as to your opinion on a mesh sling? what it is used for and if you have used this procedure and do you value it?
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PostPosted: Sat May 26, 2007 1:24 am    Post subject: Reply with quote

Luxx wrote:
Hello Dr. Disaia:

I'm in need of your opinion, when you have time:

The pocket on my L side is too big (long story), therefore, the implant rests too far laterally causing discomfort and I lack upper pole fullness. My PS is strongly opposed to reducing the pocket with sutures because he's concerned with causing permanent nerve damage/pain. His recommendation is to switch my current smooth silicone implant to a textured silicone implant. He feels that this would reduce the pocket size and reshape the breast. Do you feel that this is a viable option - would it work?

Thank you!

P.S. I'm almost 7 months post-op.


I actually tend to fix these cases with sutures. I haven't caused any problems yet doing so. These can be hard cases though so I can't fault him. Maybe his technique works for him. It wouldn't give me enough control.



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