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Lateral Capsulorrhaphy, Inferior Capsulorrhaphy, Areola Reduction, Implant Exchange

UPDATED FROM MissTheCleavage
11 months post

2 months post update

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MissTheCleavage
$4,650
I’m officially two months post from my second revision. Just playing the waiting game. Not much has changed.
I think my right needs a lift again. Not happy with the ratio. I wanted more like 45:55 or 50:50. My nipple/areola centered over the breast mound... Dr. Diaco says it’s something like 66:34...or something like that because I said I felt like mine were hanging low and I liked 45:55 and he said that wasn’t standard and then rattled off an odd ratio.
Since my last update I’ve had two follow ups and two ultrasound therapy treatments on my left. Not sure it’s helping because I stand by my theory that the asymmetry with my left is either 1. a distribution issue (because I have more side boob on the right, and the left is still too medial) or 2. the left really is bigger and a smaller implant should have been used to begin with. I’ve been concerned since my first surgery two years ago.
I don’t think I ever mentioned in my updates that prior to this second revision, I had my annual mammogram and they were so concerned about the asymmetry with my left that I had to have further testing and two actual ultrasounds on my left to rule anything out. It just looked so much bigger than my right one so they were concerned. Dr. Diaco said it’s common to have further testing like that after implants. Anyone else have a little scare like that? I was happy it wasn’t anything serious.
Anyway, at my appointment several weeks ago I had a mini breakdown and cried. I know he’s frustrated with me and he keeps telling me to be patient and that things will relax and settle and that it’s only been a month or now two months, but I’ve been doing this for two YEARS and really regret it most of the time. I have not woken up once over the last two years, looked in the mirror and said “wow, I love my results. I’m so glad I did this” like most of you ladies.... But he’s right in that I do just need to wait it out at this point... “stop chasing wet paint” he said ... so I’m just keeping busy and not stressing about what I have no control over.
So I still have the asymmetry issues with my left v. my right, I still have uneven nipple height, my left is still higher but I’m hoping it drops on it’s own without another surgery, I still have rippling only it’s higher up my cleavage because the implant is higher. I don’t like the new Round Goes Gummy Inspiras. I can’t recommend them. Mentor ripples less in my opinion and experience. And then of course what I’m really sad about.... my cleavage area.... I missed having cleavage before I got implants but now it’s not smooth because of the indentation from the sutures... he keeps telling me it will smooth out and it has started to I think. I’ve been wearing a strap to help encourage the left to drop which may help smooth out the skin where the suture is. He doesn’t think the strap will help but he said “give her one anyway” so they did and I think it’s helping. I’m also wearing a thong bra. This I decided to do on my own to keep my left from merging over again. I need to be realistic though and accept that I may very well be left with loose or draping skin in my cleavage area. Time will tell.
And then finally, my incisions... they started off looking great but now I have what might be spitting stitches. Dr. Diaco isn’t concerned but of course I am. I posted a question with pics for the RealSelf docs so we’ll see what they say.
I know how incredibly important it is to other ladies in my area to read review updates and see photos rather than just “star reviews” so here you go... hope it helps with your research...

MissTheCleavage's provider

Daniel Diaco, MD

Daniel Diaco, MD

Board Certified Plastic Surgeon

4.7 | 83 Reviews
PROFILE

Replies (5)

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December 7, 2017
Hunny I'm sorry you are feeling this way. It is always so hard when you just not it over ready. Mine re not even but I'm going to wait 12 mints. Lots of hugs.
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December 7, 2017
Thanks Spurt. I’ve been really emotional about it lately and I’m just trying to find ways to move on... it is what it is. I’ve never been a quitter and have always been a where there’s a will there’s a way but I think at some point I’m going to need to throw in the towel. I could go to another surgeon, Dr. Krau wanted $8,000 to redo them, and then ultimately I would love to go to Dr. Pousti, but he’d be more than $8,000 for sure. He’s so experienced though and so hands on and responsive. I’m not even his patient and he emailed me back at work. But do I want to spend another at a minimum $8,000 on my boobs? The answer is ‘no’ so I think I need to move on. I tried. It didn’t t work out like I had intimidated and I’ve wasted two years of my life that I can’t get back, sabbatoged a relationship because I’m super self conscious now... so I just need to move on....

I hope you’re doing well and healing nicely. I have been on much bit will pop over and take a look at your review. I think you’re wise to wait a year... see how you feel about them after some time passes.

As always, thanks so much for your support! Xxoxo!
February 12, 2018
Have you ever reviewed Dr. Scott Spiro in Nj. ? He does a lot of revisions but he's very pricey.
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December 7, 2017
Hi there, so sorry your see that issues continue. I understand how completely frustrating this must be. I also read in your other message below you’re considering moving onto another PS which I think is a good idea. If you don’t mind my two cents on the subject save the extra money and go to Pousti. Imo he’s a much better PS with more experience than the other one. His customer service also is much better, imo, if I had to gauge by the amount of complaints I’ve seen on this matter. One important thing to consider is revisions are usually more complicated requiring more experience and you want the best PS you can get. Although the other one you’re considering has rendered some ok results I have seen way too many complications (with his patients online) not to mention more cases of areola necrosis with his patients than others. I hope his fans don’t clobber me here; just going by what I observed. It’s not my intention to diss any PS here, but I’m sincerely concerned about your well-being and would hate to see you go out of the frying pan into the fire. Wishing you the very best and that you find resolution at some point.
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December 8, 2017
I absolutely agree. I don’t want to make the mistake of not spending a little extra and then end up spending more in the long run. Staying local isn’t always the best decision. And thanks for posting the travel tips! Did you go all by yourself!? That was my concern too. If I drag a friend I would feel obligated to pay for travel expenses for her too. But my only real concern is not being able to carry a bag, or having to lift a bag. I guess I would actually have to ask for help! Which I never do. I do everything on my own! But I’m sure if I asked someone on the return flight to store my bag in the overhead for me, they’d be happy to if I tell them I can’t because I just got a boob job :) LOL!

Lots of time to figure things out. Can’t do anything for at least six months anyway and I really truly am hoping the strap and the thing bra will help move things along.

I read online that massage and warm compresses can help with abscess and spitting stitches and granulomas?? So I’ve tried that and I swear it’s helping already... oh and using Aquaphor. I think my incisions look a little better. Two docs responds and didn’t think they were granulomas, but probably spitting stitches and nothing to worry about. So that’s good!
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December 8, 2017
Sorry thong bra not thing bra!
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December 8, 2017
My husband came with me. If he had not come I would’ve checked to see what nursing/after care was available in the area.

To respond to your other concern: with wheelchair assistance from the curb they will help you with your luggage. When you get to the departing flight (curb) go to the area where they’re checking luggage curbside and asked them to have a wheelchair sent for you. The person pushing the wheelchair will also carry your carry-on luggage. When you get to the terminal and they ask if you need wheelchair assistance getting onto the plane. Say “yes”.

You don’t ever have to explain your medical condition. Lol. Per hippa compliance they’re not allowed to ask. I just explained that I couldn’t lift for medical reasons. Flight attendants have no problems lifting bags up for you in the overhead. And taking them down as well. Btw, wheelchair assistance on your reservation should also give you a “pre-boarding” pass on most airlines. I forgot to mention I took Southwest airlines because there’s no penalty if you want to change your flight date last minute. Good luck.
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December 19, 2017
Hi miss how is it going? Xxxxxx
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December 26, 2017
Hey there! Just checking to see how you are doing and also wanted to wish you a merry Christmas and happy New Years!

I also wanted to see how you’ve been doing? Have things changed at all since your update earlier this month? I hope all is well.
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December 28, 2017
Hi Spurt, Hi Charm! Hope you both are well and enjoying the holidays. Happy New Year to both of you.

No changes. The skin between my cleavage has "relaxed" some as Dr. Diaco said it would.... which equals loose skin between my cleavage. I feel it looks deformed and I hate it. My left is still higher than my right but I hope if I continue with the strap, it will migrate down a little. Just sucks because I'm so limited to what I can wear because my left one is higher. You can see the bulge! So yeah, still asymmetrical, still one larger than the other, still uneven nipple height and still loose skin in my cleavage. I don't think those things will change.

I finally rated my review for my surgery as "not worth it." I'm waiting until I'm officially one year post from my revision (which is coming up pretty quickly) and then I'll rate this review as "not worth it." And then I'll wait a bit before rating my second revision. I'll start another review for that I guess. But I'm leaning toward 'not worth it' for the third surgery too.

While I think Dr. Diaco probably does a fine job on just breast augmentations (although we've got nothing to go by but a few reviews with NO photos here), I can honestly say he does shitty reconstructive procedures and revisions based on my experience. If other women look at my 3 surgeries and like what they see, great, use him..... but if not, steer clear and go elsewhere. You can get your boobs done by some really great surgeons in Miami for less than here in Tampa. I would go to Miami, or if money is no object save yourself the headache and heartache and go see Dr. Pousti in San Diego.

Anyway, there is nothing I can do about my boobs. Not only do I not have the funds, but mentally I don't think I can deal with the recovery period again.... getting someone to help with my dogs, taking more time off work, it's been two years since I started this [RS bleep] and mentally drained. I've had no social life. Sucks but there's nothing I can do about it. It seriously was an awful mistake. I look at my first review and how good my boobs and cleavage looked in a VS pushup bra and I just should have left well enough alone.

Don't mean to sound like a Debbie downer. Just being honest. I'll update with photos in a week or so once I hit one year post from my first revision and then again at 3 months post after the second revision.

I hope yours are doing well and that you're still loving them! You too Spurt!

I wish you both a very Happy New Year! Be safe! xo!!
February 11, 2018
I think you look great! I have somewhat of the same issue except worse.
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February 11, 2018
Thank you Kelly :) I looked at the pics you posted with the questions you asked the RS surgeons.... did you get high profile or moderate plus profile? Also, did you get just a lollipop lift or full anchor? The shape looks similar to mine after my first surgery.... a lollipop lift with moderate plus. Definitely not the look I was after. I don’t think my surgeon understood my goal look even though o provided him pics. He finally converted to high profile and a full anchor and I’m definely happier with shoe than after my first surgery and I do have more upper pole now with high profile implants. I see you’re in Fort Lauderdale... can I ask who your surgeon was? Are you considering a revision? Dr. Ari Krau and Dr. Hochstein do great work! I especially like Dr. Krau! Check out his reviews from some of the ladies here... if you can afford it though, go see Dr. Pousti in San Diego! By looking at you pics you need some pocket work (a capsulorrhaphy)...maybe some more skin excised too... we definitely have the same issues after our initial surgeries... I wish you the best! Please keep us posted! I know how disheartening it can be and sympathize with you. Take care! Xo!
February 12, 2018
Thanks for getting back to me. I go moderate 445. But my PS didn’t tell me before that they will be taking extra tissue. When I said they weren’t as full and perky as I thought they would be. Dr just said I should have got bigger implant. They didn’t even show me different ones. Just told me to show picture. So I did and all Dr said was ok we are on the same page. I guess I should have communicated better and spoke up.
UPDATED FROM MissTheCleavage
9 months post

One month post tomorrow

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MissTheCleavage
Feels longer than a month because next month with be 2 years since I started my journey. The upside to that is I'm still in touch with some of you so that means we've been "real friends" for two years :)

Had a follow up today. Nothing new to report really. My left is still high so he did an ultrasound treatment on it. The only thing I can find on this regard to capsular contracture but he didn't mean that he thinks I have that. I think the point of doing this is to soften the capsule so the implant drops into the pocket and rounds out. If anyone had any experience with ultrasound treatment let me know. My left does feel further than my right but it always has. It's always been larger and firmer, even after my first set of implants.

Anyway, that's pretty much it for now. I go back in 10 days for another exam and another treatment.

I think my incisions look pretty good for 4 weeks. I'll start with Biocorneum now. Oh and he still feels there is nothing to be concerned about with where the skin is from the internal suture in my cleavage and says it will continue to smooth out. We will tackle the uneven nipple height in a few months after we see what the lefty does.

Hope you all are doing well and Happy Halloween!! ????????????

Replies (3)

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October 31, 2017
I hate that even with the new format/layout whatever you want to call it with this site is that we still can't edit a post. I just want to fix my typos! "Further" = "firmer!" And what I meant was that my doctor did not mention that I have CC but the only thing I can find regarding using ultra sounds after breast augmentation is as a treatment for CC. Has anyone else had ultra sound therapy on their implants?
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October 31, 2017
Hi there, Your pics look great! I agree your incisions looks very good. However sorry to hear you’re still experiencing issues with your left side. I’ve never had ultrasound on my implants but I did have recently have an ultra sound treatment for my lower facelift at another PS med spa clinic. I was told it was suppose to be helpful in breaking up scar tissue and reducing swelling, so I imagine that’s what it might do for implants.

It seems in the doctors in the Q & A section here have mixed opinions on ultrasound treatment. But for the most part it appeared the majority of the PS there feel there’s no harm in trying. In fact my own PS told me I could go ahead and do the ultrasound for my face; but he also mentioned that he wasn’t aware of any firm evidence that it would help. Interestingly there are currently clinical studies being conducted right now with “Aspen ultrasound system” for treatment of grade III capsular contracture. From what I’ve read it won’t be wrapping up until September 2018. However it is a little promising that somebody is willing to invest in a randomized controlled study on this; imo it means there must’ve been a significant amount of anecdotal evidence to support that this ultra sound system could be helpful. Not to mention these kind of studies are very costly. Talk later. :-)
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November 1, 2017
It does in deed sound like it's safe, but not a lot of evidence it actually works... so time will tell. I may start a whole new review on it since there's not much out there yet. I read up on the Aspen system. Hopefully it turns out to be an option that works effectively! xo!
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November 1, 2017
I think you are looking great! From where you started with the concerns you had and where you are now, you look good!! :)

I have been curious about the ultrasound as well, so I am very intrigued to hear if this works! :)
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November 1, 2017
I will keep you posted on the ultrasound for sure! Especially because there are not many reviews on it so I may start one.... Quick question though - and I haven't even looked through your pics again yet which I will do in a sec, but if it's not there... do you still have the Inspira sizing chart? I can not find it online anywhere. I need the one for the "full profile".... Mine are 485s and I'm wonder what the smaller size options are.... only because I'm really thinking that my left is larger than my right and I may need a smaller implant in my left. My left is high and has more volume toward the center of my chest and there isn't really anywhere for it to go. When I feel both breasts with my hands, it just noticeably larger. And the fact that you can clearly see it's larger in clothing is bugging the crap out of me. I know I'm only a month out but I like knowing what my options are as a back up ...
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November 1, 2017
I don’t! I deleted it because I wasn’t sure if it was ok or allowed since it’s from another website. I do remember that one was a little trickier to find though. I will have to look back at your photos now that you mention this, but I wonder, is that side that’s larger, is the inframmamary crease higher? That could cause things to look and feel differently. at least that’s the case for me, and when you add a larger implant to it, it’s just more exacerbated or pronounced. Just a thought :)
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November 2, 2017
I will take a good hard look at my crease and see if it is! Over all though, I am happy with them now. I'm just really hoping the cleavage area smooths out. I don't like the extra droopy looking skin thing that's going on. Maybe he can fix that too when he fixes the nipple height if it doesn't smooth out. When stick my chest out of lay flat you can't see it, but just standing naturally .... ick .... I don't it. I keep telling myself I'm just now one month and I need to chill. But still, for the first time in 2 years, I'm actually not as stressed about them and I think I'm really going to be happy with them. :) xoxo!

Oh, and if I didn't say it already, congrats on the RealFriend appointment!!!! Well deserved! you've been posting here a long time and your reviews and posts and info were always and still are so valuable - they have been to me.

I wonder if Tiny would have an interest in being a RealFriend. I think they allow you to suggest people. Although I know how busy she is with school, work, etc. right now. I don't know if she'd be able to keep up with it. I find it challenging with my schedule too... Anyway, I'm going to check my crease and see of that is the issue!
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November 17, 2017
Just stopping by to see how you’ve been doing! I hope all I well
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December 7, 2017
Charm, I just saw that you posted here a few weeks or so ago! I’m so sorry I missed this. I hope you’re doing well! Not much info I can give you on the ultrasound therapy treatments. I’m still not 100% sure what it supposed to do for me! LOL. Everything I’ve read relates to capsular contracture, and he says I don’t have that. I think it supposed to soften the pocket? And then help the implant to drop. But I’m using a strap now and I think that’s helping a little bit. A little concerned though because the only place the implant has to go is down and I don’t want to be in the same position as I was before. It really needs to be let out a little laterally and moved over away from my cleavage, which attempted to do, and I just moved my implant up but not over. But anyway, just more waiting as always. Story of my life! I’ll pop over and take a look at your review later. I haven’t been out a lot lately. Hope you’re doing well! Xxoxo!
UPDATED FROM MissTheCleavage
9 months post

Just adding a comparison photo

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MissTheCleavage
Looking better I think ????

Replies (5)

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October 18, 2017
They sure are. I can really see it. Xxxxx happy healing
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October 23, 2017
Thank you! Just patiently waiting for things to relax... I’m 3 weeks tomorrow so I have a long way to go!
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October 18, 2017
I think so too. Looking fantastic! :-)
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October 23, 2017
Thanks my friend! Hey... so I think you were the one that said that sometimes surgeons do not like using two different sized implants.... do you know why that is?? I can’t find anything on that. I do sometimes think my left is larger and wonder if I need a little smaller implant. Just thinking out loud! Could just be swelling but I’ve always felt it was larger. Always looked larger but I thought maybe it was just because it was malpositioned after my first and second surgeries...
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October 23, 2017
Hi. I can’t answer for all surgeons what the reasons are. I’ve just read in some reviews as well as the doctors Q & A section that some surgeons do not like to mix up the implant size when the breast size difference is minimal. For one as the breast gets larger of the size difference becomes more minimal... if you do the math. Another reason I’ve heard is the size difference can affect the shape of the breast. One thing also to consider is that most people don’t have breasts that are the exact same size and shape. Also sometimes the breast made appear to be larger but it really isn’t. It could just be the density of the tissue on one side is different and sagging more than the other side.
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October 23, 2017
Sorry my message posted before I meant to. And please excuse all my typos. In any case this may be an interesting question to post in the doctors Q & A section here.
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October 21, 2017
Yep! Coming alone nicely! Wish I could give you a thumbs up emoji but it won’t work on here, lol
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October 23, 2017
Lol! Maybe once the new RealSelf platform officially rolls out we will be able to use emojis! Thank you though! I’m just back to practicing patience ... and healing .... again ... But I’m an old pro at it now! :)
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October 23, 2017
Yesss!
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October 23, 2017
Thanks Rose :)
October 23, 2017
You look great !! Glad you are almost at the end of your journey. I'm still trying to find a breast revision surgeon. I live in nj. My ps died march. He screwed up my symmstia repair. I now have bottoming out and lateral displacement and need inframmary fold reconstruction. I wasted so much money on this crap.
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October 23, 2017
Thank you my friend. I hate that you are going through this too. We have very similar stories and issues.... even now. I’m still mildly concerned about my cleavage area but I know I have to be patient while I heal.... let things relax and settle.... I don’t know what your financial situation is but if you do decide on another surgery, try and go see Dr. Pousti in California. He has the experience, lots of experience, with symmastia and other complicated issues. I’ve spent $15,000. It would have cost that if I went Dr. Pousti to begin with. Dr. Krau in Miami is good too. I’ve not heard of any really good surgeons in Jersey. Is NYC an option for you?? Please keep us posted. I know you pop in on my review from time to time so at least we can keep tabs on you that way! If you need an ear, we are always here to listen. xxoox sweetie! Hang in there!