Today I went to a P.S. to have a consultation about my breast implants, that did not come out how I wanted. I wanted to discuss maybe changing to silicon implants, from current saline(put in 2yrs ago). I thought maybe this would correct the droopy look my breast have, as I wanted the "fake" look. He confirmed my suspiscion that the implants were definently over the muscle, and just sagging in my breast. Is it common for platic surgeons to just lie and do what they want? What can/should I do now
I Asked my Plastic Surgeon for Under the Muscle Implants, and He Put Them over the Muscle.
Doctor Answers (8)
It is possible but unlikely that any physician would intentionally give a patient misinformation, especially in this situation of your primary surgeon describing to you your initial surgery. Much more frequently is the case where a second surgeon makes statements about your current condition that seem to refute previous information that you were given.
The issue you are having is more likely implant dropout, which is what the second surgeon is describing. This problem can occur in anyone, especially with large implants, but can be exacerbated by surgical overdissection at the time of implant placement. In addition, submuscularly placed implants can also have another problem occur called 'window shading', where the pectoralis muscle is over dissected from the lower sternum causing the entire muscle to slide upwards, exposing the implant. The combination of dropout and window shading will give you an implant that was once placed submuscularly but is currently in the subglandular position. So its not so much that your implants are over the muscle now, but more accurately they have drifted below the muscle on your chest wall.
Now, let me also clarify some bits of information that I believe you have a misunderstanding of. Saline or silicone implants do not have a different impact on the appearance of your breast, and changing from one to the other will not make a difference in how you look. One exception is the extremely overfilled saline implant that will look like a ball and give an obvious fake look, as well as a very firm feel. In general, implants that are placed over the muscel will look more obvious (fake) than implants that are placed under the muscle. Please note however, that if the implants dropout, than the fake look seems to go away, at least in the upper poles of the breasts.
If you are unhappy with the appearance of your breasts, it is crucial that you consult with a surgeon certified by the American Board of Plastic Surgery, who specializes in revision breast implant surgery. Together, you and your surgeon will discuss your best options for revision surgery and it is likely you will have an excellent improvement to the appearance of your breasts.
Best of luck!
If your breasts are sagging, placing larger implants will not necessarily lift them. Commonly a breast lift procedure should be combined to improve the shape as well. I can not really comment on yoru other concerns because I did not do your original surgery and do not know exaclty what was done.
Over or under for fake look and droopiness correction
I am a little confused. You say you want a fake look and correction of droopiness. Generally this is better accomplished with over the muscle (rather than under) which is what you got. If you put the implant under the muscle, it will look less fake and you may be aware of more ptosis.
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Subglandular (relative to submuscular) placement of implants more reliably produces the "fake" look you were originally after. Also, understand that your final result reflects many variables, some predictable and others unpredictable. For example, the interaction of the mechanical implant with your tissue is unpredictable in advance, the amount of skin stretching caused by the implant is impossible to predict, your skin elasticity and post surgical settling also hard to know in advance. This is why a particular result is impossible to guarantee in advance. Every patient and every situation is different. Generally, plastic surgeons incorporate techniques most likely to result in the desired outcome.
If there is an element or elements of your result you are dissatisfied with, discuss each of these with your surgeon. It is unfair for me (or any surgeon) to comment on your problem specifically without more information, such as before and after pictures, a physical examination, and an understanding of exactly what was done during your procedure and after your procedure (post operative period).
Do plastic surgeons lie and do whatever they want?
A Board Certified Plastic Surgeon has been cleared by a very strict standard to be competent and ethical. This doesn't mean they all are all the time or that they might not change. You need to understand that lifting of your sagging breasts would not be accomplished by putting the implants above the muscle. You should get the notes from your surgery, the preop and op notes and find out what happened. It would be good for you to track the discussions that are documented in the record and see why there may have been a miscommunication between you and the doctor.
Also, it is not malpractice for a doctor to make a change of plans during surgery but in the case of above and below the muscle implants, these decisions are made before surgery and intraoperative findings almost never change these plans.
Answer to your question
I am sorry to hear about your problem. To answer your question, no it is not common for plastic surgeons to lie to their patients and do what they want. Based on the experience you describe, I would suggest you request a copy of your operative report. This way you can read exactly what was done. It will also be of benefit for any future surgery you may have to have your operative report available for your new surgeon.
Best of luck.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.