I am 115 lbs. 5'7". A-C. We agreed to go with a high profile, smooth, round, saline submuscular implant. Surgery in August. PS talked to me, marked where the incisions would go, then waited until the OR was available. Laying on the Operating table, PS informs me that he thinks we should go Subglandular because of my shape. I question the wrinkling due to be so skinny. He felt we would be okay. Trusted him. Now, I am wrinkling and there is a lump. What are my $rights w/ his unprofessionalism?
What Rights Do I Have? PS Changed the Operating Procedure As I Lay on the Table Hooked Up to IV and Ready to Go.
Doctor Answers 8
Miscommunication between Patient and Plastic Surgeon
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Changing the surgical plan....
Cosmetic surgery procedures should be thoroughly discussed by the patient and physician, and a detailed surgical plan laid out. The risks and benefits of the procedure and options for alternative procedures should be also discussed.
If for whatever reason the plan has to change, the same process should happen. Ideally Not on the operating table.If you signed an informed consent for a submuscular augmentation, a new consent should have been provided (assuming no drugs were given to you prior to signing the new consent.) .
Being very thin is yet another reason for going submuscular
In my opinion the suglandular placement is an outdated technique fraught with increased complications.
Make sure to tell your surgeon about all your issues
Your question is really more of a legal one than a medical one, so the physicians on RealSelf may not really be able to answer what your "rights" are. I would recommend to you and any patient who has any issues or concerns after any plastic surgery, to discuss them with your surgeon. When you are at your appointment, don't be afraid to speak your mind if there is something that you do not like. Your surgeon would be the best person to answer any questions you have about the specifics of your surgery. After that, you can seek out a second opinion from another plastic surgeon in your area to see if there are any other ideas that they may have. Beyond that if you are still unhappy with the way you are being treated by your surgeon, then you certainly can explore other avenues, but, especially in the early post-operative period, try to make sure you express your concerns directly to your surgeon or patient care coordinator to see what they can offer.
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The decision of going over or under the muscle is particularly critical to the outcome in breast augmentation.
I personally am very selective in the patients and procedures that I do. Communication and agreement on every detail of any operation avoids this type of problem. I never proceed with any operation if there is any doubt on the patient's part.
Placement Of Breast Implants - Who Makes That Decision And When?
Breast augmentation, more so than any of the other cosmetic procedures I perform, requires both patient and surgeon buy-in and agreement for almost every step along the way. In my practice, the patient determines which manufacturer of implants they want, what type of filler they want, what covering and shape, the route of entry for the implant as well as positioning, cup size and cc range.
This being an elective surgery, if the patient wants something the surgeon disagrees with, the surgeon can refuse to do the surgery. If the surgeon wants something the patient hasn't bought into, the patient can choose another surgeon. Making last minute decisions about whether the implant should be above or below the muscle may be necessary intra operatively based on anatomical findings. If the surgeon changes his or her mind as to location of the implant pre operatively while the patient is laying on the operating table with or without premeds on board, that decision bypasses the informed consent and strips away patient's rights.
Unfortunately, the rippling may or may not have been present even in the submuscular position, but in my opinion, there is a greater chance of the rippling with the saline implant in the subglandular position.
I believe this is a case where the patient should speak frankly and directly to her plastic surgeon, and the patient and the plastic surgeon should come to an amicable agreement as to the next step.
Plastic surgeon changed operative plan on the table.
I would first address the issues with the surgeon and ask him/her about the options for resolution. Other than this, your options are to discuss it with the hospital or facility at which he/she works or with an attorney.