Breast Reduction Gone Wrong - Charlotte, NC

Please know that there is always a back-up or "covering doctor" any time I am not immediately available. This has been my practice for the last 18 years. To make sure that there is someone who can immediately respond to a patient need, when I am away or out of town, my nurse is the "first responder", but there is always a doctor available.

Dr. Ditesheim, Thank you for setting the record straight about the back up doctor. My doctor had his plastic surgeon brother backing him up, when I realized that he had removed fat from my butt. Using the word upset to describe my reaction is probably an understatement. Looking back, I think my doctor may have hated me for exposing this to his staff, and brother. By the way, his staff was wonderful. He just skipped over the questions about the pain in an email. He answered all of my other questions, and denied allowing his newbie doctor to work on me. Prior to the email last December, I had planned to return so he could put the fat back. Well, I was not totally unconscious during the procedure. I was able to hear him talking to this young female doctor. He told her" There is a divot. Don't go any further." This so called divot is below my tale bone. Fat was removed above and to the side of my tailbone. She did some of the fat transfer, too. He told her " Don't go in there, her orbital bone is high." Once the trust is broken, it is very difficult for women to communicate with their doctor. I tried to be optimistic, even after the fat was removed from my butt. I wanted to believe this was all going to turn out well in the end. In my mind, Dr Jekyll and Mr. Hyde best describes the doctor in the consult vs the doctor that worked on me. What good would it do to call him out? Thanks again for setting the record straight about a back up doctor.

Thanks for your reply. I do agree with you. When there is a decision for surgery, there is an implied trust. Despite TV "real life" shows, when I am in the operating room the tone and decorum are professional. While I am not a pilot, I think of it similar to flying a jet and being responsible for the lives of the passengers. There is no room for anything but the highest standards in staff, preparation and expertise. The trust is not given it is earned. If there is going to be another surgeon or teaching or anything that could be different from what the patient understands to be happening, this must be discussed ahead and be acceptable to the patient. This was the topic of a lead article in the New York Times, front page this past Sunday. Thanks again

Thank you for your professional comments. There are many cosmetic device salespeople selling their latest gadgets to cosmetic surgeons. Faces are injured, and lives are ruined by the hunt for more money. I understand how expensive it is for a plastic surgeon to practice in today's world. A small but growing number of surgeons have chosen a different path, however. They choose to wait and see the long term results of these quick miracles fixes. Nobody knows or can prove that Ultherapy will eventually cause fat atrophy, even if it does not show up during the first year or two on a younger patient. Mothers faces are being damaged everyday by lasers. You can't imagine what it is like to have your kids stare at you in disbelief. Fortunately, I have a supportive husband that loves me. Money invested in this high dollar equipment has to be recouped by the surgeon. Patients should be warned about every possible side effect. Instead, there is a sales presentation. I have learned the hard way. My fat transfer did not work. This would be okay, if I had not suffered more severe damage. Where I really needed the fat replaced, was just left out anyway. Trusting the liposuction techniques, and fat injections being administered by a high-dollar surgeon- that I was referred to by another plastic surgeon- was automatic. None of this is your fault. You are not responsible for other doctor's actions. You appear to be a sincere, professional surgeon. There is nothing more powerful than a personal recommendation from a satisfied patient. You don't even have to have a website, if you have happy customers. Ladies will travel the globe for the right plastic surgeon. Again. thank you for your comments.

How great of you to write this. I wish all women could read this, it is one of the best comments and advice I have ever seen on Real Self. Only experience can permit full disclosure, as it takes time to see the results, the complications and the unexpected. It also takes a commitment to follow patients over time to really test predictability. You are right, there are people out there who are "selling" before all the information is in. There are also people who really don't care. But knowning the difference, we would all want a surgeon who is honest, transparent, caring and focused on getting what I tell my patients: safety and predictability.

If there was a doctor "covering" for you, why wasn't an appointment scheduled when she called your office? It seems the only person "covering" is you. Moreover, the reason "this woman" has posted after 8 years is because she wants everyone to know that everything that glitters is not gold. She saw all of the glowing reviews and she wanted to inform others about her experience with you. Furthermore, if you think 8 years is enough time to heal emotionally from such a tramatic experience then there is an obvious disconnect with your patients. Perhaps she magically grew another nipple. And the thought of leeches crawling on her was wiped from her memory. That is the only way this woman" can move past her botched procedure. After viewing her post, you should have realized that she is not well emotionally. Instead of expecting her to call you you should have called her. After all you are the caring, compassionate doctor, right?

Thank you for your thoughts and suggestions. The best way I can personally help anyone is for that person to communicate with me. I would suggest to anyone who has frustration that calling me or coming to my office is the way that person may be helped through a difficult situation. Even 8 years later, I am happy to see anyone who I have performed surgery for, particularly if there is an issue I might be able to address or make better. As I do not know who this person is I cannot call her, or certainly I would. Thank you

Hi Dr. Ditesheim,
I had been considering a consultation with you recently for some fillers and/or some potentially more invasive solutions. I read (and responded to) a post yesterday concerning a bad experience someone had with your practice recently. Although qqqtrader11 may seem a bit rude in his/her response, I do think that he/she has pointed out some things that should be taken into consideration. So based on your previous replies above where you said you remembered this patient's incident, I'm confused as to why you would say you would certainly reach out to her if you only knew who she was? If you don't know her name off the top of your head, but remember her, the prcedure and but when I read this post here, it makes me wonder why if you

Shoot, sorry about that... I pressed the "post comment" button by mistake. I was trying to ask, if you remember this patient and the details, then you do know who she is and could easily contact her, right? I am in agreement that if you want to do anything you can to help her, even 8 years later, you could begin by calling her. I don't wish to be rude, but I'm getting a sense that you are contradicting yourself here. I had a rhinoplasty in Nashville 7 years ago & $8000 later, my surgeon do not "correct" anything he said he could/would, and on top of it, I wound up with this odd horizontal line between my nose and my cupid's bow when I smile due to him repositioning some cartilage or something of that nature. I was 24 and didn't know better than to think that are cosmetic surgeons and procedures are created equally. I have thought about writing a review to share my experience and procedure with him in it's entirety (even 7 years later -- as the alterations we trust our doctors with last for our lifetime, we are literally faced with them every day, great or botched alike) but, several of his other patients have already done that so I think what's already listed gives potential patients enough room for pause. I didn't push more for him to fix things due to the mountain of paperwork I had to sign. I am 100% aware of, and believe this legal documentation is necessary for you all to protect yourselves... But in my circumstance anyway, this simultaneously allowed him to essentially "mess up" and leave me with no recourse. Needless to say, given the results of that experience, and what was essentially the equivalent of throwing $8,000 out the window, I make sure to do my homework on both my physician and the potential procedure(s) I'm considering, and it has since served me well. I've relocated several times and have found amazing doctors since, so I know that "bad" is not the norm if you really research and consult with several physicians first. I really wanted to schedule a consult with you based on your areas of expertise and your other positive reviews, but I'm having second thoughts here. Like the other woman above, I am also very wary of and concerned about being "pitched" the latest products/treatments/surgeries that we do not yet have all the information on potentially adverse effects, or how these things will affect us in the long term. It makes me borderline livid that these device reps (and pharmaceutical alike) come in with their charming sales pitches and doctors just go for it... hook, line, sinker, without being informed enough, or skilled enough, that practice now offers it. And although that's usually not the case in the seemingly most reputable offices, it still happens enough to be apprehensive when selecting a physician. I am hoping the negative items I have read are flukes, and would appreciate any comments from you. In doing so, I would also like to know your experience level specifically in injecting restylane specifically to eradicate small malar bags and restore fullness to the upper cheek/eye area so as to not cause any further damage in light of the fact that the fluid causing them is idiopathic and intermittent? I may need to try something more invasive, and I do have other items I'd like to address, but would like to begin there if possible. I was advised that my injector should to be adept in restoring this area with specific regard for the idiopathic/intermittent fluid retention. Is this something you have had success with?

Thank you for your comment. While protecting confidentiality, I can tell you that the person who made the post "8 years later" never contacted me or my office for help or further care. While it is my intention to deliver the best care to every person I treat, i humbly recognize that I will not meet every person's expectations.

You also asked about cheek and periorbital injections of filler and the complication of intermittent or idiopathic fluid collection or retention. First, filler injected in the cheeks is "off-label". This means that the FDA has not given it's "stamp of approval" as safe and effective to use filler products in this location. Second, injections in the cheek can cause lymphatic blockage which can result in intermittent fluid collection or retention. As I would advise any potential patient, the only help I can provide is in a private consultation after listening and examining you. I hope this is helpful.http://www.empowermd.com/gallery-patient/injectable-fillers/