I have a general question regarding a Doctors responsibility and obligations.

I have what is referred to as "dog ears" from a previous face lift. I went to a different Dr. to fix the problem and was suggested to get a forehead lift to fix the dog ears. I had the surgery done with this Dr. and and it didn't remove them. Now he suggests another surgery although minor will cost me another $1500.00 . Shouldn't he be responsible in picking up this unexpected cost?

Doctor Answers 9

Revisions and corrections

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When a patient trusts their face to me and pays me to provide them with the result they are seeking, I achieve that result to the best of my ability. If they are are not 100% happy with the result- be that dog ears, pixies, widened scaring, lumps, bumps, tethering etc... and I think I can improve it without signficant risk, I do it completely free of charge. No professional fee, no facility fee and no fee for consumables.Thankfully this is rare.

I think it is a quirk in the cosmetic surgical industry that the consumer has to pay part of revision surgery. I cant think of another results driven profession whereby the provider can charge again to try and achieve the outcome which has already been paid for.

It seems to work in my practice which is outcome not revenue driven. 

In your situation you wen tot ask about dog ear excision - a procedure which should cost a few hundred dollars and takes 15 mins under local anaesthetic, you were sold a browlift which will likely have been thousands of dollars. This has not addressed the problem, I find it  extraordinary that you are to be billed again.

Dog ear repair

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The dog ears should have been addressed by performing a procedure to reposition the earlobes not a forehead lift. I am perplexed why that was recommended. The original doctor should repair them at no charge. This new doctor is not obgbligated to do it complimentary but maybe as a reduced fee since they did perform the forehead lift.

Kevin R. Smith, MD
Houston Facial Plastic Surgeon

Facelift and other surgical revisions

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Dear cindy van:

I am sorry for your disappointment. I wish to believe it is not the intention of any surgeon to leave behind a "dog ear" nor any other side-effect, deformity nor complication following any procedure. We certainly wish to meet your expectations and pursue the very best job we know how to.

Surgery is a science and an art. While perfect results may be desired, they are definitely not guaranteed. Our canvas is the human body and each canvas is unique in its makeup. You may have had excess skin for which your surgeon hoped the skin would retract so it would not be visible or he / she did not extend the potentially visible incision long enough to flatten the irregularity.

There are many ways for your primary surgeon to handle your concerns. In my practice, these include:
  • 1.I try to absorb the greatest amount of the revision cost possible. I do this by not charging for the professional (surgeons) fee. I also try to reduce the cost for the operating room or treatment room and anesthesia as well.
  • 2.If you visit a second opinion surgeon and he or she performs the correction, I would not expect that surgeon to absorb nor reduce any of the revision costs.
  • 3.If the complication requires medically necessary care such as a heart attack, surgical infection or flap ischemia (lack of circulation), most but not all medical insurers will cover (within the terms of your contract) the care of this complication.

It is best for you to review these and any other “fine line” concerns with your surgeon and your insurance company.

I hope this is helpful. All the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.9 out of 5 stars 103 reviews

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Who should pay for revisions?

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Each plastic surgeon has their own policy regarding revisions.  This should have been discussed up front prior to any surgery.  Many surgeons will do touch-ups or revisions with no professional (surgeon's) fee, but will have the patient pay for supplies costs, facility fees and/or anesthesia fees, depending on the gravity of the revision needed.  Dog ear correction in my opinion should be a minimal supply cost as most to fix, but you will need to address this with your surgeon and review their policy.

Todd C. Case, MD
Tucson Plastic Surgeon

Dog Ears

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Sounds Crazy.    Probably the first surgeon should have had the opportunity to correct the dog ears from the original face lift.   

It is reasonable to charge for basic OR supplies such as sutures etc for revision work.   Around the country -   Some doctors are free while others charge a full OR fee up to $2000 or $3000. 

In our practice -- we do for free or charge a $500 Mini OR fee depending on the revision needed 

Mark Mandell-Brown, MD
Cincinnati Facial Plastic Surgeon

Free surgery?

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Hi Cindy,
Thank you for your question. I'm glad that your brow lift looks nice, and I'm sorry the pooches remain. It is hard to say what the policy is. Generally all Board Certified Plastic Surgeons will have a lot of experience on how to deal with this type of problem. Almost all surgeons do "whatever is reasonable". They will go out of their way to bring this problem to a happy ending. Perhaps the cost can be zero if it involves a minor revision with local anesthesia. Please call the coordinator and a suitable compromise can be obtained. Discuss this calmly without accusations. Good luck with your revision.

Below is a similar case where dog-ears were removed

Max Gouverne, MD
Corpus Christi Plastic Surgeon
4.7 out of 5 stars 36 reviews

Charge for correction of dog ears

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I personally would not charge for excision of dogears.  Check your written agreement as the fee may be for anesthesia or facility to cover expenses.  Share your disappointment with your surgeon and don't be afraid to question why there would be a fee and what it is for.

Who picks up the cost of a revision after a facelift?

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In my own practice I do not charge patients an additional professional fee for revisions after elective aesthetic surgery. This is something that is worked out between the patient and the surgeon prior to the operation.

Dog ears post revison

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This is not an easy question to answer and it depends on the understanding between you and the surgeon.If the secindart procedure is truly minor I will usually charge my patients a nominal fee for my supplies and do it for them but every doctor is different.At the end of the day it is servicing our patients that matters most.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

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.