Need Revision to Enlarge Pocket - Normal?

BA performed 4/6/11. Right implant has not moved since the day my bandages were removed. 5 weeks PO, my PS says that he needs to re-operate to make the pocket bigger so the implant can descend. This is going to cost me another $800. Is this common, or could this be his mistake? Opinions welcomed!

Doctor Answers 6

Revisionary Breast Surgery Appropriate?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for the question and picture.

Your plastic surgeon is in the best position to determine the potential need for further surgery. Personally, I would rather wait several months to allow the implant every opportunity to “settle” on its own. Again, the plastic surgeon knows your situation much better;  it would be foolish for online consults and to second-guess this decision-making.

The costs of returning to the upper room also seem reasonable.

Best wishes.

Implants occasionally fail to drop

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It appears that your right implant has failed to drop. Although most implants will drop into place over the first 4-5 weeks after surgery, every once in a while this does not occur. Sometimes this occurs because the pocket is too small, and sometimes this occurs as a result of an early post-operative capsular contracture. Reoperation in this case seems very reasonable.

Kevin Brenner, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 23 reviews

Implant revision

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Sometimes one implant will drop and the other does not or sometimes the level or size of the pockets isn't just quite right.  This sort of problem can occur even in the best of hands.  Surgery is not an exact science because it deals with human tissues which can be variable and unpredictable.  The fee your doctor is charging seems very reasonable to me.  Operating room and anesthesia supplies and staff salaries are very expensive!  I think it is a good idea for all patients to ask their doctors ahead of time about reoperation policies and costs.  That way there are fewer misunderstandings.  My guess is that once that right side is lowered a little, you will notice a big difference in how your chest looks and feels.  Follow your doctors instructions about massage or wearing a bra very carefully.

Lisa Lynn Sowder, M.D.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 76 reviews

Breast Augmentation Revision?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

After performing sub-muscular breast augmentation, it is possible one implant may remain higher than the other. Although it is not a very common complication, it is not very unusual either. Usually this situation is communicated with the patient before surgery and patients are advised what will happen if this situation occurs. Every surgeons approach is different; some surgeons will update the cost and take care of the patient, some surgeons they advise the pt that this may happen, if so, there will be a small fee for the patient. Eight hundred is a small fee that will just meet the cost of the surgery and the doctor is not trying to make any income from any complications with breast augmentation but still it is the approach of the surgeon. The most important issue I think, these types of situations should be communicated with the patient before surgery.

Need Revision to Enlarge Pocket - Normal?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Yes sounds fair, to cover costs of supplies and meds. But best to discuss in detail with your chosen surgeon. 

Breast Augmentation Revision

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Looking at your pictures, it does appear that your right implant is sitting quite a bit higher than the left, and if your surgeon feels that a revision is warranted, that can be a definitive solution to your problem. Your surgeon is the only person who knows the size and shape of the implant pocket and whether or not your implant has a good chance of shifting with more conservative measures.

As far as costs for revision, it varies from surgeon to surgeon and should have been spelled out to you preoperatively. Although you don't specify, there is still a cost for facility and anesthesia for every surgery along with the surgeon's fee. Every surgeon has different guidelines for whether a cosmetic revision requires another surgeon's fee and how much that will be. Unless the surgery is done at your surgeon's office, he may have no control over the facility and anesthesia charges, and that may be the $800 you are talking about.

Sorry to hear about your situation, but a minor revision to the pocket should resolve your problem and I wish you the best.

Derek Lou, MD
Houston Plastic Surgeon
5.0 out of 5 stars 11 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.