What should I do about my capsular contracture with Sientra anatomicals? Was my PS negligent in decision making w/o me?

Dec 14, went to reputable PS and decided on Sientra anatomical, oval, HP 370 implants in both submusc. On the day of, the anesthesiologist came in 1st, gave me 1st dose of midazolam. PS came in AFTER, and decided last minute to put the implants ABOVE. Went fine, but w/i year, developed CC, now Grade III or IV. Singulair didn't help. Second PS said replace both submusc, w/ lowest risk of cap con, wld be the most aggressive txt to prevent reoccurrence. (1) was this malpractice? (2) what to do?

Doctor Answers 3

If you agreed to submuscular placement

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your surgeon must have some exceptional reason to overrule that agreement so find out what his reason was.  I can't thank of any reason but maybe he has a great one.  But in general, when this happens, you should be able to discuss your problems and concerns with your surgeon and allow him to fix the problem.  If you exhaust all avenues, then you can find another reputable surgeon who can help you navigate this slippery slope of resolution as none of us like attorneys.  The good thing is that your Sientra implants will be replaced for free as you have a warranty against contractures.

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

What should I do about my capsular contracture with Sientra anatomicals?

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I am sorry to hear about the problems you have experienced. Although I do understand your concerns regarding the events that took place,  especially the use of sedation prior to finalizing the surgical plan, I do think that you are best off communicating your concerns/frustration directly with your plastic surgeon in a calm/constructive fashion.  

Generally speaking, it is important for patients to understand that sometimes (despite best efforts and intentions) complications do occur. This occurrence of a complication does not necessarily equate to “malpractice”.  I can assure you, that for the majority of plastic surgeons the occurrence of complications  is very troublesome;  you will find that the surgeons will “bend over backwards” to help patients through the challenging courses they experience postoperatively (and to improve outcomes).


The alternative, proving "malpractice", will be difficult, stressful, time-consuming... Again, assuming you are working with a well experienced board certified plastic surgeon, best to allow him to improve your outcome.

Capsular contracture.

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Hello, and thank you for your question. I am sorry you are having some problems with capsular contracture following your breast augmentation procedure. The issue regarding placement of the implants continues to be highly debated in our specialty regarding subglandular versus submuscular placement. It has not been fully settled at this point and I do not believe it is malpractice to place the implants above the muscle. In many instances we routinely will do this with a texture device. I know many reputable surgeons that placed smooth walled devices in the subglandular location as well. I would recommend that you discuss your options with your treating physician. Best of luck.

John J. O`Brien, Jr., MD
Saint Petersburg Plastic Surgeon
5.0 out of 5 stars 31 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.