Bottom Out/ Double Bubble and Very Loose Breast? (photo)

This is 12 weeks after a "touch up" from a aug 15 months ago that was bad. I DID USE A BOARD CERTIFIED surgeon. I am guessing bottom out and double bubble mean the same thing? The dermal fat graft to "fill up" the loose saggy breast seems to have not worked either? when is it malpractice/vs just a bad outcome? I am thinking of getting a lawyer. i have had 2 of the 3 guys in the practice (first aug gave me cc on the left and loose hanging right). i am afraid to go back,but what do i do?

Doctor Answers 3

Bad Outcome After Bad Outcome

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I am sorry that you are experiencing these problems. I do not recall whether or not  I responsed to you asking whether fat grafting was appropriate for your complication. If it was you, you may recall there was a board certified surgeon who also responded and thought fat grafting would be fine. Unfortunately, certification by the American Board of Plastic Surgery is only the first requirement in a long list that you should check off as you look for surgeons that perform revision breast surgery.

As I said in my response then, your implant had dropped out, and lifted the inframammary fold off of the chest wall, a situation that would not be improved by fat grafting. I also mentioned that the likely reason that this happened in the first place was the surgeon was trying to get the implant low enough on your chest wall to 'lift' the sagging left breast, which didn't look so good with the implant in the correct position.

Correction can be performed in one of two ways.  The current pocket can either be sewn smaller and higher using permanent suture material, or a new submuscular pocket can be recreated on top of the current pocket, collapsing the current pocket on itself to form the new floor of the new pocket (neo-submuscular pocket formation, my prefered technique). In addition, even if your implants are repositioned correctly, but the sagging breast is not addressed with a lift,  your breasts are unlikely going to have an acceptable appearance.

I presume that you returned to the same office for your revision surgery because it would be free, and they said it was a simple problem to fix.  It's time to begin your search for a surgeon that is a specialist in breast surgery and revision breast surgery. This is a complex problem requiring skill and experience, and may require 3 to 4 hours in the operating room, so it is unlikely going to be inexpensive.  By doing this though, you will probably have your problem resolved once and for all. 

Bad outcome from breast surgery

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So sorry for the troubles you have had.  You have posted other questions about this and I will try to comment a bit now.  Please understand that this is not medical advice as I have never met you.

First, you had previously said, I believe, that this revision was not done by the surgeon you expected.  That person was unavailable so another doctor did the operation and changed the plan on what you were expecting.  What I would have expected in this elective setting would probably be for your surgery to have been postponed and rescheduled until your surgeon was available.  Especially if the planned surgery was going to be different from what you had expected. 

All you can do now is visit other surgeons and ask what can be done.  Your very poor skin elasticity may require Strattice to fix the bottomed out breast and this is quite expensive. I know that costs are an issue for you as you have previously said, but there won't be anything that can be done by new surgeons that won't be substantially expensive.  As to the legal issues here, there is a difference between "malpractice" and a "poor outcome" or a "complication."  You would need to speak with an attorney to help determine where you are with this.

Breasts Augmentation and Complications/Options?

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I'm sorry to hear about the complications you have experienced after breast surgery. Although this is not the appropriate forum for legal advice, I think that it is clear that you have lost confidence in the plastic surgeons who have taken care of you thus far. At some point, it will be in your best interest to meet with well experienced board-certified plastic surgeons who can demonstrate significant experience helping patients in your situation. You will be able to do a significant amount of initial research online but eventually in person consultation ( involving a careful review of your previous surgical history,  careful physical examination, and a clear communication of your goals) will be necessary to plan appropriate revisionary surgery.

Best wishes.

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.