Surgeon Did Not Address My Concerns About the Asymmetry, Should I Have to Pay For Him to Correct This? (Photos)

I have been very self-conscience of my breasts for yrs, (assymetric/sagging)I met w several PS, did a lot of research I chose a PS,who was confident he could address my assymetry & improve greatly(had breast lift&aug,tummy tuck wlipo)I explained fully my concerns,& now feel they weren't addressed, I discussed w my surgeon, he said he could put a larger implant on smaller side, or replace both,& I would be charged except his fee, why should I have to pay again, when that is why I had surgery?

Doctor Answers 9

Breast asymmery issues

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Symmetry is the curse of plastic surgery and even though the same operation is done on both sides they frequently heal like they are on two different people. You appear to have some nice improvement as you progress and it is possible that this will continue. When you get to the 6 month period  it may be time for a reassessment and possible revision to center the nipple over the implant  and revise the mastopexy.  Possibly converting to a vertical type.

Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Revisionary costs

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If you were expecting perfectly symmetrical breasts I can understand your disappointment. Unfortunately, it's a common one, but there is not a plastic surgeon anywhere that can deliver perfect symmetry to asymmetrical breasts.  You chose your surgeon carefully.  You paid for his time and expertise, not a guaranteed result.  He did address your asymmetry, but there is some remaining which is always the case to some degree. There are refinements that he agrees are possible and in an effort to make you happy he is willing to give you more of his time and expertise for free.  But there's also the costs of the implants, anesthesiologist and operating facility.  This is standard practice and was probably covered in the financial policies part of all those papers you signed.  I would hope these policies would have been pointed out before surgery even if you didn't ask.  There is probably a limited time those policies are effective before you incur a cost for his fees as well so you may want to get into the details sooner rather than later.  Meet him half way as he has proposed.  No else will do it for free.

Lori H. Saltz, MD
San Diego Plastic Surgeon
4.3 out of 5 stars 29 reviews

Revision will fix breast asymmetry.

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This should all have been made clear to you before surgery.  When having cosmetic surgery, you are not paying for a guaranteed result.  You are paying for the surgeons expertise and best effort.

For a revision, we also charge for the operating room and recovery room, for the anesthesiologist, and for new implants, but we do not charge a surgical fee.  This would not seem unfair to you if you understood in advance.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Revisionary breast surgery charges

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What you are experiencing happens in every plastic surgical practice. It is important to continue calm, non-accusatory communication with your plastic surgeon who appears to have done a  nice job for you. Some imperfection after the surgery that you have had done is to be expected; fortunately, revisionary  surgery should improve the situation.

I think that the waiving  of the surgeon's fee is  generous and reasonable. Other charges, such as anesthesiologist  and facility are to be expected.

Remember, that revisionary surgery carries risks and that nobody  ends up absolutely symmetric.

Best wishes.

Redo Breast Surgery

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Plastic surgery is an art not an exact science.  Having had several consultations, you were aware that there were a variety of issues that needed to be addressed and I would hope that some of these issues were explained to you. The doctor you selected did a very nice job and your asymmetry is improved.  Your doctor is willing to address your current concerns by donating his time to help you achieve the results you expected.  If cost is an issue, it may be possile for your doctor to revise the left breast under local anesthesia and limit any outside costs.  Tightening up the lower potion of the left breast may improve your results and create the outcome you desire without the need to replace your impklants.  Good luck.

Beverly Friedlander, MD
Short Hills Plastic Surgeon
4.8 out of 5 stars 19 reviews

Misunderstanding after plastic surgery

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You do still have some asymmetry but your doctor has done nice work for you and is trying to help get it better by charging nothing for his time and effort to revise the result.  Sometimes a doctor will eat all the costs of a revision but more often, there are charges for equipment, facility etc.  You also seem to not have understood the procedure because you for sure had a "lift" which moves the nipple up and tightens the lower pole.  The implants add volume but if by "lift" you mean more upper pole fullness, a larger more projecting implant would be needed.  Make sure you really clarify these issues with your doctor before any revision so you have no more misunderstandings.

Expectations with breast asymmetry

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There are many issues when breast asymmetry is corrected including the skin envelope of the breast, and breast volume. There is always a degree of asymmetry despite correction, and all should expect it. Your photos show very good results, far better than 'before'. False expectation, and hearing though not understanding can happen at any consultation. It appears that your surgeon is continuing to work with you and costs that are not his own, such as a facility, may be beyond his control.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Paying for "re-do" Plastic surgery

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This is always an emotional issue for patients. Everyone, including your surgeon would like for your surgery to have optimal outcomes and for you to be thrilled with your results. In some cases, refinement to your results is possible and makes sense to consider. However, it is not a time to assume that mistakes or errors were made that you need to be compensated for. The costs of new implants if needed, anesthesiology, the use of a private surgical suite or hospital and the surgeon's time and staff still exist. Your surgeon is being generous and professional about offering to do additional surgery without fees for their time and effort. 

All patients should have a very clear understanding of the office financial policies before surgery. Furthermore, it is fair and expected to ask your surgeon before surgery: how often revisional surgery is required, who decides if additional surgery is offered and what costs are associated with more surgery. Knowing all of this up front will not eliminate disappointments but will take away any confusion about what happens in this event.

You had a lot of asymmetry before surgery and now have a nicely improved shape, normal appearing scars and less symmetry problems. You and your surgeon need to work together to decide if additional surgery and the costs associated with surgery are worthwhile.

Dr. Mosher

Mathew C. Mosher, MD
Vancouver Plastic Surgeon
4.5 out of 5 stars 34 reviews

Paying for Re-do Plastic Surgery

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Overall it appears that you have had a very nice result.  While there remains a volume asymmetry and a slight difference in the position of the lower portions of your breasts, communicating your goals with your plastic surgeon is imperative.  

It appears that you had a 'Lollipop' lift with good positioning of the nipple-areolar complexes.  The slightly hanging portion of the lower left breast can be addressed by removing the excess skin in this area which would require an additional incision (which both you and your plastic surgeon may have discussed pre-op).  This may also give your breasts a more apparent volume symmetry  (your plastic surgeon can show you the effect of the lift in the office by placing a hand along the planned area of skin removal).  As for the volume, changing implants may help improve asymmetry...not achieve symmetry. If you are realistic than you may wish to consider this.  

While you may not feel your surgeon met your expectations, it is clear that he/she made a very significant improvement.  Attempting to make this result 'better' requires new implants (which must be paid for) and anesthesia as well as the surgeon's time.  I have to agree that not charging a surgical fee is appropriate, however the remaining costs must be covered as your surgeon achieved a very nice result even though they didn't quite meet your expectations.

Best of Luck!

Louis DeLuca, MD
Palm Beach Plastic Surgeon
4.9 out of 5 stars 58 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.