Could there be more damage done to my chest from mastopexy and augmentation than I know?

I have developed moderate pleural effusion post mastopexy and augmentation which was on 7/2/15. My surgeon states he's never had this happen before in any of his patients. He told my husband that I was a bleeder and told me maybe he cauterized my blood vessels too deep. I now have a popping feeling in my chest on deep inspiration. I was a completely healthy 34 year old prior to this surgery.

Doctor Answers 3

Could there be more damage done to my chest from mastopexy and augmentation than I know?

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Hello dear, thanks for your question and provided information as well..
The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast…

Could there be more damage done to my chest from mastopexy and augmentation than I know?

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Thank you for your question.  I'm sorry to hear about your condition.  I would admit that I have never had that experience in a patient in my practice, but I also know that medicine is a tricky profession.  Almost any side effect or complication that one can conceive of has or will happen at some time in the career of a surgeon.  It is almost impossible to list every potential complication of surgery but even for a minor surgical procedure things can occur that are unforeseen and unpreventable.  You should listen to your surgeon and medical team regarding the treatment of your plural effusion (fluid development in the chest).  I suspect the sound you are experiencing is the fluid in the chest.  Best wishes for a speedy recovery.

Pleural effusion after breast lift plus implants is unusual, but possible.

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Congratulations on having had your surgery, and kudos to your surgeon for his honesty and forthrightness. Pleural effusion is indeed possible, and should represent no problem long-term as long as you continue follow up with your surgeon. But you characterize surgery as "damage," which is unnecessarily pejorative. Sure, ANY incision or pocket creation involves "damage" to tissues--at least until surgeons can wave magic wands and make that do the job!

If the communication from your pocket to your pleural cavity is tiny, this may well heal without concern and the effusion will reabsorb. Your popping feeling will resolve as well in this scenario.

However, if the communication is larger, the effusion persistent, or other issues develop, then you may need re-operation to close this communication surgically, with tissue, capsule, or acellular dermal matrix (abbreviated ACD or ADM) or Seri, for example.

I would have no hesitation to trust your surgeon completely, as he has already demonstrated his truthfulness in explaining what MAY have happened, and has admitted a POSSIBLE cause. There are a few surgeons who would simply say "I have never had that happen" and let someone else fix the problem if it doesn't heal on its own, or simply ignore your calls. Your guy sounds trustworthy, and that's worth a lot!

BTW, I have had this happen to me, although I recognized it at the time of surgery (which was for a Poland's syndrome male chest implant patient with hypoplastic  tissues), causing me to repair the defect and leave the implant out so proper healing could occur. I told my patient and his wife exactly what happened, and personally accompanied them to X-ray to confirm proper closure and no pneumothorax. Some time later we did the implant placement without further incident, though it did take a second operation. Stuff happens, even to the best-trained, most experienced, and careful surgeons, of ALL specialties.

Honesty IS the best policy, no matter how unusual the incident. All of our patients are imperfect humans, just like all of us surgeons. Continue in your surgeon's care and best wishes! Dr. Tholen

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