Should I Have to Pay for Complications After Breast Augmentation?

I am 7 days post-op BA with moderate profile silicone implants 275 cc's placed dual plane. My right breast was a cup smaller than my left but my surgeon assured me I would get symmetry using the same size implant. Right after surgery, right breast felt very hard, looked square and was 1.5 inches higher than my left. I also developed severe black bruising extending down to my abdomen. I was told that I had hematoma and will require drainage. They want to charge me $1400 to correct their mistake! Why am I responsible to pay for the surgeons mistake after paying him $6,000 already?

Doctor Answers 10

$ Complications

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

Complications can and do occur, even when all the precautions have been taken by both the surgeon and the patient.  The most common complication we see is post operative bleeding or a hematoma. Some hematomas can be handled without surgery, some with minor drainage in the office and others need to go to surgery to drain the blood.  This should not be delayed, the pressure from a hematoma can cause compromise of the circulation to the skin and the blood supply to the nipple/areola.  Long term we know that hematomas increase the risk of capsular contracture around the implant.

Cost for complications are usually made on a case by case basis with a conversation between the patient and the surgeon.  It is not unusual for the surgeon's fee to be waived and the patient charged the fee for anesthesia and the facility.  If this causes you an undo financial burden, talk directly to the PS, not his staff and ask if you can work out a deal.  

Good Luck,

David R Finkle, MD

Who Should Pay to Treat Cosmetic Surgery Complications

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Every Plastic surgeon that I know has a clear policy defining the financial responsibility of the surgeon and the patient in case of complications. The policy is made clear to each patient before surgery. It may differ from surgeon to surgeon with the majority of surgeons not charging their fee for re-operating on the patient but the patient having to pay the facility and anesthesia costs. Bleeding is a known complication of all operations and we educate all our patients of the small risk that it may happen despite our best efforts. I agree with you in one respect. I personally would not inflate an implant as much as would take to make up for a breast size discrepancy of a full cup. This never works well because it results in a stiff implant with crenated folds which will be visible and palpable. The overall result and the decision to fill the implant as much as it was would suggest to me that your surgeon is not a real Plastic surgeon (member of The American Society of Plastic Surgeons ( You may want to seek a second opinion from such a member surgeon. Good Luck. Dr. Ajdea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Hematoma after breast augmentation: not always preventable

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

You are assuming that this is your surgeon's mistake when it may not be. It is not uncommon for surgeon to charge for operating room and anesthesia fees and to consider waiving his professional fee but that is not true in all instances. Even if the surgery was done perfectly, hematoma is a risk. You can be the safest driver but that does not mean you will never get into an accident even with the best of intentions.

Hematoma following breast surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hematoma are a know complication of breast augmentation surgery.  It would seem unlikely that you have a hematoma as both breasts are relatively the same size and shape. If unsure see your plastic surgeon for a follow up examination. A small hematoma will resolve on its own a larger hematoma must be drained to prevent future complications.

Who pays for complications of breast augmentation surgery?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I am sorry that you experienced a postoperative complication and may require additional surgery. Responsibility for that procedure should be spelled out in your patient financial agreement. My policy is not to charge for the revision but the patient is responsible for fees payable to the anesthesiologist and for the surgical facility. You should certainly feel free to discuss your concerns with your plastic surgeon and his administrator.

Complications following breast augmentation

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

Most offices have financial policies regarding complications and revisions following cosmetic surgery.  These financial policies should have been discussed with you prior to surgery.  These types of policies are necessary because it is impossible to guarantee a result or that a patient will not have a complication – every patient and every surgery is different.  In cosmetic procedures, there are certain problems that will happen statistically no matter how well the care or how careful the doctor and surgical team.  

I would encourage you to discuss the financial policies with your surgeon and his/her office staff.  I am sure that they would be willing to explain their policies in more detail -- many times, surgeons will waive their fee for a post-operative complication; but the patient still needs to pay for operating room and anesthesia costs.

Paying for hematoma evacuation

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

When you’re talking about surgery, there will always be a chance for complications. Developing a hematoma is a risk affiliated with breast augmentation. It is common the surgeon would require for you to pay the OR and anesthesia fees to evacuate the hematoma. It is very early in your healing process so the sizes of your breast will continue to change.

Who pays for complications of breast augmentation

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


In New York City, patients pay for the operating room and for anesthesia for complications.  But of course they don't pay for a new surgical fee.

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

Surgical complications can be costly

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

I'm sorry to hear (and see) your complication after breast augmentation surgery. I'm sure you were informed of the most common complications related to breast augmentation surgery. Hematoma after augmentation is rare, but it happens. No matter how carefully your surgeon planned and executed your operation, there are complications that occur that are anyone's control to prevent. Hematoma is one of these complications. There are costs associated with draining a hematoma. Your surgeon likely asked you to pay for the facility and anesthesia portion of the revision. Most surgeons would not ask a patient to pay a surgeon's fee for this sort of complication. 

Revisional surgery

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


  Most plastic surgeons will not charge their fee for a revision that is determined by you and the plastic surgeon but you would be responsible for any charges from the facility and anesthesia.

  This varies from doctor to doctor and you need to discuss this.  Revisional surgery is in the cards for all patients if necessary.  Noone wants to do additional surgery but if necessary, it gets done.

  You are very new in your procedure.  Judgements cannot be made this early.  Stay close to your plastic surgeon and be patient.  If you need revision, then the costs can be discussed or would be contained in your agreement.

  In my office, I do not charge the surgical fee but do have patients pay for the other costs.

                Steven M. Lynch, M.D.

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.