Dr Changed Several Very Important Details from Our Discussed Plan During the Actual Surgery. What Can I Do?

I was suppose to get a lollipop, possibly an anchor, lift with 325 implants. One filled to 370 and the other filled to 390 to correct asymmetry. An adjustable pump would be used to help with healing and in choosing the final outcome in size. I made it clear that I desired to have smaller areolas which could be achieved with either lift. The dr changed several key factors during the actual operation. He did a crescent lift without adjustable implants both filled to 390 and areola size not reduced

Answers (5)

Reasons for change

As I am possibly the surgeon involved; I am happy to respond but of course there are confidentiality issues. When a breast lift is combined with an implant sometimes just the volume enhancement of the implant provides significant lift and expansion of the tissues. The result is that frequently less lift is required than anticipated and also more tightening of the lower pole skin. This may negate a lollipop type lift as tightening the lower pole with a lollipop lift can result in a constricted appearance of the lower pole of the breast and/or widening of the vertical scar. In most cases the patient are very appreciative of the fact that a similar result has been achieved with far less scarring. If significant areolar reduction is still desired, then this can only be achieved with an areolar lift or a lollipop lift, however if the lower pole of the breast is full, I recommend only an areolar lift. If conversion to a more extensive procedure is required this can be done under local anesthetic at any time, though I usually recommend waiting until all swelling has subsided and stretching and settling are complete. Similarly, if there are subtle changes in volume desired, these can be done. Decisions are always made at the time of surgery to achieve the best possible shape and symmetry, which may not correspond exactly with what was planned. Often once the implants are in and the patient placed upright in the operating room, the surgeon has to make decisions as to the best appearance and volume at the time. The difference between 370 and 390cc is 4 teaspoons. 

Operative Plan Changed

During surgery, sometimes the operative plan can change. Once the implants are placed under the breasts, most surgeons sit the patient up on the table.  In some cases, the implants lift the breast more than anticipated obviating the need for a full anchor or lollipop lift.  I would discuss your results with your surgeon.

Details of procedure different than what was discussed

It would be easy to criticize your surgeon but the reality is that in the operating room things might have to have been changed to get the best result.  If the results are good then the question is really quite moot.

If the results are less than what was expected your surgeon should be able to tell you why and to explain the rationale for what was done.  He or she should also tell you to wait at least 6 months before assessing the final result and determining what, if any, revision work is needed.


If you have lost confidence in your surgeon seek another opinion. 

Daniel Greenwald, MD
Daniel Greenwald, MD
Tampa Plastic Surgeon
52 reviews

Operative Plan

Its very important that you discuss your concerns with your surgeon.  Perhaps there was some miscommunication prior to surgery that can be addressed now.  Its also possible that your surgeon had a good reason for altering his plans in the OR which he can explain to you.  Keep an open mind until you speak with him.

Operative plan

discussing the surgical plan I think is critical so that the patient understands what needs to be done, but sometimes "audibles" are called in the operating room because of factors that change. A circumareola produces less scars than a vertical but I would have thought he would have discussed this with you prior to surgery?

Steven Wallach, MD
Steven Wallach, MD
New York Plastic Surgeon
30 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.

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