Malpractice due not doing correct procedure to fix tubular breasts? (Photos)

Question

I received a breast aug on 8/27/2021. I had tubular breasts. My doctor was supposed to fix this issue, but what it looks like to me and everyone's I've shown is that he just popped the implants in and called it a day. He showed no concern for the way my boobs look in our post op appointments although they are obviously messed up. I need other doctors opinions on whether or not this is malpractice due to him not doing the correct procedure that I needed to fix my tubular breasts.

Donald R. Revis Jr, MD · Answer

Good afternoon,
You are correct you have a terrible result, and will require further reconstructive surgery to repair, but it would depend on what the documentation on your chart shows- what procedure was discussed in the doctor's notes, what procedure was quoted and consented for, etc.

Finny George, MD · Answer

Hi, thank you for sharing your question. I'm sorry you went through this experience. Your pre-op photos reveal a mild tuberous deformity, which could have been corrected during your surgery. I am not certain that the proper implants were selected for your breasts. Based on your current photos, you should be able to correct this appearance with a lift and maybe an exchange of implants for those that match your anatomy. An in-person evaluation will be needed to devise the proper plan. I hope this helps.

Gianfranco Frojo, MD · Answer

Tuberous breast deformity is a wide spectrum of breast aesthetic appearances related to tight constricting fascia of the breast. When this fascia is too tight (in varying amounts), it can result in a wide range of nipple herniation/asymmetries/bulges and high riding/constricted breast folds with small lower poles. The method of correction is the same in most of these patients. This includes placing a highly cohesive silicone gel implant below the muscle with a proper dual plane augmentation and releasing any constricting fascial bands to permit the implant to exert its effects on the breast. It appears that there was not an adequate release of any of these fascial restrictions. I would have also performed a breast lift. You need a complex breast revision. These can be highly challenging surgeries. You need to find a highly experienced American Board of Plastic Surgery Certified Surgeon with extensive aesthetic breast surgery experience.

Chul Hwan Seul, MD, PhD · Answer

The implant seems to have gone up a bit, and it seems to have some capsular structure. If you have a capsule contracture, you need to manage it with capsulectomy operation, and you need to lower the position of the implant. It seems necessary to consider fat grafting and mastopexy to solve sagging shape and tubular bust.

Gerald Minniti, MD, FACS · Answer

You needed a breast lift from the start. The fix was never just implants. You'll need to go to a breast surgery specialist to perform the lift.

Daniel Barrett, MD · Answer

Dear isabellagarb,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You do not have tubular breasts, but do sag. If you did not chose to have and pay for the lift, it is not malpractice to not do the lift. It appears that both you and your surgeon tried to avoid doing the lift by choosing very large implants. This does not always work, and a lift is still needed. There is no malpractice.

Camille Cash, MD · Answer

I'm sorry to hear of your result with your breast surgery which I agree is not good.  Based on your preop photos a lift is needed to help reshape the breasts in addition to the implants.  If you are not able to come to an agreement with your current surgeon I encourage you to visit with another board certified plastic surgeon near you for a consultation to discuss your options.  More information is needed with regard to signed documentation to determine if there is malpractice.  A lawyer may be able to shed more light on the topic.

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