To answer this, one must first be aware of both sides of any discussion, and without having been present during consultation, no one here can agree or disagree that your surgeon "bears responsibility." I know you were asleep during surgery, but you weren't during the consultation, or the markings pre-op, or when you signed the consent form. Of course, what your question really relates to isn't responsibility--it's about cost. Who pays for what? This should always be discussed BEFORE surgery, especially with revision surgery. Just as an aside: who bears responsibility for choosing the surgeon who operated on you? They did not "take all of your money." You chose elective surgery, and willingly paid for the operation. If a specific size of implant was chosen and agreed upon, was this specified in the consent form? Or did the consent agree to the surgeon utilizing his best judgement? Would you really want your chosen expert to utilize anything other than his most thoughtful decision-making in the performance of your surgery? Do you really believe that your surgeon openly disregarded your requests or went against agreed-upon plans? Intentionally making patients unhappy is not a good business plan! Please understand that when a patient is unhappy, their surgeon is probably unhappy as well, and both will have to bear some part of responsibility for the present state of affairs. So, respectfully, lose the attitude, unless you want your surgeon to react defensively rather than charitably. A confrontational attitude causes lawsuits, most of which have little or no merit and even though the aggrieved patient is often upset enough to force the issue (and lawyers greedy enough to "fan the flames" of discontent), these cases are almost always losers for everyone. And the patient ends up paying full price elsewhere for more surgery when the most recent surgeon would happily put in larger implants for implant costs and minimal OR/anesthesia fees with limited or no surgeon's fee--all in a effort to convert you to a happy patient. Sure, you want it for "free," but this isn't an overdone steak, and re-do surgery costs should always have been discussed in advance, even if exact implant sizes were not. That being said, 50cc is 3 tablespoons and 1 teaspoon, and such a minimal amount that this difference is truly scarcely visible--it takes 200-250cc to equal one bra cup size, and I'm pretty sure I don't know what "a touch bigger" is in cc. Is it more than a "tad?" And lots more than "a skosh?" This certainly required more than your summary of what must have been an important and significant amount of discussion. Frankly, this whole issue is likely about more than 50-100cc too-small implants. Sure, your suits don't fit like they used to, but if 50cc (or 100cc) will revive your competition wins and magically "fill" that loose breast skin, then understand your surgeon has a "cost" involved in re-do surgery as well as you do (he could be doing a "paying" patient rather than one simply covering costs), so make nice and stop looking for someone to "blame." It's truly better than the alternative. Best wishes! Dr. Tholen