Is Window Shading of the pectoral muscle the fault of the surgeon?

Question

I went in for a simple swap from a mismatched set of saline to silicone, and wound up with an implant lower than my IMF, and window shading of my pec. The doctor wants 12k to fix it, but I'm certain the doctor caused the problem. Anyway, I've read that it caused by over zealous cutting of the pec. True or false?

Earl Stephenson, Jr., MD, DDS, MBA · Answer

In my opinion, window shading occurs with very aggressive release of the pectoralis major muscle. This is something that would be recognized within the appropriate healing time. 2 to 3 months. This is not something that would be new as an asymmetry many years down the road. So if this asymmetry was due to window shading you should have noticed this prior to your second surgeons opinion.

Curtis Wong, MD · Answer

its unfortunate you have a surgeon that doesn't have a favorable revision policy.  The vast majority of surgeons will do a revision within a certain amount of time from your original procedure for no surgeon fees.  Costs of materials, the OR and anesthesia would be the patient's responsibility.  There are some surgeons who simply cannot give away their time because their time is too 'valuable'.  I know one of those surgeons and his attitude and ego are his downfall in his dwindling practice.  I think most people know what fair means.  As for the window shading, if it wasn't there before, then it can be presumed that the procedure contributed to it.  But fault is difficult to assign since that may have been part of the plan to give you what you desired.

Erik Hoy, MD · Answer

I'm sorry to hear of your experience with your previous surgeries.  It's difficult to give you accurate advice without photos and without a more detailed history and physical.  In general, window-shading of the pectoralis muscle can be caused by over-release of the origins of the pectoralis muscle.  It's usually recommended that the insertions along the sternum be fully maintained, so that the lower edge of the pectoralis is maintained in it's low position.  However, the belly of the pectoralis muscle rises slightly whenever an implant is placed beneath it.  Also, many surgeons try to maintain the lateral connections to the pectoralis, a thin fascial connection to the serratus muscle.  This could have been over-released, or more likely it was weak due to repeated surgeries in the same area, and may have been thin or weak to start with.  The window-shading may have been the "fault" of your surgeon, but more likely it was a combination of these factors after repeated procedures in the same surgical field.  Release and redraping of the pectoralis with placement of ADM between the lower edge of the pectoralis and the chest wall can help reposition the muscle inferiorly and would help prevent the inferior malposition you mentioned as well.  Best regards,-Erik Hoy, M.D.

John Sampson, MD (license obligations) · Answer

If you had a simple replacement if implants, I am not sure if you can blame the surgeon.This is a complicated problem with a sometime difficult fix. I would seek a competent BC plastic surgeon to take care of the problem. You can ask him his opinion of "blame". These question are too complicated for this venue.

Douglas Taranow, DO, FACOS · Answer

Windowsahding may or may not be the fault of the operating surgeon.  The pectoralis may lift and cause an unsightly transverse ridge despite minimal release of the pectoralis muscle.  While overaggressive muscle dissection is a know cause, I cannot pass judgement without a physical examination.

Is Window Shading of the pectoral muscle the fault of the surgeon?

Answers (8)

Answer: Window shading

Answer: Window shading

Answer: Is Window Shading of the pectoral muscle the fault of the surgeon

Answer: Is Window Shading of the pectoral muscle the fault of the surgeon

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Is Window Shading of the pectoral muscle the fault of the surgeon?

Answers (8)

Answer: Window shading

Answer: Window shading

Answer: Is Window Shading of the pectoral muscle the fault of the surgeon

Answer: Is Window Shading of the pectoral muscle the fault of the surgeon

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Everything you need to know about Breast Augmentation

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