What if my doctor put in silicone when I clearly stated I wanted saline and all my paperwork says saline (including cost).

Question

When he was talking post op about the silicone, I interjected and said, what do you mean silicone? I was supposed to have saline. He said, really? Hey, its on me. But you will really like the silicone. It seemed like on my visits prior to surgery, I reminded him that I was having saline. I had saline 7 years ago and decided to go smaller and insisted I stay with saline. He said not a problem. Now what do I do?

Ary Krau, MD, FACS · Answer

Dear Aztamara,     If it turns out that you received silicone implants instead of saline as consented then a mistake was made.  However, in my opinion, no damage done.  Silicone implants are absolutely safe and no less safe than saline.  Additionally, they are superior implants on all counts.  The only advantage of saline implants is that they are less costly.  It appears that it was an honest mistake from which you benefited from.Ary Krau MD FACS

Vincent N. Zubowicz, MD · Answer

If you got a good result from silicone gel I would suggest you accept it. Aesthetically silicone gel implants are better than saline and are equally safe. Nevertheless if you indeed want saline I would expect your plastic surgeon to replace the implants free of charge to you.

Andrew Wolfe, MD · Answer

It is certainly your right as a patient to get the implant that you chose.  There are many reasons you may prefer saline, even of there is no price difference.  The most obvious is ease of detection and correction of a deflation -- if your saline implant fails, you will typically notice overnight, and the exchange may take 30 minutes, tops.  If you have silicone, on the other hand, a rupture is more difficult to diagnose, and will typically only become apparent if a capsular contracture develops.  This requires a more extensive operation to correct.  Given this, it is inaccurate to state that silicone is as safe as saline.  It isn't.  Silicone may offer different advantages in naturalness of feel and appearance that would lead a patient to chose it, but that is despite its drawbacks.  My practice is 95% silicone, and I am a fan of both standard and highly-cohesive implants.  For some patients, however, saline is the preferred implant.  It is, quite simply, up to the patient.In short, it sounds like a mistake was made by the surgeon and you got the wrong implants.  It shouldn't happen, but it can.  Trying to convince you after the fact that what you got is better anyways is unfair at best.  If you prefer to have your implants exchanged for saline, you should have that option.

Salvatore Pacella, MD, MBA, FACS · Answer

There are several ways to determine EXACTLY which type of implant you have:  1) Take a look at the operative note  2) You may have been given a card listing the serial number and style of the implants.  This will give you a definitive answer on what type of implant you have.  Its possible your surgeon may not remember specifically which implant she/he placed in every single patient, but this information should be readily available in your records.

James Nachbar, MD · Answer

I would get a copy of the operative note from your procedure, as well as the implant sheet (often this is a separate sheet filled out by the nurse during the surgery), and the implant information (stickers, card, or sheet) that you got from your surgeon, and then review those with the surgeon and double-check exactly which implant you received.Then, if you did not get the implants you had agreed to before the surgery, you have a choice.  You can keep the ones you have, or if you are concerned about the silicone implants, you can get them replaced with the implants you had agreed to.If you do want them replaced with the ones you wanted, and which you had already paid for, I imagine that most surgeons, had they made an oversight and used the wrong implants, would replace them with the ones you want without any cost to you.  But be sure you have taken your time to do your research, and you are certain you want to proceed, before changing them.Good luck with whatever you decide!

Jeffrey Zwiren, MD · Answer

It is really up to the surgeon to review your operative choices and use the implant that was agreed upon and for which consent was given.  Mistakes can happen.  If you are not happy with the gel implants ask your plastic surgeon to replace with saline as agreed pre operatively. I aways go over the implant to be uses including style and shape in the pre operative holding area to make sure this error does not occur.

Curtis Wong, MD · Answer

in reality, you got a great deal unless you are convinced, despite all of the literature out there, that silicone is somehow harmful to your.  If not, you got a deal here with implants that are softer, more 'real', and it won't spontaneously deflate on you so no surprises.  I hope you will allow yourself to heal and then make the decision that is best for you.  AND if you really feel you need saline, it seems fair that your surgeon take care of everything for you.  But you should have a deadline to make this decision.  I personally believe you got the better deal.

Erik Hoy, MD · Answer

The implant choice should be up to you, and if a silicone implant was placed instead of saline, then this should be corrected by the surgeon.  The implant type is often (not always) specified in the consent.  Silicone implants are safe, are more expensive, and in most cases provide a more natural result.  Likely he is correct that you will like them better, especially if you are used to the feeling of your previous saline implants.  If you aren't satisfied, then it's perfectly reasonable for you to ask to have them replaced.  Best wishes,-Erik Hoy, M.D.

William B. Rosenblatt, MD · Answer

You just got a $1000 gift from  your surgeon. Silicone is much more expensive than saline. The outer shell is the same. I think that silicone is a better , longer lasting implant. Give yourself 3 months to heal -- you should love the implants.

Frederic H. Corbin, MD (license restricted) · Answer

Clearly a mistake was made and if you desire should be rectified by exchanging your implants at no cost to you.  I will say this though most patients prefer silicone over saline.

Dr. Corbin

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