I received a small peri-areolar breast lift and implants. I am 21 years old and went from a c to d cup and fixed minor asymmetry. I am currently 8 months post op and need a revision. I have extreme scarring around my nipples, the nipple placement is lower than asked, and he made the pocket too big causing disfigurement. He is going to have to remove both implants and sew up the pockets. I feel he did a terrible job and I need help to know if I should trust him to fix it. What should I do?
Answer: Bad Surgery v Bad Situation I can see why you are displeased with the result: the scarring, the nipples point down and out, and you seem to have a "double-bubble" on the right. Let's look at them one at a time.Surgeons take too much credit for good scars and too much blame for bad scars. The redness and thickness of your scars is typical for someone your age 8 months after surgery. Truthfully, there is nothing a surgeon can do to prevent that from happening nor could a surgeon even inflict thick and red scars upon a patient even if they were so inclined. With time they will soften and fade. When a patient with scars like yours after a donut lift insinuates to their surgeon that he or she did something wrong, that patient demonstrates a level of immaturity that makes productive discussion difficult. That redness is a variant of normal, and 100% under biological factors in your own body no one can control.Your chest wall and breasts naturally have a down and out sort of a direction. That can never be remedied with a donut lift, but any more aggressive of a lift would entail a greater degree of scars. Again, that is simply something for which the surgeon cannot be blamed. Look at your favorite after photos. Did the preoperative shape of those patients look like yours? And are you looking at afters of people who had a donut lift with their augmentation or just augmentation? One important thing: you only sent your after images, not your before. Plastic surgery can only be judged by the degree of improvement of that patient, not a comparison of a final outcome with a particular photo or a hypothetical aesthetic ideal. Do you look better now? Do you see in your preoperative photos any characteristics that predict some of the shape issues that bother you now? I bet so.Presumably you vetted your surgeon before your first operation. I don't see anything that justifies losing trust. Give him or her a chance, but you have to approach this maturely, which means a clear recognition of your preoperative configuration and that he or she cannot control the way you heal. Surgery is not magical, and if you do not accept the limitations on what can be achieved for you, then you will frustrate yourself and not put yourself on a path to improving.Your insurance almost certainly only covers postoperative complications such as bleeding and infection, which fortunately you do not have. I've never heard of one of those policies that covered someone without a complication just wanting a better outcome.Give your surgeon a chance. Best of luck to you.
Helpful 2 people found this helpful
Answer: Bad Surgery v Bad Situation I can see why you are displeased with the result: the scarring, the nipples point down and out, and you seem to have a "double-bubble" on the right. Let's look at them one at a time.Surgeons take too much credit for good scars and too much blame for bad scars. The redness and thickness of your scars is typical for someone your age 8 months after surgery. Truthfully, there is nothing a surgeon can do to prevent that from happening nor could a surgeon even inflict thick and red scars upon a patient even if they were so inclined. With time they will soften and fade. When a patient with scars like yours after a donut lift insinuates to their surgeon that he or she did something wrong, that patient demonstrates a level of immaturity that makes productive discussion difficult. That redness is a variant of normal, and 100% under biological factors in your own body no one can control.Your chest wall and breasts naturally have a down and out sort of a direction. That can never be remedied with a donut lift, but any more aggressive of a lift would entail a greater degree of scars. Again, that is simply something for which the surgeon cannot be blamed. Look at your favorite after photos. Did the preoperative shape of those patients look like yours? And are you looking at afters of people who had a donut lift with their augmentation or just augmentation? One important thing: you only sent your after images, not your before. Plastic surgery can only be judged by the degree of improvement of that patient, not a comparison of a final outcome with a particular photo or a hypothetical aesthetic ideal. Do you look better now? Do you see in your preoperative photos any characteristics that predict some of the shape issues that bother you now? I bet so.Presumably you vetted your surgeon before your first operation. I don't see anything that justifies losing trust. Give him or her a chance, but you have to approach this maturely, which means a clear recognition of your preoperative configuration and that he or she cannot control the way you heal. Surgery is not magical, and if you do not accept the limitations on what can be achieved for you, then you will frustrate yourself and not put yourself on a path to improving.Your insurance almost certainly only covers postoperative complications such as bleeding and infection, which fortunately you do not have. I've never heard of one of those policies that covered someone without a complication just wanting a better outcome.Give your surgeon a chance. Best of luck to you.
Helpful 2 people found this helpful
February 19, 2014
Answer: Inadequate lift Your results are typical of patients who undergo breast augmentation with an inadequate lift. Your breasts are still too low, too far apart and asymmetrical. I recommend a new technique called Implant Exchange with Mini Ultimate Breast LiftTM. Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. At the same time, your implants can be exchanged and the pocket elevated. Aligning the areola, breast tissue and implants over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant. Small round textured silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision. Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it. Your areolas can be reduced to a more appropriate size and the old scars excised. Best Wishes,Gary Horndeski, M.D.
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February 19, 2014
Answer: Inadequate lift Your results are typical of patients who undergo breast augmentation with an inadequate lift. Your breasts are still too low, too far apart and asymmetrical. I recommend a new technique called Implant Exchange with Mini Ultimate Breast LiftTM. Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. At the same time, your implants can be exchanged and the pocket elevated. Aligning the areola, breast tissue and implants over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant. Small round textured silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision. Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it. Your areolas can be reduced to a more appropriate size and the old scars excised. Best Wishes,Gary Horndeski, M.D.
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Answer: Unhappy with Surgery and Surgeon I am sorry you are unhappy with your Surgery. I speak for all the surgeon here that we try to make all patients happy with their surgery and that we are as "unhappy"ourselves when we do not achieve the result the patient desires. Sometimes it is the anatomy of the patient, sometimes the expectation of the patient, sometimes the surgical technique chosen, sometimes complications just happen.I also think you should return to the operating surgeon, discuss your concerns openly with him and give him a chance to improve on your outcome. Your problems are not so difficult to correct!Last but not least I would very much encourage you to read and re-read Dr. Teitelbaum's advice. He is a master in the Breast surgery field, has tremendous experience and is known for his candid assessment and advice. I wish you all the best!
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Answer: Unhappy with Surgery and Surgeon I am sorry you are unhappy with your Surgery. I speak for all the surgeon here that we try to make all patients happy with their surgery and that we are as "unhappy"ourselves when we do not achieve the result the patient desires. Sometimes it is the anatomy of the patient, sometimes the expectation of the patient, sometimes the surgical technique chosen, sometimes complications just happen.I also think you should return to the operating surgeon, discuss your concerns openly with him and give him a chance to improve on your outcome. Your problems are not so difficult to correct!Last but not least I would very much encourage you to read and re-read Dr. Teitelbaum's advice. He is a master in the Breast surgery field, has tremendous experience and is known for his candid assessment and advice. I wish you all the best!
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February 18, 2014
Answer: No longer trusting your surgeon certainly adds complexity to what you can do in the future. If your surgeon has a good reputation and track record, this would be considered just a 'bad day' result and revisions can certainly make it better. But you need to identify all of the issues you have and find out what your surgeon recommends to have it repaired. If you truly don't trust your surgeon, you will need to find another that participates with that insurance policy you have and if it limits your revisions to your original surgeon, then you simply have to make the best of it.
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February 18, 2014
Answer: No longer trusting your surgeon certainly adds complexity to what you can do in the future. If your surgeon has a good reputation and track record, this would be considered just a 'bad day' result and revisions can certainly make it better. But you need to identify all of the issues you have and find out what your surgeon recommends to have it repaired. If you truly don't trust your surgeon, you will need to find another that participates with that insurance policy you have and if it limits your revisions to your original surgeon, then you simply have to make the best of it.
Helpful
February 15, 2014
Answer: Several problems need to be addressed You are right that you have asymmetry of the breasts due to bottoming out of the right breast creating a double bubble. The reason the nipple areole complex has stretched out and is too large is that you may need a more aggressive lift like a vertical lift. Based on your photos which does not replace an in person evaluation or consultation there are several recommendations. I would recommend waiting until you are 22 and switch to silicone implants. I would repair the capsule either with a capsule repair or new pocket. Finally I would do a vertical lift and possibly a dual plane to score the subareolar area. I say this because I suspect you have a degree of tubular breast deformity but would have to see your pre-op photos. In regard to insurance, that covers emergency hospital care during the first 30 days for things like bleeding, infection, deep vein thombosis, heart attack etc. It does not cover you for dissatisfaction or need for revision. This you have to discuss with your surgeon who seems very willing to correct it for you. Good luck, Dr. Schuster in Boca Raton
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February 15, 2014
Answer: Several problems need to be addressed You are right that you have asymmetry of the breasts due to bottoming out of the right breast creating a double bubble. The reason the nipple areole complex has stretched out and is too large is that you may need a more aggressive lift like a vertical lift. Based on your photos which does not replace an in person evaluation or consultation there are several recommendations. I would recommend waiting until you are 22 and switch to silicone implants. I would repair the capsule either with a capsule repair or new pocket. Finally I would do a vertical lift and possibly a dual plane to score the subareolar area. I say this because I suspect you have a degree of tubular breast deformity but would have to see your pre-op photos. In regard to insurance, that covers emergency hospital care during the first 30 days for things like bleeding, infection, deep vein thombosis, heart attack etc. It does not cover you for dissatisfaction or need for revision. This you have to discuss with your surgeon who seems very willing to correct it for you. Good luck, Dr. Schuster in Boca Raton
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