Disappointed after revision. Additional work needed and extremely costly. What should I do? (Photo)

I had a capsulloraphy done w exchange but the results did not come the way I had hoped. Still need more internal sutures and a lift. Had I known this I would have gotten a lift w the revision. PS now wants an additional $6.5k for lift and sutures. Is this "normal/fair"? I am so sad I can't look in the mirror and feel like an idiot for spending money on the original revision at all. What should I do? Should I talk to the office manager or directly with the Doctor? What should I say? Looking for options.

Doctor Answers 3

You Have A Nice Result

You have a very nice result based on the photos.

You say you are so sad you can't look in the mirror, but I do not know what you are disappointed about specifically. Your breast shape looks nice, and the breasts falling to the side when you are supine is normal.

Do you want them higher and firmer? If so, I would consult with your surgeon about the lift, ask about Strattice (I also use this product in my practice with excellent results), and anticipate spending money for a new procedure. You should speak to the surgeon about the medical risks/benefits/procedure, and the office manager about the pricing.

I hope you find a solution and are satisfied! Best of luck!

Do I need a lift?

 I would have to say, that from looking at the sequence of photographs, your outcome looks quite good to me. With gravity, and a curved chest wall off to the side like you and most women have, all breasts whether with or without implants will migrate outward with gravity. The heavier the implant and the more stretched out the skin, the faster this will happen. I've had good success supporting the side of the capsule internally with a product called Strattice. The Strattice is less likely to stretch therefore the effect of may the sutures last longer. As far as who pays for revision, each plastic surgery practice will have their own rules and guidelines. In my opinion, if you needed a lift preoperatively but decided to opt for just an implant, and this was presented to you as an option with its inherent costs, then there should be some fee to now go in and do the lift. When these surprises about additional costs are presented to patients I can understand why there would be some disappointment. In my opinion, having a frank discussion with your plastic surgeon about your dissatisfaction and together coming up with a plan to remedy it will usually lead to a better financial outcome than going in mad and demanding restitution. It's my belief, that no plastic surgeon wants an unhappy patient talking to other prospective patients about their less than satisfactory outcome. Good luck in the future and I hope this gets resolved to your satisfaction.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 reviews

Disappointed after revision

Dear Ella,
After reviewing your previous photos and posts I would have to say that your surgeon did a tremendous job and you look wonderful! Yes you have some asymmetry, but it is markedly improved overall and much more beautiful.
  • All smooth implants are going to fall some to the outside when lying down. Newsflash, all breasts without implants that have any volume will also fall to the side when laying down, especially as one ages (past your 20's and after kids it will be more obvious).
  • Because you had stretched out and asymmetric skin envelopes pre-op, and then downsized your implants, there is certainly a risk of needing a lift as expressed by responding physicians to your previous posts. I am guessing that the lift at this point would be to improve the nipple position on the left. You were not charged for a lift, and didn't have one. If you want one now, of course it is reasonable to pay for it. The nicer and more reasonable you are, likely the less it will cost you, but you shouldn't expect it to be free.
You look quite early post op and my recommendation is that you thank your surgeon for the great job, and would like to revisit the fine details after 8 months to a year. There is a saying in plastic surgery that "the enemy of good is perfect", and sometimes you wish you had just stayed with what was good. It is a shame you aren't happier with your results because I think you turned out even better than I would have expected after looking at your before photos.

Stacey Folk, MD
Denver Plastic Surgeon
4.8 out of 5 stars 23 reviews

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