Should I really pay more for my surgeon to fix my breasts after she failed the first time? (photos)

Question

Hello- I’m 19 and 5’7”. I got a breast lift along with saline implants due to tubular breasts. I had my year post-op appointment last week and the first thing she said was “there is definitely something very wrong here” and diagnosed me with capsular contracture among admitting she didn’t do as good of a job as she could’ve and quoted me $10k to fix it. Should I really be paying another $10k to fix everything when she admits that some of it is her fault?

Gerald Minniti, MD, FACS · Answer

The real issue is your surgeon's judgement and her aesthetics. You were not a candidate for a circumareolar lift, not even close. In addition to bringing into question her abilities to judge your immediate, on table appearance after a second surgery, I would be concerned about her ability to execute well a revision surgery.

Finny George, MD · Answer

Hi, thank you for sharing your question. You seem to have a capsular contracture but this can happen with many patients who have undergone breast augmentation. You also began with a very challenging tuberous breast deformity and have made a significant improvement, thanks to you surgeon. If you trust your surgeon, you should allow them to help again. If not, a second opinion can be helpful.

Leland Deane, MD, FACS · Answer

All I can do is tell you what I think should be done. Realize that there is no one 'right' answer and also you may have signed a permission form for surgery that stated somewhere that secondary surgeries were the financial responsibility of the patient. Also, you had a difficult preop problem(s) and I would have warned that secondary surgeries are likely.

If the surgeon thinks that your problems now are due to a complication that they can correct, then most (and I myself) would do everything possible to lessen the financial burden on the patient. This usually means 'no surgeon fee', but the patient is responsible for the facility and anesthesia. Some surgeons will go so far as to pay for the facility and anesthesia themselves. If a surgeon's fee is charged, it is usually greatly reduced.

These are guidelines only, but the amount that your were quoted sounds high.

Hope this helps, and best of luck.

Casey Anderson, MD, FACS · Answer

You may want to see other consultation if you are no longer feeling comfortable with your original surgeon. Revision surgery is more difficult than primary surgery so be careful.

Leila Kasrai, MD, FRCSC · Answer

Each surgeon sets their own payment policy. Some surgeons may not require patients to cover any part of their corrective procedure, while others may require some portion of the surgery to be covered (for example, just the surgical facility or anesthetist fees). You can discuss your concerns with your surgeon to see what the $10k would be for. They may be able to explain what it covers.

Gary M. Horndeski, MD · Answer

Unfortunately, your original operation provided an inadequate lift. Most likely your implants were placed in front of the muscle resulting in capsular contracture. You will need a repeat lift and probably replace the implants retro-pectoral. In general, pre-pectoral implants lead to capsular contracture and should not have been done. A reasonable compromise would be for you to pay for facility and anesthesia and your surgeon should not charge you her fees.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Michele A. Shermak, MD · Answer

Hello!
These are complicated cases for sure. For revision work I would say that the cost of the OR facility and anesthesia are often necessary to get the case done. The surgeon can choose to waive her professional fees.
What I would say in this case is that if capsular contracture is an issue, oftentimes the implant companies warranty the implants for 3 years and they will pay for surgery and implant replacement. You can check this for yourself or ask the surgeon. 
The next surgery should go better. Best of luck to you!

Daniel Barrett, MD · Answer

Dear karma.xx,
every surgeon has a revision policy. Many involve reduced or even no fees for the surgeon (depending on the situation) while the patient may still be responsible for facility (the use of the operating room, staff, and supplies) and anesthesia fees. Best to go back to your surgeon and have a talk about your concerns again. 
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

That is a question you need to ask your surgeon. Look back at your preoperative paperwork to see what was said about revision surgery.  Some surgeons charge for supplies and the OR and anesthesia, and some charge a reduced surgical fee, some the full fee, and some wave the surgical fee.  Charging for the OR, supplies, and anesthesia is reasonable and standard since all these things will be used again.  Also, every breast augmentation surgery does carry the risk of capsular formation in spite of the surgeon's best efforts.

Benjamin Van Raalte, MD · Answer

Yours is a very difficult case. In fact, I would have told you as a surgeon, it would take at least two procedures to get you an optimal outcome. Capsular  contracture is not the fault of the surgeon,  it unfortunately occurs. Some of the gel implants do have a partial warranty for contracture but not the saline. It is also not unusual for patients to interpret what they hear differently whether they think the surgeon said, admitted or agreed. You should refer to your written documents.  Usually returning to your original surgeon is the lowest cost option for revisions. The documents usually spell out what is covered.
The amount quoted does seem high but I don't know what it entails like expenses such as mesh or ADM.
Looking at your pictures perhaps a peri areolar lift to reposition the areola and one attempt at just releasing the capsules might get an acceptable result at a lower cost. Higher cost options include a full mastopexy, new gel textured implants, mesh or ADM. Get a second opinion but not from a direct competitor.

Should I really pay more for my surgeon to fix my breasts after she failed the first time? (photos)

Answers (12)

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