If the Implant Pockets Were Not Made Deep Enough Originally, is That the Surgeon's Fault?

I've reached my 6 month mark but am facing reoperation because the implants have not dropped enough. Is that my surgeon's fault in that he did not make the pockets deep enough originally or did he and my body healed them up slightly? A capsular contracture has also developed in my left breast. I'd say Grade III, not painful but palpable. Regardless though, pockets need to be made deeper and now I face both re-surgery nerves and anesthesia fees. I don't want to pay for HIS mistake.

Doctor Answers 10

Is That the Surgeon's Fault?

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No, I would not say it is the surgeon's fault or responsibility. Each patient's body reacts differently to the implants. 

They often are high riding early on as the pectoral muscles compress the implants and displace the fluid contents up into the upper pole of the breast.  In most patients the implants settle as the muscles relax over several months, but this is not totally predictable. 

As far as capsular contracture goes, these are also not completely preventable. There are, by the way, non-surgical options that can be tried short of the operating room, and you should discuss these with your surgeon.

Both of these problems are know risks, and not the fault of anyone--not the surgeon, not you.

Thanks for your question, Suzie, and best wishes. 

Seattle Plastic Surgeon

Need Revisionary Breast Surgery; Is This Surgeon's Faults?

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No, it is not necessarily the surgeon's fault that the implants have “not dropped enough”. In other words, there is no way to know whether the breast implant pockets were  dissected correctly or not. We DO know that sometimes, despite best efforts and “correct” surgery, breast implants do not behave the way we would hope they would.

 Assuming you have confidence in your plastic surgeons abilities,  based on seeing lots of examples of his/her work,  I would suggest that you proceed with the revisionary surgery. Costs of facility and anesthesia fees are commonly charged.

I hope this helps.

If the #Implant Pockets Were Not Made Deep Enough Originally, is that the Surgeon's Fault? ANS:

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When surgeons make the pockets for the implants we rarely put them exactly where we want them because we know they will settle over time...And most of the time they hit right where we expected...But sometimes they just don't drop like out experience tells us and in fact, sometimes I'm surprised that putting strange implants in a body works as well as it does most of the time! So adjustments shouldn't be seen as a mistake...Unless it is repeated often

You might try this first...

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     I had a patient dependent on Accolate for softness in one of her breasts.  She tried Flaxseed capsules and got off the Accolate completely.  I use in on anyone with threatening firmness and it seems to help most of the time.  Worth a shot before spending a lot of money on aneshtesia.  No picture makes it hard to assess the failure to drop.

Nathan T. Leigh, MD
Edina Plastic Surgeon

Implant revision, capsules, malposition

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implant revision, capsules, malposition

sorry for your problems

capsules can occur in up to 20 percent of patients. it is impossible to say if its the doctors fault.  this can often be treated under local or sedation to limit costs.


Implants and capsular contracture

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Settling can occur differently betweent he two sides, if you also have a capsular conctracture, that is something that is uncontrollable.

Capsular Contracture and Revision Surgery - Preventing Recurrence

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Sorry to hear about your postoperative results. If you truly have capsular contracture, there are several things that may be helpful in preventing a recurrence:

1. If you currently have a smooth implant, changing out the old implant to a textured implant may decrease the incidence of capsular contracture recurrence.

2. Taking Singulair for at least 3 months daily may reverse early capsular contracture, and may also prevent it from recurring.

3. Placing the implant in a submuscular position, if it is currently in a subglandular position.

4 Using an ADM, or Acellular Dermal Matrix, during revision surgery can help as well.

Thank you for your question and best of luck!


Gregory C. Park, M.D.

Capsular contracture is not the surgeon's mistake

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Implants that mature will generally settle into the muscle pocket.  Both right and left muscles are not always equal in strength so you can have uneven settling with this muscle issue.  Capsular contracture can heal the implants with different degrees of tightness and this can keep the implants too high.  Implants that are very large can look too high if your chest is short.

There are some mistakes surgeons can make and there are some healing issues that can cause implants to be too high.  Stay close with your surgeon and he will be able to help you for the lowest cost because he is most interested in getting you a nice final result.

Best Wishes

Dr. Peterson

Marcus L. Peterson, MD
Saint George Plastic Surgeon

Not a surgical mistake but a common complication

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Unfortunately Suzie you have the most common complication of breast augmentation which is a capsular contracture.  We as plastic surgeons have no way of controlling this problem.  It is quite fair of your surgeon to only charge you anesthesia fees as most of us charge OR and anesthesia fees but not a surgical fee in the early post op period.  Good luck with your surgery and I am sure you will do fine and find it much easier than your first surgery.  Dr. Schuster in Boca Raton

Implants didn't settle

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Your implants didn't settle and you have a contracture.

  • These are well-known risks of implant surgery. . 
  • Not settling is more common with saline implants under the muscle because the saline implants are light and muscle pushes them upward.
  • Everyone's body heals differently, surgical results can't be guaranteed. But I am sorry you are going through this.

You should also be aware that capsular contractures can return - even after surgical release. With my best wishes.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.