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

Question

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.

John J. Corey, MD · Answer

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

Jed H. Horowitz, MD, FACS · Answer

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.

	sorryJH

Jourdan Gottlieb, MD · Answer

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.

Tom J. Pousti, MD · Answer

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.

Nathan T. Leigh, MD · Answer

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.

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

Answers (5)