If surgeon and I don't agree on size, do I have the rights to go against him or her? (photo)

Question

If I wanted 450 and the surgeon recommend 340 at the most, do I have the rights to go against him or her. Insist on getting what I want, or are most surgeons set in . So they won't do it unless you agree to their sizes? Or they will go ahead with it, as long as the patient is knowledgeable about the size different effects may have on their results and future?

Dean Trotter, MBBS, FRACS · Answer

I suggest you go back to see your Surgeon and have a discussion regarding the size.  If you are already unhappy with the surgical decisions then you are setting the scene for an unhappy outcome.You should continue discussions with your Surgeon until you are both fully understanding each other and are happy with the surgical plan.Good luck,Dean

Naveen Setty, MD · Answer

Thanks for your question and picture.  Honestly, every surgeon will approach this situation differently.  My personal preference would be to strongly recommend against an implant that I do not feel would fit a patient's anatomy.  If the patient insisted on a bigger implant, I would recommend a second opinion.  It is hard for patients to understand the long-term potential complications with choosing too large an implant.  As surgeons, we see these complications.  You will probably find a surgeon that would be willing to put in any size implant you wanted.  That may not be the best idea.

Michael Law, MD · Answer

There are definitely a range of sizes of breast implants that will result in a natural looking results , and a lasting result. Implants that are too large will likely stretch the skin and result in an unfavorable result and the possible need for re-operation.There are times when patients are looking for a different type of surgery than I will perform.  In most cares prospective patients can get a sense of a surgeon's philosophy and experience by viewing their website. Typically, people see me because of my training an my goal of trying to always create a natural-appearing result from plastic surgeon.Having said all that, your plastic surgeon isn't required to do what you are asking, and you are not required to go forward with your surgeons plan if it doesn't suit you.  It sounds like you may be better off with a different plastic surgeon.

Angela Champion, MD · Answer

We are here to help you make the best decision.  With that said, it's your body and your final decision.  I would talk with your surgeon again and see why he/she won't go larger than 340cc.  Could it be that your body won't accommodate a larger implant?  Ask questions and go from there.  If you insist on going with the larger implant, you may be asked to sign a consent/waiver stating to the fact that you chose a larger implant against the surgeon's recommendation.  Definitely communicate with your surgeon and make an informed decision.  ac

Christopher J. Schaffer, MD · Answer

Size choice is ultimately up to the patient.  450 ccs doesn't seem unreasonable but it may be depending on the base diameter measurement of your breasts.  The base of the implant shouldn't extend beyond this measrurement otherwise complications that are difficult to fix have a higher rate of occuring.  We do refuse to do unreasonable sizes that extend beyond the confines of the patient's anatomy as it is not in best interests of the patient's health or safety.  It is your right to have a certain size implanted just as it is the surgeon's right to decline if he or she does not feel it is not appropriate.

Fadi Chahin, MD, FACS · Answer

Thank you for your question. During the discussion portion of your consultation, typically the surgeon will ask questions to get a baseline idea as to what you are looking to achieve. Based on this, you are generally given an implant size range that will aid in achieving these results. Should you come in requesting a specific size and the Dr. feels that this is unrealistic, I would definitely take this recommendation with high regard. Any surgeon's main goal is to prevent complications for their patients as well as offer them the best results possible. With this being said, implanting a larger implant than he/she may be comfortable with can have complications. Although there are surgeon's that will give you exactly what you want I would suggest extreme caution in dealing with them. You could possibly benefit from seeing multiple board certified plastic surgeon's on consultations to get a general idea if the size that you are requesting is even attainable.  I hope this helps you and good luck.Fadi Chahin MD, FACSPlastic and Reconstructive SurgeonDiplomat-American Board of Plastic SurgeryDiplomat-American Board of Surgery

Robin T.W. Yuan, MD · Answer

If you and your surgeon disagree on size, that usually means there is "no meeting of the minds". I would discourage you from having surgery until there was agreement. When a surgeon and a patient are not in sync, that often means trouble down the road. It doesn't mean you are right and the surgeon is wrong, or vice versa. It is just not a good way to have elective surgery. It is not necessarily a question of right or wrong, but more about philosophy and risk.Robin T. W. Yuan, M.D.

Tom J. Pousti, MD · Answer

Thank you for the question and picture. Most good plastic surgeons would not use implants that they feel will potentially increase risks of complications. In other words, if the breast implants that you choose are too large for your frame, based on careful measurements, then most plastic surgeons would simply not proceed.Although not possible to give you precise advice without direct examination, I would share your plastic surgeons concern that a 450cc breast implant would be too large on the frame of the photographed chestwall that you have submitted.Be careful with your decision-making. Correcting complications can be more costly in many ways.I hope this, and the attached link, helps.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question. If you trust your board certified plastic surgeon then you should follow his or her advice. Most experienced plastic surgeons are inclined to use the largest implant that will provide an excellent result.If your surgeon recommends a smaller size that you request there must be a good reason.I am sure you can find someone to do the procedure that you want but I would suggest that you meet with your surgeon again and try to understand the reason for his or her recommendation.

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