Simple Implant Exchange Gone Horribly Wrong. Miami, FL

Miami Plastic Surgeon
4.8 out of 5 stars 328 reviews
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My breasts weren't horribly bad, I just wanted to...

My breasts weren't horribly bad, I just wanted to exchange saline overs to silicone unders for better coverage, mammograms, and regain some of the lost shape and volume from breast feeding While my experienced, board certified surgeon told me to "trust him, they will look awesome" they are so much worse then my previous implants I had for 19 years. It is with such regret that I went to a surgeon who created problems, and although did a revision, did not address all the problems he created. I am so much worse off - severe animation deformity, symmastia and constant muscle pain from over dissected/released pectoral muscles. I received no follow up from my doctor or his office after revision surgery. I hoped and prayed and followed his post surgery instructions but unfortunately my results speak for themselves, and it will cost me a lot more time, money, and stress to fix my breasts. I emailed updates and pictures at 10 weeks post and subsequent updates with pictures showing the outcome - and my doctor has not responded. I cannot believe doctors can get away with not addressing issues they create by over zealous use of the knife. Had I known he was going to cut any of my muscle away from my sternum I would not have agreed. I did not ask for large breasts or close cleavage, but he changed my cleavage and folds so much that now if I don't wear a thong bra or tape my breasts I have symmastia. The mental and emotional stress is exhausting.

Symmastia confirmed and HIPAA request

So a couple of doctors responded to my question about symmastia and it is as expected:

"Yes you do have synmastia/symmastia. The skin in the center of your chest has separated as a result of the implant pocket being dissected too far toward the midline. This is correctable and in my opinion requires temporary removal of your implants to allow the tissue planes to adhere to one another again, followed by replacement of smaller implants.Hope this helps." Dr. Ali Mosharraf

"Yes you may have an element of symmastia on the left.  If it bother you, it would need to be corrected surgically by re-establishing the division between your breasts." Dr. Tyler C Street, MD

I only wish my PS would see this issue and RESPOND with options!

On another note, I have booked in to see two PS next week. One of them asked to see my operative reports from the surgeries with Dr Krau. I called his office and they sent me an authorization form to release the information. I did some research about the Health Insurance Portability and Accountability Act (HIPAA), and found their form a little off. There are some specific items that must be included on the form. HIPAA says the recipient (that is me) can use the information for whatever purpose I choose, however, the PS forms states the information can be used for the following purpose: "Representation in a personal injury action" - QU: DO THEY EXPECT ACTION? Secondly, once protected health information (PHI) is disclosed, the recipient can re-disclose the information and it may no longer be protected by federal or state law. I believe the key to this item is that the RECIPIENT can re-disclose the information. On the PS form it says "once the PHI is disclosed, it may be re-disclosed to individuals or organizations that are not subject to the federal privacy regulations such as expert witnesses, litigants, insurance companies and even may be public record if filed with a court of law". Does this mean I would be signing that they can disclose and release my PHI to anyone since it was missing "BY THE RECIPIENT"?!

So I downloaded a standard HIPAA form just to ensure I wasn't authorizing re-disclosure by anyone but me! By law they have 30 days to respond. I have no idea what operative reports include, but I will keep you posted!

Dr Krau non responsive to request for operative records

So I am still waiting for my operative records from three surgeries with Dr Krau. I followed up earlier this week and despite sending him a HIPAA request, got a response saying I have to fill in their HIPAA form which unless I am reading it wrong, basically asks me to authorize their right to re disclose my personal records. After several hours of research I do not believe I am. It just amazes me how doctors can screw things up, not even acknowledge the bad outcome, and then totally ignore their patient's questions about what can be done to fix it, and not even try to help you out by providing my health records in any timely fashion that could greatly assist another doctor to fix the issues he created. How is this professional or ethical? They get 30 days to respond, so maybe they are just too busy right now to PDFs a copy to me? If I don't receive them in this time frame I will follow up through the appropriate channels. My advise is when this doctor tells you to "trust him, they will look awesome", save yourself time, energy, money, stress, lack of sleep, frustration and depression! Don't just look at the good reviews! No point posting any more photos although one revision specialist I am consulting with provided this photo of what he believes is happening in my situation Causing the high animation above my nipple on my left breast, and symmastia. I can't look at myself without feeling sad, and I can't wear any low cut tops, sports bras, without feeling completely self conscious. Seeing two doctors this week. Can't wait to hear what they say I can do to fix it albeit dreading yet another surgery!

Dr emailed operatives reports and took them to see to PS

So Dr Krau's office did provide the operative reports from the three surgeries I had with him, although they still have not provided the pre and post photographs I requested. I took the reports to the two PS consultations I did in the DC area this week.

1. Dr. Jabs will not even consider doing this type of revision surgery after reading the operative reports and examining my breasts! He recommended Dr Spear, a revision specialist, who I happened to see yesterday.

2. Dr Spear will operate on me for about $17,000.00 - without any guarantees of fixing the problem. After reviewing the operative reports, he was unclear on what Dr Krau did and why, and said there really is no way of knowing what can be done until he is in there. He did say there is not enough research on Galaflex for using it to assist with window shading, and that it is like to produce more scar tissue then other ADM.

He said I had 4 options. 1. Don't do anything. 2. Explant. 3. Create a new neo-pectoral pocket which may or may not address the problem, since he is unsure of how much muscle was detached / released. The more released, the bigger the problem. 4. Return to sub glandular but no guarantees the animation will be hidden although should be better then it is now.

He said no matter what he did, he would have to use ADM (at $3.5K a piece) to address the animation and close cleavage/borderline symmastia. He said there is NO WAY to reattach the muscle, and while he cannot tell for certain, it appears the muscle was detached/released very high up on my breast. He said the left breast had a superior closeness/symmastia, while the right breast had an inferior one. In other words, one breast was worse on the top half, the other worsen the lower half.

Both indicated they had not seen this type of muscle animation deformity so high up on one breast before!!!!

Any which way I look at this is devastating to me. More surgery, no way of knowing what or how it will be fixed, and it will cost me thousands of dollars. Why do doctors think it is ok to NOT help unscrew the problems they create?

It's getting worse

My left breast animation is getting worse. My muscle aches every day even when I do nothing but type on a computer! Has anyone ever seen muscle animation so high up on the breast? Had I know his was a possibility I never would have changed to sub muscular. It is so depressing!

Revision by Krau

Apparently this is acceptable work according to Krau! If he took responsibility for his work and provided a duty of care he would have responded to my concerns and addressed the issues he created during revision surgery. Instead he chose to ignore and my left breast is deformed. What comes around goes around! Happy Hanukkah Dr Krau.

Visible lumps, symmastia confirmed

7 months post revision. Over the last few weeks another lump has appeared. This one is in the IMF left side and visible. I went to see another PS who after examining me, reviewing operative reports and photographs confirmed the following issues.

1. Pectoralis muscle was over dissected / detached half way up my sternum which is creating window shading high up on my breast and only covering about 1/4 of the implant. Essentially implants are predominantly subglandular.

2. Symmastia both sides, worse on left side.

3. Lumps in breasts are presumed to be the galaflex broken away from the tissue and rolled up into a ball.

Dr said I did everything right with researching and interviewing surgeon, but the plastic surgeon performing my first and subsequent revision surgeries made mistakes and cut too much of the muscle. He saw my before and after photos and agreed that I did not have symmastia before. He said I clearly do now and confirmed my worse fears since my issues can never be 100% corrected. The muscle can never be reattached to the sternum. Basically I am screwed! What he did say was that he can make things better then they are now but at a cost of approximately $15,000.

This 4th revision surgery would include addressing the symmastia and pocket revision, removing the galaflex mesh, repositioning back to subglandular, and fat transfer. It does. It include new implants, he will recycle the ones I have. So I ask myself - why did I change from original salines? The expense, physical and emotional distress is so much more worse now then it ever was with my pre:Dr Krau breasts!

And BTW, Dr Krau is still not responding! I think they call it "patient abandonment".

Galaflex lumps

Since my Doctor abandoned me, and not a lot of PS seem to know much about gala flex, I reached out to the company who produce It. They have been most helpful. They reached out to Dr Krau's office regarding the gala flex lumps in my breasts, and apparently the office coordinator told them that "I failed to follow post operative procedures and did not wear the post operative garment"! Wow such lies! I followed all post operative instructions and if I had any questions after my three surgeries I asked them via email or text or phone. I was so cautious and did what was advised so not to jeopardize the outcome. I am flabbergasted at this doctor's attempt to discredit me. I have the emails and I have two reviews that tracked progress and communications. The gala flex rep said the rolled up gala flex / lumps would not have happened if it had been sutured/attached correctly.

Boobs by Krau worsen

I can't believe the issues can keep getting worse. You be the judge. This PS completely deformed me! 19 year old saline implants were a dream compared to how I look now. I just have to live with it or find $16-17k in attempt to fix what Dr Krau did to me!

1 year post revision still looking for answers

I have seen 7 PS since Dr Krau did not respond to my concerns and ongoing issues since revision surgery last June. I have been told that my situation is so complicated and can never be resolved! All have stated that the muscle was over released from the sternum and the pockets were over dissected causing both high animation and mild symmastia. Wile not true symmastia as there is some separation but still loss of any separation in cleavage. I do not not where to turn.

Dr Krau finally responded stating he could no longer treat me because I said he did something wrong and trust is needed in dr - patient relationship. I told him I did not have an option but to see other PS since he stopped responding to me did not provide any follow up. I only repeated what other PS told me was the likely reasons for my issues. All were sympathetic and quite horrified that my doctor abandoned me, refusing to take responsibility and treat me. I am starting to think that because the damage is done and there is no fixing me that Dr Krau decided no point trying. I am at a loss! I am in constant pain on left side and can't wear any clothes that show my breasts. Any flexion of pec muscles exposes a line across the top of my breast, and forget sexy bras as I lose any separation of cleavage. Dr Krau told me to trust him, and they would look awesome! How does someone go from that stance to ignoring the terrible outcome that only resulted from surgery with them? How is this professional let alone ethical?

Anyway, of the 7 surgeons only two would do surgery. They all stated either it was too complicated, they didn't have enough experience with this type of revision or using Galaflex (that remains as a rolled up lump in my left breast and hard quarter size lump in my left breast), or they had no confidence in being able to resolve the issues. I asked about going back to subglandular but apparently risk for capsular contraction dramatically increases with more surgery, plus rippling and feeling the implant because I lack natural breast tissue. Further staying sub pectoral will not change the result since the muscle can never be reattached to the sternum and it is very difficult to close off the pocket medially and get the tissues and skin to adhere back down. I can vouch for that since Dr Krau was supposed to have done a medial capsulorrhaphy (sp?) but there was no change and in fact it is worse!

At any rate I know I don't want to live like this but more surgery scares me just as much. I am so paranoid about people seeing my deformity, and I have to wear clothes that completely cover up my breasts which is hard in a sports bra or swim suit! I am constantly reminded because of the pain in my left pectoral muscle.

Girls what shall I do? I even have asked about explanting but because of how much muscle was cut I am likely to still have the muscle animation, plus I would be left with sagging stretched skin because I have minimal natural breast tissue.

This has been one of the worst experiences of my life. I did my due diligence. I researched for 5-6 years and believed I had found an ethical, professional, highly experienced and caring surgeon. I am so sad that Dr Krau dumped me. I still believe he is a capable surgeon but given what I have heard repeatedly about how difficult my situation is, there is no going back and resolving my problems. Maybe he realized he cannot fix me so it was easier and less costly just to cut me off!


After a lengthy search I thought I found an experienced, and caring surgeon. I cannot say I have the same opinion since my outcomes are unacceptable and my doctor is either too busy or choosing not to respond to my questions about what can be done to address the problems since having first revision surgery last October 2015 and more surgery in June 2016 that did not address the issues created in first surgery.

1 out of 5 stars Overall rating
1 out of 5 stars Doctor's bedside manner
1 out of 5 stars Answered my questions
1 out of 5 stars After care follow-up
1 out of 5 stars Time spent with me
1 out of 5 stars Phone or email responsiveness
3 out of 5 stars Staff professionalism & courtesy
3 out of 5 stars Payment process
2 out of 5 stars Wait times
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