PS mistake, what route should i take?

[fivefive]

Hi!

I had my surgery 30 days ago. I told my doctor i wanted 300cc on left and 325cc on right. To make me a full B. After the healing, I'm finding myself a bit small. I checked my serial numbers and i found out that he put 300cc on both. This was not our agreement and I am quite upset. Getting 325cc on my right would have made me look more equal. What route should I take with my doctor, I have an appointment this wed. I don't understand how they could make a mistake like that. Now, I am experiencing boob greed aswell. I am expecting him to atleast fix the error and replace the 300 with a 325 but since I am going thru the pain of surgery again shoud i upgrade my size on both? I like how I look naked but in clothes, they look the same as when i was wearing a padded bra. I paid alot so i wanted this to be perfect just like the rest of you. Also, if he made the error about the sizing on 1 side, do you think he will be willing to upsize on both at no cost? How do I approach him on that without sounding boob greedy? (but i know i am) Any help or suggestions will greatly be appreciated.



height =5'5"
weight =112
silicone gel mentor 300cc moderate plus.
flat 32 a to now a 34b

[Dr. Mele]

Dear Fivefive:

Thank you for your post. Before you get too upset. You may want to ask your plastic surgeon how much volume was placed in each implant. The serial number tells you the shell volume, but not the amount of fluid added.

If indeed the agreement was to add more volume on the right, and this was not done, then you will want to ask why not. Perhaps it looked too big in the operating room. Regardless, if it looks too small now, then I would expect them to figure out how to do what was agreed upon. You will probably want to wait until the swelling from the surgery has resolved; however, before trying to fix it so you get a more predictable result.

If it looks too small, and the agreed upon volumes where added, then you are really going to want to wait until you have healed completely before making any decisions. It may still improve with time. 25 cc's is a pretty small difference in volume.

As far as upsizing both implants. Now you are changing the volume agreement. You may want to sort out the 325/300 problem first and then negotiate a larger volume. If you are going to have surgery to add volume, it would be a good time to do both sides. If you are wanting a significant increase in volume, don't forget there is the added cost of new implants. You will need to negotiate that with you plastic surgeon.

But remember serial numbers do not equal fill volumes. You want to check that first.

[fivefive]

Doctor Mele!,

Thanks for replying so quickly. Since I went with Mentor Silicone Gel implants, they could not be filled, because they're permanent sizes right? Is it possible for him to have put the 325cc in, then would have replaced it? He would have told me about such a change. The reason it's only 25cc is because my right is smaller than my left and my chest wall was a little further back on my right. He told me he would make them look equal. It doesn't as of now and the thought of surgery again scares me.

As far as upsizing, if i go through surgery again, i might as well go larger by like 50cc and/or 75cc. That will make me feel that going through surgery was for another greater purpose and not just correcting a mistake.

I'm scared of my PS now.

Thank you for taking the time.

5'5"

[Dr. Mele]

Dear Fivefive:

For some reason I had Saline on my mind. You are correct of course. Silicone gel implants are prefilled and the volume is not adjustable, so the serial number tells the story of the volume. If you are going to have another surgery, it is also the best time to change sizes.

I would certainly approach your plastic surgeon about the size discrepancy. If the plan was to decrease the asymmetry with a larger implant on the smaller side, then you deserve an explanation of why that was not done.

It is difficult to make the breast symmetric, and there is normally some asymmetry. The reason I recommend waiting is that currently there is some swelling in your breasts. The breasts are most likely not swollen equally and it will be more difficult to improve the asymmetry while this is the case.

Sorry this happened. Good communication is as important as good surgery. I would bring this up and see what the rest of the story is. The way they handle it will tell you a lot about. If you still trust your surgeon, then see if there is a way to work things out. If you need to see another surgeon, it will likely cost more; however, it is your body and you are worth the added expense if it provides a safer and more predictable result.

Lastly, revision surgery to change sizes tends to have an easier recovery than the initial placement. I hope this will be the case for you.

[fivefive]

Hi Doctor Mele!

I went to my doctor and told him that the one side was still smaller and i was wondering why because it should actually be bigger because it was 325. He said that we had a conversation in the operating room that 300 on both would be more sensible afterall. He said that I agreed and that we had the discussion before the anesthesia and everything. The thing is I do not remember the conversation at all. I remeber everything from the things they put on my legs to make my blood circulate... i remember the ivy... the nurse did it wrong the first time, so the anesthesiologist had to do it. I remember the smell in the tubes in my nose. I do not remember even seeing my doctor in the OR. I told him all this. When we agreed initially about the 300&325 he even said that my right would be bigger by 10cc but because my chestwall is slightly further back it would make it look as equal as it can. So I don't even know why he changed his mind. Then claims to have had the conversation.
He even says he can pull all 4 people in the OR and they will vouch that I agreed on the last minute change. But he is willing to change it for free. BUT he says if I am not happy and the right side looks much bigger and if I want it reversed, he would have to charge me full price for reversing back. Then he goes back to saying 25cc is a teaspoon and a half. It's really only me that can see the difference.

LONG STORY SHORT : He is willing to switch it to the 325cc in 4 months if I decide to do that BUT he says if I am not happy and the right side looks much bigger and if I want it reversed, he would have to charge me full price for reversing back.

My thoughts... I don't know why he is willing to do it free of charge if we did have the conversation. I am sure we didn't have the conversation. I am scared to have him redo it because he might intentionally make it look bigger.
I didn't even mention the upsizing. His tone changed and he got defensive when I mentioned that I remember him marking my chest and the reasons 325 would be good., and when my husband said that he remembereed too, Then the doctor said "look i remember all that" "I'm already willing to do this free of charge in 4 months." I feel he is making me feel that I owe him the favor but I think it is really his mistake.

Do you think a surgeon would ever admit to having made a mistake like that?

am just scared he might make me look way bigger on purpose, then charge me full price to fix it. It's so twisted! AHHH! Don't know what to do. I have 4 months to think about it.

I wish I had you as my docotr instead.

[Dr. Mele]

Dear Fivefive:

Have you even seen the old Paul Newman movie Cool Hand Luke? The crux of the plot is summed up by one line spoken by the warden to Paul Newman's character, a prisoner. The line is. "What we have here is a failure to communicate." A discussion with a patient right before anesthesia is likely to be forgotten. That is what anesthesia does.

I strongly dislike changing plans at the last minute. One of the best parts about elective surgery is that we are deciding what surgery, where we want it, and how we want to do it well beforehand. On operating days I just want to operate, and to operate effectively, I need a well constructed plan. There are times when changes are necessary and decisions need to made at the time of surgery. There are times when I change the plan, and I am the first one to bring it up and explain it. I wouldn't change plans without a good reason, so I am upfront about explaining what was done and why.

Moreover, if there are some decisions that can't be made until we are in the operating room I will explain that beforehand. I also try to explain what criteria I will be using to make the decisions. This is what makes Plastic Surgeons professionals. We are paid to use our best judgement. We are not just technicians. I listen to my patients goals and try to make certain they are reasonable, and construct the safest and most predictable way to obtain the goal. This is done before we get to the surgery center so everyone knows what is going on.

In terms of setting reasonable goals. Asymmetry can be improved, but is never completely corrected. Asymmetry can occur in all plains of view (front, size, looking down) and sometimes one view is compromised to improve another. With all that you have been through, I still would recommend two things before going any further.

First, you will want a second opinion. If the second opinion leaves you confused get another. You need to understand fully what can and can't be done and know what you should expect to happen.

Second, allow your body some time to heal. Operating too soon can lead to increased scar and a longer recovery. Let your body heal. Let the injury resolve, and let the emotions work themselves out. That way you will be in the best state of mind. I realize this will not provide resolution, but it will give you the best opportunity for a safe and predictable result.

You don't want to burn any bridges so do keep your follow up appointments and do try to establish some understanding of what to expect. You have the time at your follow up visits to discuss what will be done. 25 cc's is 5 teaspoons. It is a small volume. Since I haven't seen you I don't know if that will fix the asymmetry. evaluate the size difference after the swelling has resolved. There are other options I have used to compensate for differences in rib cage projection. In a few cases I have used a moderate profile implant on one side and a high profile implant on the other. There was LOTS of discussion before doing this though.

Then you will have a decision to make. The most important decision is to answer the question. "Do you trust your surgeon, completely?" If you do not do not let him operate you. You need to know that your plastic surgeon is going to use every once of their knowledge to make the best possible decisions for you at all times. This way, even if there is still a little difference afterwards, you will know that everything possible was done with all the information available to get you the best result. You will not be doubting yourself for having surgery with someone you didn't completely trust.

Like I have said before in this forum. I have never seen you, so I can't tell you what is best. But I would recommend seeing another plastic surgeon and get a second opinion about what can be done and when would be best. If only for your peace of mind.

[fivefive]

Dr. Mele,

Thank you for your advice. I am following it to the tee. Are you open to receiving a photo so you can give me your opinion?

Please let me know.
Thank you so much!

55

[Dr. Mele]

Dear fivefive:

Hope you had a good weekend. I am open, but it is not the same as being there, and it will not likely change my advice.

[Gypsyrose]

Originally Posted by fivefive

. I paid alot so i wanted this to be perfect just like the rest of you. .

Hi, I know this is for the Dr... But I just wanted to add that I don't think any of us feel that we are perfect... we are as close as our PS could get us and bigger My PS explained that the implants don't fix all imperfections...please give it some time before you go under the knife for the extra 25ccs... My breast are uneven in size. I had two different volumes in my first breast augmentation because they were saline, but my second breast augmentation was silicone and the difference between an 800cc and the next lower implant was too great, so mine are both 800cc about a 15 to 20 cc difference and I can't tell now that they have settled... I even have a thread on here with famous women whose implants don't look 'perfect.' In the end though, it is about your happiness.

[fivefive]

Hi Dr. Mele,

I am scheduled to have my surgery on Monday, Mar. 1st.

I decided to stick with my doctor since our last meeting felt rather pleasant. I am getting larger implants... a 400cc or 450cc on my left and 25cc bigger on my right.

I went to the office today to sign some papers and he is making me sign a "release of all claims". Is this common for elective surgery? In the release he also says that I should agree not to make any derogatory comments or negative statements of any sort about him or his staff to any person or media representative, newspapers, tv, internet, movies or radio.

Isn't this against freedom of speech?
I was just wondering if this is common within plastic surgeons to have patients sign this form of release.

Thank you for taking the time to read this.

Sincerely,
fivefive

[Dare]

Originally Posted by fivefive

Hi Dr. Mele,

I am scheduled to have my surgery on Monday, Mar. 1st.

I decided to stick with my doctor since our last meeting felt rather pleasant. I am getting larger implants... a 400cc or 450cc on my left and 25cc bigger on my right.

I went to the office today to sign some papers and he is making me sign a "release of all claims". Is this common for elective surgery? In the release he also says that I should agree not to make any derogatory comments or negative statements of any sort about him or his staff to any person or media representative, newspapers, tv, internet, movies or radio.

Isn't this against freedom of speech?
I was just wondering if this is common within plastic surgeons to have patients sign this form of release.

Thank you for taking the time to read this.

Sincerely,
fivefive

Sorry to butt in, but thought you might find this link interesting, (and disturbing?), fivefive...

http://magazine.angieslist.com/Artic...or-review.aspx

Looks to be a growing trend.

[fivefive]

thanks for sharing!
I'm debating on whether or not to have that removed before my surgery. It is against freedom of speech. I wonder how he'll react.

[Dr. Mele]

Very interesting. I received an unsolicited email from Medical Justice (mentioned in the article Dare linked to), on this subject recently. I have not included such language in my consent forms, but I understand where it comes from.

As plastic surgeons, the only thing we really have is our reputation. I have a good number of unsolicited and positive reviews on line; however, when the number of reviews is incredibly small when compared to my thousands of happy patients. It only takes one bad review to leave a bad taste.

With Yelp, Angies List, Yahoo, ATT, YouTube, Google all allowing user comments, it is very easy for anyone to say anything they like (true or false). They don't even have to be a patient, it could be a cross-town rivals staff. Accusations against Yelp and LifeStyle Lift come to mind.

Freedom of speech is great when it is equitable. When only one side gets to speak, this is not what I consider freedom of speech. Doctors are restricted from revealing that you are their patient, never mind the details of any "problems". As a result, there is no discussion, and there are always two sides to every story. I think this is the motivation for such language in consent forms.

I'm no lawyer, but you can say whatever you like online. If you read any chat/board, especially those not well monitored, you know it's true. I enjoy participating in JBI because you all are so civil, and genuinely interested in getting the best result possible. The clause you quote has never been enforced in the courts, and it seems unlikely that it could be. Slander is very difficult to prove. It is rare for a celebrity to win against some of the most outrageous claims, despite access to the best lawyers and piles of money. If you are looking for a legal opinion, I would suggest finding a legal forum. It would be interesting to see what they say.

This question aside ... I will repeat what I wrote above:

The most important decision is to answer the question. "Do you trust your surgeon, completely?" If you do not do not let him operate you. You need to know that your plastic surgeon is going to use every once of their knowledge to make the best possible decisions for you at all times. This way, even if there is still a little difference afterwards, you will know that everything possible was done with all the information available to get you the best result. You will not be doubting yourself for having surgery with someone you didn't completely trust. If it costs more to start over with a new plastic surgeon, you are worth it.