In a recent case in British Columbia, a breast augmentation patient was sued for leaving negative reviews for her plastic surgeon. According to the Daily Hive Vancouver, the defendant is a blogger who visited her plastic surgeon in 2015 soon after the birth of her child. During her consultation, her surgeon shared that she had a “chest wall deformity known as Pectus Excavatum,” which is commonly referred to as a sunken chest.
In a court document outline the case, it states that her surgeon suggested using two different sized implants to counteract her condition, however, the patient decided instead to get larger implants of the same size on each side. After the surgery, the patient stated that “her left breast was higher than the right breast and the lower half of the breast was quite black and blue, indicating bleeding.” Her surgeon then recommended a follow-up procedure, but the patient declined and stated she wanted to have a secondary surgery with another doctor.
In her online review, she wrote, “I knew something wasn’t right immediately from the bottom half of my breast being almost entirely black and blue. He shrugged it off, said it was fine. I took his word for it even though it didn’t feel or look fine.”
Her review went on to detail her surgical journey without mentioning the doctor had offered to perform a corrective procedure. She then stated in a separate review that the doctor had not taken any steps to suggest another approach to her pectus deformity and that he was bullying her to take down her review.
Based on her refusal to remove the reviews that included inaccurate information that could harm the doctor’s reputation, the judge ruled in the surgeon’s favor and asked her to pay $30,000 in damages.
What is Pectus Excavatum?
According to Concord, CA plastic surgeon Eric Mariotti, MD, Pectus Excavatum is a Latin term that means “hollowed” or “sunken” chest. “It describes a deformity of the chest wall where the breastbone and rib case are curved a a way that makes the middle of the chest sunken instead of smooth. It is more common than people realize, with some studies stating one in every 300-400 births. This may sound like a large number, but most of the cases I see are mild cases, where often the patient doesn’t even realize that they have it.”
“Chest wall deformities and asymmetry such as Pectus Excavatum are very common and it is crucial that your plastic surgeon make you aware of this at the time of your consult,” says Toledo, OH plastic surgeon Peter Koltz, MD. “The sternum can be bent inwards or outward, which is known as Pectus Carinatum.”
As Dr. Koltz notes, the surgeon’s original approach in this story is one the patient should have heeded to avoid further surgeries. “Unless we are correcting the skeletal tissue with big surgery, sometimes placing an implant can camouflage the issue. However, if you do not account for the difference in each side with different sized implants, you will ultimately be asymmetric with your result.”
Dr. Mariotti says in cases like these, he cautions patients against choosing large implants, which is what the patient in the story did instead of taking her surgeon’s initial advice. “Unlike normal chest anatomy, where the implants may want to fall apart from each other over a rounded chest wall, in these patients, the implants will tend to fall towards each other. Although this may sound good, too much of a good thing can make the implants touch in the middle. Plastic surgeons may choose to alter their technique of muscle release to try to avoid this.”