Boob Jobs Gone Wrong

Hard implants, breasts that are too far apart, uni-boob-we've all heard the horror stories or seen the results of botched breast enhancement surgeries. Why does this happen? New York City plastic surgeon, Tracy M. Pfeifer, MD, whose practice is made up of about 30 percent of patients who need breast surgery revisions, explains what commonly goes wrong.

When it comes to fixing breast surgeries, Dr. Pfeifer says most often there are issues with the fold under the breast, no separation between the two implant pockets, disruption of the pectoralis muscle from the sternum and implants placed too far under the arm.

“I also see a lot of patients with overly large implants who had augmentation alone when they actually needed a breast lift with a smaller implant,” Dr. Pfeifer says. “And I see poorly placed scars, or scars that did not heal well.”

A lift along with a smaller implant may be needed in many cases, even though the patient will have an additional scar. “These scars heal very well,” she says. “It is up to the surgeon to use his or her ethical judgment and not perform augmentation alone when the patient also needs a lift. If the patient refuses the lift, in my opinion, the surgery should not be performed.”

The surgeon's technique may be to blame for issues involving the pectoralis muscle, inframammary fold and placement issues. “Displacement of the implant can be avoided with precise pocket dissection during initial surgery,” Dr. Pfeifer explains. And leaking and/or deflation can be unavoidable, so scrupulous care is needed on the physician's behalf, she says.

“One of the most frustrating things for everyone involved is that even after an excellent surgery, perfect is not possible,” she says. “Once we are trying to correct a problem, often the result can never be as good as it would have been if done correctly the first time.”

When seeking a physician to address issues with breast implants, Dr. Pfeifer says, “I believe the patient should seek someone out whose practice is mostly composed of breast surgery and who performs revisional surgery on a regular basis. Not all plastic surgeons are interested in or have the patience for revisional surgery. The patient is already frustrated and has spent a lot of money; and the surgery itself can be technically difficult as well as time-consuming.”

Checking to ensure that a physician is board certified in plastic surgery should be at the top of the list when considering any sort of aesthetic surgery to avoid the need for revision later on.

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  • MP
    Posted on

    Dr. Pfeifer is a miracle worker! Any woman who has been through the nightmare that I have been through with botched BA's and dealt with surgeon's who have lost their licenses can only understand what it's like to go through life wondering if you will ever be 'close to normal' again. As I write, granted I am only 2 weeks post-op and have gone through almost a 9hr complete surgical reconstruction, going to smaller implants and needing a lift that wasn't planned. Dr Pfeifer and her staff are the most amazing people I've ever worked with. They are here for me every step of the way, every day. I have a long haul in front of me but am confident that she has done a miracle...and know that I will be taken care of in the future as I heal.

  • Strong opinion
    Posted on

    Anyone considering augmenting their breasts in anyway needs to seriously do some research and make sure their surgeon is qualified to do the procedure they're interested in. My best friend is a prime example of someone who DID NOT do this and she's paying for it now.

  • Richard Baxter
    Posted on

    The final result of breast augmentation, like any plastic surgery,is a combination of the surgical technique and judgment and the body's healing afterward. One thing that is particularly important in breast augmentation is to select an implant size that conforms to the dimensions of the breast. Many of the common problems arise when the implant is simply too large. So the discussion about size needs to start with measurements including the base diameter of the breast.

  • anonymous
    Posted on

    It is very overwhelming to the Every-Day woman who may be considering breast augmentation to ask know what the "right" questions to ask ARE. We have learned to research Board Certified Plastic Surgeons but as to what is correct procedure or practice is unknown to many of Us. I would never think to ask HOW my pocket would be created or WHAT the surgeon's opinion is on lift vs larger implant etc. We just don't know these things and if the Doctor is confident and friendly during the consultation we could be led to agree with whatever they feel is "best" without knowing any differently. It would be a relief to find a SMART, SOLID list of questions to take with you to a consultation appointment!

  • Leslie Stevens Anonymous
    Posted on

    I truly believe that if your surgeon uses an implant size and dimension that is appropriate for your breast width and proportions the chance of having issues with malposition, dramatically decrease. These days, the consumer has a multitude of sizes and shapes of implants to choose from. Meticulous dissection and preparation of the pocket is essential. However, even doing so and using an implant that is too wide for ones breast could lead to the above mentioned problems down the road. Another issue that was not mentioned is progressive thinning of the skin over an implant that could lead to visible wrinkles, particularly in the lower, outer portion to the breast. This occurs when an implant that is too large is placed in a woman with little to no soft tissue coverage or breast gland. Over time the tissues stretch and thin out even more revealing the implant underneath. Remember there is such a thing a too big and it depends on the individual. Choose a board certified plastic surgeon that follows these principles.

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