Saturday, September 09, 2006

Woman awarded $8.25M after breast augmentation & mastopexy complication

In a full display of "jackpot justice" American-style, a Florida jury awarded a women over $ 8 million (USD) to compensate for pain and suffering for complications resulting from an augmentation mastopexy surgery. This episode highlights both a tort system out of control as well as the risk associated many breast operations (reductions, lifts, augmentations).

Simultaneous augmentation-mastopexy are tricky operations with known higher complication rates. If you think about it conceptually, you're doing a procedure with two competing forces - tightening the skin + "stuffing" the inside. When these the tension from the surgery exceeds the remaining blood supply to the breast tissue & nipple complex, you get tissue loss. Sometimes this is confined to just "fat necrosis" where some small areas of the fatty breast tissue harden & cause little problem other then being able to be felt. Large areas of fat necrosis can require surgery to remove as it can be both painful and hard.

Despite risks much higher then either procedure alone, we do these fairly frequently. Why? Patient demand and convenience. Staging these procedures requires 2 facility, anesthesia, and surgeons' fees which raise the cost a great deal. Also factor in recovery time from an additional procedure and it's easy to see why patients demand theses & surgeons' offer them.

What can be done to minimize the risks?
Don't operate on smokers or diabetics
Don't stuff oversized implants in
Don't go to "the edge of the ledge" while tucking the skin
Consider an adjustable device like the Mentor Spectrum implant (see here)


1 comment:

Dr. Tony Youn said...

The society that we live in is a victim-based society. If something goes wrong, we must find someone to blame and get even (or rich from it). It's terrible how some people can't some responsibility for themselves or allow there to be some leeway for a bad result. Sometimes people heal poorly, and there is nothing that can be done to prevent it. It's amazing the amount of money that goes to paying people who sue cities for slipping and falling on a icy sidewalk, people who become multi-millionaires off their medical problems, and those who strike it rich after getting into a car accident. It's a lottery system nowadays, with everyone wanting their piece of the pie, but not necessarily willing to work for it.
While there is definitely real malpractice out there that must be addressed, this type of "play money" verdicts are what put doctors, hospitals, and insurance companies out of business. Who suffers? The people who could have used the money, either in more money to fund people without insurance, money to decrease working people's insurance premiums, or even general money for a city's budget. It's stuff like this that makes an honest physician like myself want to retire early and get the hell out of Dodge before I have my car, house, and savings taken away from me. But alas, I am venting...