A 27 year old female underwent a bilateral augmentation mammaplasty using rather large (450 cc) saline implants.
Following the surgery, she had several complaints regarding the operation. In particular, she complained that excessively large breast implants had been implanted and that, partly because of the excessively large implants, she had developed a “double bubble” on the inferior aspect of each breast. This is a condition wherein which you have the patient’s own breast lying on top of a separate noticable mound of skin and implant. The patient eventually had the implants removed by a different plastic surgeon. She then sued the original plastic surgeon for medical malpractice.
The patient’s attorney and the professional for their witness preparation services asked me to review the medical records of the case, and the deposition of the patient (the only deposition taken so far in the case).
The treating doctor’s records were in order, with a series of entries and handouts, signed by the patient indicating receipt, explaining details about the operation (bilateral augmentation mammoplasty) and most of the complications which could occur.
After a Riviera criminal defense firm viewed the records, I noticed that a very thorough informed consent had been given. There was nothing in the records indicating that the presence of a “double bubble” could occur, but it is my opinion that such can occur in cases wherein which it is not anticipated. Thus, regarding the informed consent issue, I felt there was no departure from the standard of care.
The records contained several entries regarding the patient’s desire to be really large, and to have implants at least as large as one of her friends’ (450 cc) who had the surgery previously.
The deposition of the patient was most informative. It seemed that she apparently had a case of amnesia. She didn’t recall signing the numerous documents which were presented to her during the deposition. In particular, she didn’t even remember signing the consent for photography, but admitted the photos shown to her were, in fact, of her. She didn’t remember receiving anything like an informed consent, and didn’t remember receiving a multipage (12 including the signature page) handout regarding the augmentation mammoplasty. On looking at the handout during the deposition, she indicated she would have really liked to have received such information prior to the surgery.