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Medical Legal Aspects In Surgery: Cosmetic Breast

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Medical Legal Aspects In Surgery: Cosmetic Breast Question: Discuss the Medical legal Aspects in Surgery for Cosmetic Breast.   Answer: This leaflet contains information on breast lift surgery also known as Mastopexy. It outlines the procedure, risks involved and the benefits accrued. What Is It? A breast lift surgery or Mastopexy involves the removal of excess skin and making the adjacent tissues tight to achieve a youthful and firmer shape to the breast. Robert et al.1 explain it’s that done in 4 ways that is, crescent lift to correct little sagging, peri-areolar lift for mild, vertical lift for moderate and inverted T for extensive sagging This procedure is highly risky as will be discussed in this leaflet. The following diagrams further illustrate the results of an effective breast lift surgery: What Are The Possible Risks? The risks of breast lift surgery are numerous and outweigh the benefits. They include; Anesthesia related complications like blood clotting, pneumonia, strokes, lung infections, heart attack and even death in extreme cases. Anesthesia awareness, that is, waking up before the surgery ends, is also possible though it’s a rare occurrence. Dixon3. Possible bacterial infection on the part operated on as it’s basically a wound. In breast surgeries, the most common infection is cellulites. This is a painful condition than leads to death in extreme situations. Buildup of fluids under the skin or Seroma is another possible problem given that this is a surgery. This forms ugly and painful blisters that always require additional surgery hence more health risks to the patient and additional costs. Excessive bleeding (hemorrhage) both internal and external can also occur. Many patients experience this and it may lead to low blood pressure. It may also lead to low blood count and numerous complications to the patient. Numbness due to damage to the nerves is another possible occurrence. This can last longer than expected or even forever. The patient therefore loses sensation. Intense pain and swelling of the breast is very common. For smokers, the pain may last longer as their wounds take long to heal. This makes one uncomfortable and intensifies their suffering. Another risk is Hematoma or big and uncomfortable bruises resulting from blood gathering in one place. This blood has to be occasionally drained; a very painful process indeed. This is very common in breast lift surgeries.   Dissatisfaction with the new look is common among those opting for cosmetic surgeries. The “movie-star” look with firm and perky breast is rarely realized. Sabel5(pg 278).The patient is always disappointed and rarely get value for their money. A high cost of the operations is unnecessary extravagance that can be avoided in the harsh economic times faced world over. Breast lift surgeries are expensive and a preserve of the filthy rich as others consider them a luxury. It costs so much and dents the pockets of one too many. Mac Neil7 insists that the internal organs face a risk of being damaged during surgical procedures breast lift surgeries. The incisions procured always damage other organs increasing suffering Deep vein thrombosis(DVT) which is blood clotting in the deep veins of the body especially the legs can easily occur.Marrioti5.This eventually leads to the clots being transported to the lungs hence occurrence of a condition known as Pulmonary Embolism(PE). The condition is characterized by breathlessness, chest pains, confusions and even death in extreme cases. Scars from the incision take long to clear out and always look unsightly. The scars very rarely disappear months after healing. The patient would most likely feel ugly even after the reconstruction. What Are The Benefits? The benefits of breast lift surgery can however not be overlooked as they are numerous. Some of them include- Better or improved shape of the breasts. The sagging or unsightly breasts get a facelift and are made to look more beautiful courtesy of the surgery. Higher self- esteem and contentment when sagging breasts are made firm. Boosted confidence levels due to better looks. Bland4 says that it leads to reduced health risks for those with oversize breasts and lessens their sufferings from chest pains and intense discomfort. Disclaimer: If you have questions concerning the surgery, feel free to talk to your consultant or nurse. Given the risks in Mastopexy it has become imperative for such information leaflets to be included along with the standard informed-consent documents. This document has tried to define the principles of risk disclosure which generally caters to all the patients in various circumstances. With an informed consent form this disclosure leaflet will try to clarify the facts on this particular condition and the medical knowledge that has been available so far. This document will serve as a starting point for patients and may lead to further relevant questions that can be addressed by the plastic surgeon, hence the relevance of this quick glance document is huge for an inquisitive as well as an uninformed patient. There are certain standards of medical care which can be determined on case by case basis and this document will help in generating the required caution for a patient.   References: Robert MF, Alex VD. Cosmetic Breast Surgery: A Complete Guide to Making the Right Decision- From A Double A to Double D. 2nd Ed. New York: Marlower and Co; 2004. pg150-176 Dixon JM. Breast Surgery. 5th ed.Edinburgh and New York: Saunders Elsevier; 2014. pg57-100 Bland KI . Klimberg VS Breast Surgery. 3rd ed. Philadelphia: Wolters Kluwer Health; 2011. Pg 467-500 Mariotti C. Oncologic Breast Surgery. 2nd ed. Milan: Springer; 2014. Pg 177-190 Sabel MS. Essentials of Breast Surgery. 2nd ed. Philadelphia: Mosby/ Elsevier; 276-300 MacNeil F. Breast Surgery. 3rd ed. Oxford: Oxford University Press; 2008. Pg 14-21

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