A Great Friday in the OR: Back Mice and a Capsular Contracture Trial Patient

I just finished my Friday OR cases and wanted to share what I did — because both of these procedures are favorites of mine for the same reason: they fix something painful that's genuinely tortured the patient, and the relief afterward is immediate.

I know a lot of surgeons hate Friday surgery because complications can roll into the weekend. I personally love it. Surgeons love the operating room, and ending the week with two impactful cases is one of my favorite ways to roll into a weekend. Happy Friday.

Here's what I did and why these are such satisfying procedures.

The first case was a removal of a lipoma — a benign fatty tumor — from a patient's lower back.

These specific lower-back lipomas have a great nickname: "back mice." It's essentially a small, mobile lipoma that sits in a particular spot on the lower back and can produce surprisingly significant pain.

• Small lipomas (often around 1–3 cm)
• Located in the lower back / lumbar region
• Often sit close to nerves
• Can produce persistent, focal pain that's very out of proportion to their small size
• Often missed on imaging because they're subtle
• Often dismissed by clinicians who haven't seen them before

If you have lower back pain in one specific spot and you can feel a small tender bump in the area, back mice are worth considering as a diagnosis.

The wonderful Lady Spine Doc has a great video discussing back mice — I'd recommend looking that up if you're curious or think this might be you.

• The surgery is quick and outpatient
• Patients feel better essentially immediately
• A problem that's been invisible to imaging and dismissed by other providers is finally fixed
• The patient walks out of the OR genuinely relieved

It's a fun small surgery to start a Friday with.

My second case was a capsular contracture revision as part of the FDA trial I'm a principal investigator on (the STANCE trial, on clinicaltrials.gov if you want to look it up).

Capsular contracture is genuinely one of my favorite areas of plastic surgery to treat, because the patient population is so often incredibly grateful afterward.

These patients have typically:

• Had multiple painful breasts for years
• Been told their problem can't really be fixed
• Tried multiple prior surgeries that didn't work
• Been gaslit into thinking they should "just live with it"
• Been tortured — that's honestly the right word — by daily pain, distortion, and discomfort

So when we successfully clear the contracture and they wake up with soft, comfortable breasts again, the response is real. These are some of the happiest post-op patients I have, because the daily quality-of-life improvement is so dramatic.

Some of my contracture revisions are done as part of the STANCE trial — an FDA trial for a scaffolding company seeking approval for use in capsular contracture treatment.

Why a patient might want to be in the trial:

• Access to a product being evaluated for this specific indication
• The trial typically makes the surgery less expensive than a standalone capsular contracture revision
• Patients contribute to the research that helps the next generation of contracture patients
• All the standard advantages of a well-run clinical trial: structured follow-up, careful documentation, attentive monitoring

If you have a current capsular contracture and you're wondering whether you might qualify, clinicaltrials.gov has the full information, or you can DM me. There are real costs and benefits to participating, and I'd be happy to walk through them.

The thing back mice removal and contracture revision have in common is this:

That's genuinely a lot of what makes plastic surgery satisfying for me. We get accused of being a "frivolous" specialty by some folks who think we just do cosmetic work. But:

• Back mice patients have been dismissed by primary care, orthopedics, and pain management
• Contracture patients have been told their pain can't be helped
• Hand surgery patients I see have similar stories
• Breast reduction patients have been told their daily pain isn't bad enough to fix

All of them are fixable, and the day-to-day quality-of-life improvement is enormous. That's why surgeons love the operating room.

A meta-comment: a lot of surgeons avoid Fridays because if a complication develops, it tends to land over the weekend when staffing is lighter. I get it.

For me, the trade-off works:

• The cases I tend to do on Fridays are lower-complication-rate procedures
• I have good 24/7 coverage for my patients
• I genuinely love starting my weekend with two satisfying cases
• It's a great mental reset going into Saturday

If your surgeon does Friday cases and you have concerns — ask them about their weekend coverage. That's a reasonable thing to want to understand.

This Friday's lineup was a back mouse lipoma and an FDA-trial capsular contracture revision. Both are favorites of mine because they take patients who have been suffering and dismissed and give them immediate, meaningful relief.

If you have lower back pain in a specific spot that nothing has helped, look up back mice — they're real, fixable, and often missed. And if you have a capsular contracture that's been written off as untreatable, consider getting another opinion — and DM me about the STANCE trial.

Happy Friday. The operating room is a wonderful place to spend it.