At the first consultation, it is important to review and go over
your medical history, goals and expectations as well as seeing if
you and the plastic surgeon have a good rapport. Building
mutual trust is paramount for a great relationship to be established
between patient and surgeon. More than likely you will have
the option of viewing before and after photos of the procedure you
are interested in.
With breast augmentation the procedure and your options are
discussed in length. The breasts will be examined closely so
that the plastic surgeon can ensure the expectations you have can be
met. You will also be going over the surgical plan on the day
implant size along with
of the implant and where your scars will be
implant size for your statue and body will be determined
along with you telling the surgeon what cup size you are aiming for.
The surgeon takes into accountability the width of the breast
(breast width dimension) distance from the crease under the areola
and of course the thickness of your tissue and what coverage would
be best. If the patient has all the breast tissue above the
and the areola/nipple complex is in the middle
of the breast mound, then this is the ideal candidate for breast
augmentation. If your breast tissue is sagging and the
nipple/areola complex is at the level of the
inframammary crease or
lower, then usually some sort of
is going to be suggested.
Your surgeon will be going over all the pros and cons of each
implant placement and
implant incision site, and more than likely tell
you exactly how big you can go with breast augmentation without
forsaking any unforeseen complications. You need to remember
that rippling is fact of life with implants. Saline implants
however do ripple more than silicone, but even with silicone thin
patients who have very little tissue can still occasionally see
Patients who want to have silicone implants are
required by law to be the age of 22.
If a patient is younger
than this and has some sort of deformity of their breasts or lack of
tissue, then with the plastic surgeon’s okay, you can receive
The most important thing to remember going into this procedure is
that breasts are not symmetrical. Different size implants are
used commonly to help improve symmetry and or
saline implants so
that the surgeon has the ability to add more saline to one of the
breasts to even them out. Every effort will be made by your
surgeon to make your breasts symmetrical and as close as possible to
your desired size, however, there are no guarantees as to what you
might end up with size, shape or if the breasts are symmetrical.
Patients will be encouraged to try on various size implants to
help with determining size. You might be encouraged as well to
do this at home with the
Rice Test and or Water Test. This way will help you
become accustomed to your new prospective size and to see if you can
live with this comfortably. More than likely you will be sent
in to discuss the financial end of the procedure with the patient
coordinator. This person is so important in your journey with
plastic surgery, as she is normally the one that will be able to
answer any of your concerns you might have as well as tell you when
the surgeon has an opening for surgery. Information with
“informed consent” is given to you along with instructions of what
you can be expecting pre and post operatively.
If you do
decide to go forward and schedule the surgery, you will be
instructed to get a pre operative physical with a routine blood
analysis so that you will have your medical clearance for surgery.
More than likely your Plastic Surgeon will give you a list of over
the counter and prescription medication to stay away from for a few
weeks leading up to the surgery. Your Plastic Surgeon and also
the Anesthesiologist needs to know everything you are taking on a
routine basis, so that there is no drug interactions and
complications caused by any herbal, over the counter analgesics, and
The price of having a breast augmentation consultation ranges from
free to $500.00. Normally when the consultation costs money
upfront, the plastic surgeon will allow you to deduct this price
from the actual procedure. It is very important you find out
before hand what the cost of the actual consultation is going to be,
so make sure you have this clear when setting the
appointment. Normally consultations can take from 15 minutes up to
more than 2 hours.
Make sure you bring your list of
Consultation Questions that you have printed out with
you so you can stay on track with making sure every concern is
addressed. Choosing a surgeon based on price alone is not a wise
move to make, as this is your body and major surgery.
Making an informed decision on the plastic
surgeon your are considering include:
Not all cosmetic procedures include surgery. Nevertheless
your safety is still important in every case. Non-invasive
procedures are most commonly performed in your physician’s exam
rooms. These include the following procedures that don’t require
anything more than a local anesthetic and or oral sedation.
Surgery however can take place in one of three settings:
Where surgery takes place is often a matter of your doctor’s
preference as well as your own. According to ASAPS in 2003,
some 75% of all cosmetic procedures (surgical and non-surgical) were
performed outside a hospital setting, in either a freestanding
surgery center or offices. It is very important that the
facility where you have your surgery is properly accredited.
Some situations necessitate surgery in a hospital setting.
If a patient is diabetic, has high blood pressure or other medical
conditions they may need to be in an environment where immediate
consultations with experts in other fields are available. For
most healthy patients, office based surgery can be more comfortable.
Studies show when you are in an accredited office-based surgery
facility you are as safe as you would be if you were in a hospital
or ambulatory surgery center.
Ask specifically about the accreditation of the facility
recommended for your surgery. Then verify that the
accreditation is active and in good standing. Look for
accreditation from these three national organizations:
American Association for Accreditation of Ambulatory Surgery
Also individual state licensing and accreditation can be
considered. Each accrediting organization has defined
individual standards for its member facilities.
accreditation requires the following:
operating the facility has ABMS – recognized board certification
and hospital privileges
must pass a regular peer-reviewed quality assurance inspection
must meet defined standards of medical staff qualifications
and its staff must meet defined standards of emergency
life-saving training and equipment
must use only board certified anesthesiologists or nurse
and the operative suites are inspected regularly for safety,
sterility, protocols, record keeping and staffing
The American Society of Plastic Surgery (ASPS) and the
American Society for Aesthetic Plastic Surgery
(ASAPS) are the only two professional medical
societies that require members to operate in accredited or licensed
facilities as a condition of membership. Some physicians go
through accreditation as a requirement of state licensing, and some
do voluntarily. Meeting high standards established by
accreditation organizations may not be required in order to practice
outpatient surgery. But given the choice, where would you
rather obtain your care – in a facility that is accredited or one
that is not?
No physician can do this alone. Therefore you need to know who
else is going to be involved in your treatment experience. It
is not uncommon for doctors to have patient coordinators, nurses or
other support staff participate in your consultation and care.
But these staff members should never be a substitute for consulting
with the doctor and certainly not a substitute for meeting with the
doctor who will be performing your procedure.
There are instances and procedures when someone other than the
physician may be appropriate to provide your treatment. They
might include registered nurses with specialized training in
injection therapies, light based treatments and non-invasive skin
resurfacing, or even have an aestheticians for less ablative skin
If your treatment will be provided by someone other than
a physician, make certain that person is being supervised by a
doctor who is on site. An appropriate provider with experience
in a safe and regulated setting is as important to a medi-spa
treatment as it is to surgery.
If you are
not given informed consent documents that outline your
If a doctor
is willing to perform surgery without a valid health evaluation
first. This is a law now in California, that the surgeon
operating must have a clearance from the patient’s family doctor
that they are in good sound health first.
If you are
not given prior to treatment
instructions and cautions.
If the doctor
trivializes the risks involved with the procedure.
If the doctor
makes guarantees of unrealistic promises.
doctor tells you what you need rather than listening to what you
office, staff or doctor is disorganized or disheveled.
If pricing is
not outlined before the treatment. The only variables
should be operating room time,anesthesiaand unexpected events.
other than the doctor you consulted with will be performing the
In order to schedule surgery, most plastic surgeons will need some
sort of deposit to hold that specific day open. You might be
looking at anywhere from 2 weeks to 6 weeks or more depending on how
busy the plastic surgeon is. Sometimes the patient coordinator
is able to fit you in sooner, if they do get a cancellation, so make
sure you ask about this option, and to be considered if someone does
in fact cancel.
The office will make sure you have your pre-operative appointments
within 2 weeks of the actual procedure. This is to ensure that
you are in good health and able to endure surgery. Any
physical or emotional conditions you have should be addressed before
the procedure and how these may influence your cosmetic enhancement
choices. A lot of surgeons ask for their patients who are over
the age of 35, to get a baseline mammogram if they haven’t had one
The balance of the surgery costs are usually paid in full by this
appointment. Remember you have to feel 100% confident in the
plastic surgeon you have picked, so if you have any questions that
have not been answered, then make sure you schedule another
appointment to speak directly to the surgeon before the procedure.
With the age of computers it has enabled us to use the type of
imaging to show your surgeon what type of look you are after with
breast augmentation. Although not a perfect science, it does
give us an idea of what a certain size implant might look like on a
computer generated photo. Computer imaging can show you how
you look now and then the changes the photo to resemble what you
might look like with the addition of breast implants.
Imaging programs you can buy for your computer or you can have this
done through a service such as
Plastic Surgery Imaging.
This site is useful in all plastic surgery procedures, by enhancing
communication with your doctor with clarifying your expectations
with surgery. This site’s fees ranges from $19 to $100 depending on
the procedure you are doing.
Not all plastic surgeons offer virtual imaging; however more and
more seem to be doing so. Digital Imaging simulates your
potential results of cosmetic surgery and is an excellent tool to
guide discussions with your cosmetic surgeon.
Axis Three is a company which offers patients considering breast augmentation
with the ability to view what their body will look like after surgery, before
surgery. Ultimately, it allows the patient to feel more comfortable and make the
decisions easier, as they can view different types of implants and different
sizes side by side. Many surgeons across North America are quickly
adopting this technology in their consultation procedures.