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What to expect from a consultation for aesthetic breast surgery

1. What objectives should you have when attending a consultation for aesthetic breast surgery?

During your consultation, you should aim to articulate your concerns and your wishes. It is quite understandable that many patients will feel shy when discussing their concerns; however, your surgeon will have spoken to hundreds of patients about similar issues, and will do his /her best to put you at your ease. Taking a friend or relative to a consultation can help put some patients at ease.

You should expect that once your surgeon has taken a medical “history” and examined you, he should talk to you about all aspects of your surgery. You should leave your consultation with a clear idea of all that surgery would involve, from pre-operative preparation, to the immediate post-operative recovery period and the longer-term implications. 

2. How should you prepare for your consultation?

The more that you are able to prepare for your consultation, the more you are likely to get from it.

Aim to ensure that you can clearly explain what it is you are concerned about and what you would like to achieve from surgery.

Try to do a little “homework” by reading about the operation on the Internet. There are many helpful sites, these include: 

It is often helpful to write your questions down; it’s amazing how many patients comment that they remembered their most important question just as they were leaving the outpatient clinic.

3. How long will my consultation take?

Your first consultation with your surgeon will probably for last for between half an hour and forty minutes. You may also see a patient advisor, which will add another twenty minutes to thirty minutes to your time at the hospital. Occasionally consultations with other patients will take longer than expected, so please forgive your surgeon if occasionally you are not seen exactly on time.

4. What will happen at my consultation?

Your surgeon will start the consultation by taking a medical “history”. It is probable that this will start with questions about your concerns and expectations. You will be asked about any illnesses or operations you have had in the past, and any strong family history of illness.

If you are taking any medicines, you should be able to provide a list for your surgeon, you will also be asked about any allergies to medicines, dressings, latex etc. You will then be examined, during the examination a number of measurements will be taken of the chest wall and the breasts. It is likely that pre-operative photographs will be taken after the examination.

Your surgeon will then discuss the surgery, its implications, limitations and any potential complications. You will then have a chance to ask any questions that you might have. If you are planning breast enlargement surgery, your surgeon will spend some time with you deciding on the size and style of the implants that will be used.

5. Who should you meet at your consultation?

You should meet the surgeon who is going to undertake your surgery. There is no point seeing a cosmetic advisor or another surgeon who will not be involved in your care. You will only have a meaningful discussion with the person who will be directly involved in your operation, don’t be fobbed off with anything else; it’s a waste of your time and is bad practice.

You may ALSO see a patient advisor; they are there to advise on the less technical aspects of your surgery.

A nurse chaperone will be available for your examination, if you are not offered a chaperone and would like one, please ask your surgeon.

6. Should I have any concerns about free consultations?

Yes. You should be seeking independent advice and as a result should anticipate a fee for your consultation. We have all heard the expression ”there is no such thing as a free lunch”, well the same applied to consultations, if its free, I would suggest there is a high chance that the surgeon/organisation will be using it as a sales pitch.  Both the Department of Health and the British Association of Aesthetic and Plastic Surgeons BAAPS advise that it is against “best practice guideline” to offer free consultations.

7. Should I be expected to pay a deposit before seeing my surgeon?

Certainly not. You can only make a judgement on the operation and your surgeon once you have met and discussed things.  He will need to meet you to decide whether you are a suitable candidate, so avoid any attempt to secure a payment before a consultation.

Occasionally a patient may make a request to book a certain date for a procedure before meeting the surgeon, under these circumstances you may be asked to pay a deposit to secure the theatre spot, if this is the case then do ensure that this is a fully refundable deposit until a date two weeks after you meet your surgeon (your cooling off period).

8. What is a cooling off period?

It is seen as good practice to ensure all patients are given a period after their consultation to reflect on the discussion. This is designed to ensure that decisions are made carefully, and once the initial excitement has died down.

It is a good idea, and should, when possible, be upheld. If you have seen a surgeon elsewhere and have already done all your “thinking and cooling off “, occasionally it is possible to make an exception to this rule, but your surgeon will have to be convinced that there are good reasons for this.

9. Should I expect to make my mind up immediately after my first consultation?

This depends how much time you were able to spend with your surgeon, and how much you already knew about your surgery. If you leave the consultation confident that you are fully aware of the implications of surgery, its limitations and the possible complications then you may not need another consultation.  If you are in any doubt, ask for a short follow up consultation to consolidate things. However, you should be given a period of two weeks to “cool off” after you consultation

10. Will my surgeons expect me to have questions about my procedure.

Yes, your surgeon will ask whether you have any questions, and it is always a good idea to prepare for this by writing a list beforehand. You will probably find that many of the questions on the list will have been answered by the time you come to this part of the consultation, but at least you will not remember something that you meant to have asked when you are on the train on the way home.

11. What should I do if I do not feel confident after my consultation?

If you feel that you were not given the time that you expected, but you felt confident in your surgeon then ask to go back and spend some more time with him/her. If you did not feel confident with the surgeon, then I would suggest making an appointment to see someone else. Choosing you surgeon is an important decision; take the time to make that decision carefully.

12. Should I bring someone with me?

This is often very helpful; in the first instance it can give you extra confidence to have a friend or relative with you. It is also likely that there will be some parts of the consultation that you remember less clearly that other, it helps to have someone to compare notes with once you have returned home.

13. What degree of confidentiality should I expect?

Confidentiality should be expected. Your case will not be discussed with anyone who is not directly involved with your immediate care, without your permission. Your surgeon will probably ask you if you mind a letter being sent to your family doctor, you have every right to say no.

14. Follow up arrangements

 Ensure that you are aware of the follow up arrangement that is offered. Be clear about who will you see if you have any concerns, and know how to get in touch with someone, even if its out of normal hours.

15. What should I do if I am unsure about surgery?

If you are in any doubt then say no, you should never feel any pressure to undergo an operation.

 

 
 

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Your comments


December 26th 2009 at 23:51:49
julie cassidy said ...
hi Simon. Im wanting to have a breast augmentation operation with uplift. My breasts are very heavy and they look tubinal due to weight, and they have became saggy, I hate it! i feel that i want them in the right place which is covered by the uplift and more round and perky. Is this the operation i need? i live in stockton on tees, who is the best/closest surgeon for this operation? What is the estimated cost involved? these boobs ae the vain of my life! help!! julie x


 

January 9th 2010 at 13:26:14
Angela Davies said ...
Hello I am considering breast implants and would like to know if implants alone can lift the breast, as I do not wish to have a breast lift. Regards Angela Davies


 

January 30th 2010 at 22:44:38
clare said ...
hi simon,i am considering having breast implants and read in an article that the operation costs around £4,250,is this right?i understand that every patient will be different but i'd like a rough idea of what price to expect.also i wish to attend a consultation in belfast,do you perform operations in belfast/ireland as i no some places over here only do the consultation here and op in england/scotland? thanks


 

January 31st 2010 at 06:33:24
Maria said ...
Hi simon, I always had very small breasts but after breast feeding 2 children they became just flat, like 2 pancakes! I want to have breast augmentation but I am worried that they won't look natural because I have so little breast tissue, besides I am very slim ( size 6-8). Also my nipples became droopy with the breast feeding but all I want is a pair of beautiful breasts! Thanks


 

February 14th 2010 at 13:52:05
sue bowles said ...
Helo simon,can you tell me if you think there is an age limit regarding breast enlargment surgery.


 

March 26th 2010 at 16:59:25
vivienne mcgowan said ...
Hi,about 16 years ago i had breast enlargement but sometimes when i feel them it feels as if the implant has gone a little lumpy like a sandwich bag that has started to empty(sorry its the only way i can describe it) also the surgeon left me with 2 huge scars about 5ins long but where the scar is its pulled tight so the top of my breast droops over,ive put up with this all these years as the surgeon would not correct it and im very embarresed about it . is this something you could fix with new implants and reduce my scar i just want to feel like a normal woman again.Hope you can help me . thanks


 

April 6th 2010 at 20:25:55
Darren Yorke said ...
Hi Simon I have pectus excavatum and i am 42 years old male and looking to have a custom made implant done for correction, i have about a 3cm dip in the middle of my chest and was wanting to know if the results are good and normal looking from this kind of procedure, i would like to go private, could you give me a rough idea of the cost for such a procedure, also if i came for a consultation, would i be able to see any before and after pics of previous people with this condition that you have treated. Thank You Darren


 

April 9th 2010 at 20:47:11
Sally Clifford said ...
Hello Simon, I was wondering where your clinic in Kent is? I am looking to book consultations with a few companies and wish to stay within my local area. I have had 2 children and breast fed them both. I am a 30b and would like to increase to a 30D or E. Many thanks


 

April 16th 2010 at 10:19:53
Pamela said ...
I am interested in having breast augmentation and noticed in an earlier post that you may be doing a clinic from Northern Ireland. Please could you give me any information on the whereabouts and when you hope to be doing it. Thanks, Pamela


 

April 26th 2010 at 16:35:38
sally keating said ...
hello, i have REALLY big nippls 6cm by 6cm big, my breast are quite saggy too, ima size 34 D. i would like to have my nipples reduced and a uplift, but what i would like to know is, will there be much scarring round the nipple after???


 

May 23rd 2010 at 18:37:05
Val said ...
Dear Simon, I had a breast augmentation at the insistence of my husband, some 32 years ago. I am now divorced and much older and hate the look of my breasts. They have a very unnatural shape. Is it possible to remove the excisting implants and make good , so to speak. Thank you


 

June 5th 2010 at 13:57:00
Keri Lianne Williams said ...
Hi Simon, I am 36 and very keen to have a breast enlargement a.s.a.p. I have been thinking about it for 3/4 years and now that I have lost weight and my breasts have now gone from a C cup to a A cup, I am going to go for it. I have read loads of different websites and feel ready to go ahead. Do u have clinics that actually operate in or near Kettering ?


 

June 8th 2010 at 14:22:07
shelley said ...
Hi simon i was just wondering about the nagor free implant replacement package i have pip implants with capsular contracture in both breasts quite bad i also get very painful lumps under my left armpit which feels like my skin is burning which last for months could this be a sign that the implant may have ruptured Any information on both questions would be great Thankyou


 

June 28th 2010 at 07:56:18
Vicky Leeman said ...
Hi there, i have a consultation booked at My Breast to see about having breast enlargement. On the bottom of my left breast i seem to have what i can only describe as a "third nipple"!! Would i need to have this removed before my operation? Or would my surgeon be able to sort this out at the same time as my procedure? Or would it just be left as it is? Thanks Vicky


 

June 29th 2010 at 13:29:46
Liarna said ...
Hi, I had my breast augmentation in November 2008, since then I have not been happy with my result and I spoke to my surgeon about this along with my patient adviser. I went for a second opinion and was told my surgeon could have done a better job. When I went to see my surgeon he told me to wait till I was a year post op before he would correct anything. I sent my patient adviser an email with all the details of what I wasn't happy with and what I was told in my second opinion.... She never contacted me again and to this day I'm still waiting on a replay. When I had my op I had just turned 18 in the October and had the work done in November. Its been a while since I have been in touch with mybreast and this is because after the year I waited I was booked in for an appointment with my surgeon but I kept getting new dates sent to me in the post, I got confused and ended up missing it and then I fell ill with anemia. I was ill with anemia for a long time and only in the past few month have I started to feel better. I never really wanted to go through a major operation when my health wasn't 100% and I was also very scared that my end result could end up worse that the result I have now. My first experience wasn't great and when I spoke with my surgeon about about having corrective work done for free it felt like he was trying to talk me out of it more than anything. I hate to have to complain about this.. this is my worst nightmare come true... I dreaded being a boob job horror story. I'm sending this message and putting it on here purely because I need someone to help me and if a director can do that I would be over the moon... I paid just short of £5,000 for this work doing I had 5 years after care included in that price. Please please please can someone help me put this right... I'm 19 and should be proud of my body at this age but find my self always covering up. I can give more details about this when I am contacted. Thanks a million. Liarna Johnstone.


 

July 9th 2010 at 17:20:00
Lucia Shephard said ...
Dear Mr Withey it was a pleasure meeting you today and i just wanted to say thank you for your professional advise you just made everthing so much clearer for me and also gave me that reassurance i so needed. all the best Lucia Shephard


 

July 25th 2010 at 18:48:42
chris said ...
Hi, I have pectus excavatum and had the Ravitch procedure about 10 years ago but still have an indent i wish to have fixed. I have read about having custom made implants to fill the depression and this is the procedure i would be interested in. However, im finding it difficult to find a UK surgeon who does this procedure. Will the results be good and normal looking from this kind of procedure, could you give me a rough idea of the cost for such a procedure, also if i came for a consultation, would i be able to see any before and after pics of previous people with this condition that you have treated. I would apprecaite any help on this matter Thank You Chris


 

August 10th 2010 at 11:49:08
annharris said ...
What is the expected time for full recovery from a breast reduction op. in an older patient(70+) I have reponsibilities for a husband and two dogs who are dependent on me


 

October 19th 2009 at 20:52:02
Shelley said ...
Hello, could you help me? i wish to arrange a consultation with your company within the next month or two and while your blog is very useful in discussing the consultation process i would like more information following the initial consultation. If you decide to proceed for surgery following the 'cooling off' period, how soon will your surgery be underway? can you arrange a surgery date with your surgen as soon as possible or is there a minimum time between the consultation and the surgery date? Thank you


 

October 28th 2009 at 09:55:03
Simon Withey replied @ Shelley...
Thank you for your question, once you have finished the cooling off period you are able to proceed with surgery rapidly. Most of our surgeons will have a waiting list for surgery, however if you talk to your surgery coordinator she will do her best to identify a surgeon who will be able to offer you your surgery as close to your chosen date as possible. If you do proceed to book a consultation with a MyBreast surgeon, and have a particularly tight schedule after your cooling off please discuss with your coordinator before the consultation. Please be aware that for very good reasons it is not possible to see one surgeon for you consultation and then be transfered to another for you surgery. We look forward to seeing you in the future, with best wishes.


 

January 20th 2010 at 15:05:20
Simon Withey replied @ julie cassidy...
Thanks Julie, from your description it sounds as if an uplift alone may be the most appropriate operation for you. You describe your breasts as being very heavy and droopy. If, as I suspect, you have adequate volume within the breast- but the bulk of the breast tissue has dropped and flattened, then a combination of lifting and reshaping is likely to provide a much more youthful and shapely breast. It is certainly worth discussing with a surgeon, who will have a much better idea o the extend of the problem having examined you. If you would like the team in the office will advise you on the closest surgeon to you, With best wishes Simon Withey


 

January 20th 2010 at 15:05:50
Simon Withey replied @ Angela Davies...
Hello Angela, thanks for your message. It is certainly possible for implants to reinflate and "lift" and emptied breast that has drooped a little, however an implant will not lift a breast that has dropped significantly, under these circumstances it either a case of accepting the droop and augmenting the breast in its existing position, or of combining an augmentation with a formal lift of the breast, or mastopexy. With best wishes, Simon Withey


 

March 29th 2010 at 13:34:31
Simon Withey replied @ clare...
Thanks you Clare, you are correct that the cost for a straightforward breast augmentation starts from about £4,250. If you stay in hospital overnight, choose to have an anatomical(teardrop shaped)implant, or need a breast lift as well as an implant then the price will be different. At the moment we are not operating or consulting in Ireland, although that is due to change in the next six months. I am writing this on the 15.3.10, so happy St Patrick's day for Wednesday. With best wishes, Simon Withey.


 

March 29th 2010 at 13:34:54
Simon Withey replied @ Maria...
Dear Maria, thank you for your e mail. It is very common for breasts to appear empty and deflated after breast feeding, and it is quite normal for the nipple to change position as the deflation occurs. This situation can be improved by re-inflating the breast with an implant, and in some cases the nipple position may be altered with a breast or nipple lift. The operation should be planned carefully because of your thin skin and the probability of a lack of skin elasticity . With best wishes, Simon Withey


 

March 29th 2010 at 13:35:12
Simon Withey replied @ sue bowles...
Dear Sue, the straightforward answer is no, there is not really a limit. Many patients will seek advice from a surgeon following changes in the breast as a result of breast feeding or ageing, in both cases it is usually possible to enlarge the breast however if there has been a considerable change it might also be necessary to lift and reshape the breast. With best wishes, Simon Withey


 

June 11th 2010 at 15:29:54
Simon Withey replied @ vivienne mcgowan...
Thank you for your interesting question. Your description suggests that you may be experiencing rippling and wrinkling of the implant beneath the breast. A number of factors influence the degree to which rippling becomes a problem. If an implant is too large and heavy for the breast it contributes to a thinning of the overlying tissues which have previously provided camouflage for the implant, thereby making any wrinkles in the implant more obvious. Wrinkles beneath the skin be related to the implant or the capsule around it. The implant related wrinkles will become more obvious if there has been any deflation of the implant, the capsular wrinkles are often most obvious at the top of the breast when standing or leaning forward. In most cases of rippling it is possible to improve the appearance, although it is rare to be able to completely remove all ripples. A variety of techniques are available and the choice will depend on the extent of rippling, its position on the breast and the present position and type of implant. It may be possible to improve the situation simply by changing to an implant with a "higher gel fill", other options include a change of implant position and the use of sheets of camouflaging material to reduce the wrinkling. I do hope that this is of some help, with best wishes, Simon Withey


 

June 11th 2010 at 15:30:36
Simon Withey replied @ Darren Yorke...
Thank you for your enquiry, I am not sure of the price of this operation and will ask the office to send you the details. It is usually possible to show before and after photographs for most procedures, however this does depend on the surgeon having the patients permission to show any pre and post operative photographs- as the correction of pectus excavatum is not a common operation these may not always be available. With best wishes, Simon Withey


 

June 11th 2010 at 15:31:07
Simon Withey replied @ Sally Clifford...
Thank you for your e mail. We do operate in Kent and the closest hospital to you would be the BMI Fawkham Manor Hospital. I do hope that this reply is not too late, as I note that your e mail dates from early April. With best wishes, Simon Withey.


 

June 11th 2010 at 15:31:26
Simon Withey replied @ Pamela ...
Thank you for your enquiry, we are in the process of finalising arrangement within Northern Ireland, but at this stage do not have the service available- it is likely to be another two to three months before we start consulting, I am sorry if our previous post was misleading it has taken rather longer to resolve the administrative issues that anyone expected. with best wishes Simon Withey


 

June 11th 2010 at 15:33:04
Simon Withey replied @ sally keating...
Thank you for your interesting question. To reduce the size of your areolar and uplift the breast you will certainly need to accept a scar around the nipple. If there is a large amount of skin excess- which may be the case given the description of your breasts as "quite saggy" then the scar may have to extend from the nipple down to the breast crease, this is described as a vertical scar. Scars around the nipple tend to heal well and are often less visible than scars of the breast itself. The final appearance will depend on many issues including the quality and elasticity of the skin, the amount of skin excess and the weight of the breast tissue. With best wishes, Simon Withey.


 

August 31st 2010 at 14:15:37
Simon Withey replied @ Vicky Leeman...
Dear Vicky, thank you for your recent enquiry. It is not unusual to find extra nipples on the breast and these are usually in a vertical line above or below the main nipple. It would not be necessary to remove this as part of a breast augmentation procedure unless, of course, you were keen for it to be taken away. Removal would normally involve a small scar, the length of which will be dependent on the diameter of the accessory nipple. I am sure it is something your surgeon would be prepared to discuss with you.


 

August 31st 2010 at 14:15:02
Simon Withey replied @ Liarna...
Dear Liarna, thank you for your recent correspondence. I am sorry to hear you have been disappointed following your surgery. If you would like to write to Samantha Anderson at My Breast she will bring your comments to the attention of the Medical Committee. It will be necessary to communicate with the surgeon involved and we will require your written permission to do this. I do hope that we can resolve things to your satisfaction. With very best wishes.


 

August 31st 2010 at 14:14:03
Simon Withey replied @ chris...
Dear Chris, thank you for your post of the 25th July. I understand that you have already had a Ravitch procedure and have been left with some central indentation, the fist thing is this is not an unusual outcome following the Ravitch which, although, highly successful in increasing the volume of the medial sternum and improving the appearance, often leaves a little concavity as the eventual contour follows the bony contour. There are various procedures which could be considered should you wish to camouflage this residual indentation. Classically these areas have been filled with custom made silicon shields, however now, more people with minor degrees of deformity, are choosing to have autologous fat transferred to the area. I am unable to give you an exact idea of the costs of surgery which will largely depend on the extent of the deformity. However, I am sure the ladies in the My Breast office will be able to give you some advice in this regard although it will take a consultation to determine exactly what is required.


 

August 31st 2010 at 14:13:03
Simon Withey replied @ annharris...
Dear Mrs Harris, thank you for your enquiry. It is certainly not unusual for patients in their mid to late sixties and even early seventies to undergo breast reduction. Recovery times do vary between patients but you would normally expect to be in hospital overnight, you will find yourself feeling bruised and sore for five to seven days and I would suggest that you have two weeks without doing or planning a considerable amount. You should probably avoid heavy lifting and strenuous exercise for a month although you can start walking, cycling and swimming once the wounds are healed and you are comfortable. I expect, given your responsibilities for your husband and dogs, you will need someone to help you for the first ten days to two weeks after your surgery. With best wishes.


 

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