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What to expect from a consultation for aesthetic breast surgery

Posted on October 13, 2009

MyBreast founding surgeon and breast surgery expert Simon Withey talks you through a breast surgery consultation and how to get the most out of it.

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 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.

3 Comments

Mrs Pearson

1st April 2015, 12:00am

I am considering a breast reduction. I have always had large breasts, but recently with some mid-life weight gain they have reached a 34G and I am very unhappy.

I would like to know if a reduction & uplift can be done with the existing breast tissue or whether implants are necessary for the uplift part? Also I have heard about "donut" lift, which has minimal scarring, eg the anchor scar....do you do this type of reduction procedure? Thank you

Patrick Mallucci

1st April 2015, 12:00am

Dear Mrs Pearson,

Thank you for your question about breast reduction. For women with large breasts, reduction automatically entails lifting the breast at the same time. An implant is not necessary for this. With regard to the donut vs. anchor type pattern of scarring, in general, for those with very large breasts an anchor pattern is required to reduce and lift the breasts sufficiently. A donut reduction/lift would be for very small reductions only.
I hope this is helpful.

Many thanks

Sandra sumner

1st April 2015, 12:00am

Hello I'm really really unhappy with my breasts.im a 28h and would love to be a d cup.hat surgery would I need.how much cost,how long off work.been thinking of having it done for yrs but was worried about scarring.im 48 yrs old and now I don't care about scarring as much,I'd just rather have smaller less heavier breast