Questions to Ask Before Breast Augmentation
Twenty questions to take into a breast augmentation consultation, covering implant type, placement, incision, recovery, long-term monitoring and what a revision would cost. Written for someone comparing two or three surgeons before committing.
The questions
Open any question for the note
Are you certified by the American Board of Plastic Surgery, and is the facility where you operate accredited?
Why ask it
Board certified sounds specific but is not: doctors from other specialties can advertise certification from boards that have nothing to do with surgery. Ask for the name of the board and the name of the accrediting body for the operating room, then look both up yourself before the second consultation.
How many breast augmentations do you perform in a typical year, and how much of your practice is breast surgery?
Why ask it
Listen for a number and a share, not for years in practice. A surgeon who does this weekly has seen more of the odd cases than one who does a handful a year between other procedures, and someone whose main work is elsewhere may be honest about that if you ask directly.
Can I see photos of your own patients who started out with a similar chest and frame to mine, shot from the same angles?
Why ask it
Stock or manufacturer photos and mismatched before and after poses hide a lot. What you are looking for is consistency across many results at your starting point, including the ones that look only modestly different, because those tell you what the surgeon can reliably deliver rather than what happened once.
What are my chest measurements, and what implant width and volume range actually fit them?
Why ask it
Implant diameter has to sit inside the base width of your own breast, so your anatomy narrows the options before preference enters. If a surgeon skips measuring and talks only in cup sizes or cubic centimeters, they are letting you pick a number that may not fit your body.
How do we settle on size, and can I try sizers in a bra or see imaging before the day of surgery?
Why ask it
Size regret is one of the most common reasons people go back for a second operation. A surgeon with a real process, sizers in a fitted bra, photos of comparable patients, sometimes 3D imaging, is far more useful than one who says they will decide in the operating room.
Would you use saline or silicone gel in my case, and what is the honest trade-off?
Why ask it
The practical difference is how each behaves when it fails and how it feels. Saline collapses visibly, so rupture is obvious and needs no scans, while silicone gel usually feels more like tissue but can leak silently, which commits you to periodic imaging for as long as you have them.
Would you use a smooth or textured shell, and what do you tell patients about the lymphoma linked to textured implants?
Why ask it
Textured surfaces have been associated with a rare cancer of the immune system, BIA-ALCL, and one widely used textured line was pulled from the market worldwide in 2019. You want a surgeon who raises this without prompting and can say plainly why they are choosing the shell they are choosing.
Would you place the implant above or below the muscle for me, and what does that change about recovery and how my chest looks when I flex?
Why ask it
Placement is not a detail. Under the muscle generally means a more painful first week and visible movement when you contract the chest, which matters if you lift or do yoga, while above the muscle is an easier recovery with more chance of visible edges or rippling if you are thin.
Which incision would you use, and how does that choice affect nipple sensation and breastfeeding?
Why ask it
The three usual sites leave scars in different places and carry different risks. The incision around the areola is closest to the ducts and nerves, and any surgeon should be able to tell you which sensations commonly change, how often they come back, and how long that usually takes.
Is there enough sagging in my case that an implant alone will not give me the shape I am picturing?
Why ask it
An implant adds volume but lifts very little, so a breast that already sits low can end up fuller and still low. If the honest answer is that you need a lift as well, you are looking at more scars, more cost and a different recovery, and it is better to hear that now than after.
Who gives the anesthesia, and what is the plan for pain and nausea afterward?
Why ask it
Ask whether it is a physician anesthesiologist or a nurse anesthetist and who is monitoring you in recovery. Also ask what you go home with, since a plan that leans only on opioids is worth questioning when nerve blocks and scheduled non-opioid medication are common in this operation.
What complications have your own patients had in the last few years, and how often have you had to operate again?
Why ask it
Any experienced surgeon has a list. A specific answer, with the problems named and roughly how often they came up, is a good sign; a claim of no complications means either a very small number of cases or an unwillingness to tell you the truth.
What is capsular contracture, how would I notice it, and what would we do if it happened to me?
Why ask it
Scar tissue tightening around an implant is one of the most common reasons people end up back in the operating room, and it can appear years later. Learn what the early change feels like, firmness, a rounder shape, discomfort, because catching it early affects what the fix involves.
After surgery, what should make me call you rather than wait for my follow-up appointment?
Why ask it
You want a short list you can remember while groggy: sudden swelling on one side, fever, a spreading red patch, drainage, calf pain, shortness of breath. Ask who answers the phone at night and on weekends, because that detail decides how the first bad night actually goes.
What will the first two weeks be like day to day, including garments, drains, sleeping and showering?
Why ask it
Most people plan for the surgery and underplan the fortnight after. Ask how long you will need someone with you, whether you can lift your arms overhead, how you are meant to sleep, and when the surgical bra comes off, then arrange help before you book the date.
When can I drive, return to work, pick up a small child, and go back to lifting?
Why ask it
These have different timelines and the child lifting one catches parents out, since arm and chest restrictions can last weeks. If your job or sport involves the upper body, get the date in writing so you can tell an employer or coach something more useful than soon.
What long-term imaging do you recommend to check the implants, and starting when?
Why ask it
The FDA recommends periodic ultrasound or MRI to look for a silent rupture of silicone gel implants, so this is a lifelong commitment of appointments and out of pocket cost that insurance often will not cover. A surgeon who has no schedule to give you has not thought past the first year.
How will implants change my mammograms and any future breast cancer screening?
Why ask it
Implants can obscure tissue on a mammogram, so imaging centers use extra displacement views and you will need to tell every technologist you have them. If breast cancer runs in your family, ask directly how placement choice affects what a radiologist will be able to see.
What is the total itemized cost, and what is not included in the quote?
Why ask it
The advertised figure often covers the surgeon only. Ask for the facility fee, anesthesia, implants, garments, medication, pathology and every follow-up visit as separate lines, plus what a complication in the first month would cost you, which is where surprise bills come from.
If I want a revision, a size change, or the implants out entirely years from now, what does that involve and who pays?
Why ask it
Implants are not lifetime devices, so plan on the possibility of another operation. Ask what the manufacturer warranty actually covers, usually a replacement device rather than the surgery, whether your surgeon waives their own fee in the first year, and what removal alone would leave you looking like.
Working through a breast augmentation consultation
Practical guidance for the conversation itself
Choosing who operates
Verify the credential, do not accept the phrase
Look the surgeon up in the American Board of Plastic Surgery directory yourself, and check that the operating facility is accredited or is a licensed hospital or surgical center. Both take a few minutes online. Marketing language about being board certified or double board certified means little until you know which board.
See two or three surgeons before deciding
Consultations are usually cheap or free relative to the operation, and the differences are informative. If two surgeons measure you and land on a similar implant range and the third proposes something much larger, that is worth understanding. Bring the same questions to each and write down the answers the same day.
Notice how the consultation is run
A useful visit includes an examination and measurements, discussion of placement and incision options with reasons, and time for questions with the surgeon rather than only a patient coordinator. Pressure to book that day, a discount that expires, or a refusal to discuss complications are all reasons to leave and go elsewhere.
Ask for the FDA patient decision checklist
Manufacturers are required to provide a patient decision checklist that your surgeon reviews with you and you sign before implant surgery. Ask for it early rather than at signing, read it at home, and bring back anything on it you do not understand. It covers risks in plainer language than most consultation notes.
Getting size and expectations right
- Cup size is not a unit of measurement. It varies by brand and by band size, so decisions made in cup letters tend to disappoint. Work in implant volume and width alongside photographs.
- Bring photos of results you like and, just as usefully, results you do not. Being able to say too round or too wide gives the surgeon something concrete to work with.
- Try sizers inside the bra and clothing you actually wear, including a workout top, and walk around. What looks right standing still in a gown often reads differently in a fitted shirt.
- Ask what will happen to the result over time with pregnancy, weight change and simple ageing, since none of those stop after surgery.
- If you are aiming for a specific look tied to one photograph of one person, say so out loud. Different underlying anatomy is the usual reason two people with the same implant look nothing alike.
- Decide in advance how you feel about a second operation. People who accept from the start that a revision may happen tend to be steadier about it than people told it would be once and done.
Planning the weeks after
- Arrange an adult to take you home and stay the first night, which most accredited facilities require anyway for general anesthesia.
- Set up the house before the date: things you use moved to waist height, front fastening tops, extra pillows or a wedge if you are told to sleep propped up.
- Book time off honestly. Desk work often resumes within a week or two, while anything involving lifting, reaching overhead or being on call for a toddler takes longer.
- Fill prescriptions before surgery and confirm which of your usual medications and supplements to stop, and when. Blood thinners, some anti-inflammatories and nicotine all matter here.
- Write down the after hours number and put it in your phone, along with the date of the first follow-up.
- Give the result time before you judge it. Swelling and implant position both change over weeks to months, and early photographs are a poor guide to the outcome.