Breast Implants: 21 Must-Ask Questions For Your Plastic Surgeon

Jager Weatherby on 28 Apr 2014 at 4:00pm


You researched (and researched and researched) and found the courage to take the next step:  Your very first appointment to talk about breast augmentation is finally scheduled!

To help you in your quest for better breasts, we've compiled a list of 21 must-ask questions for your prospective plastic surgeon. Take 'em with you if you feel so inclined. You can even use our list as a reference at the end of your appointment.

    Are you certified by the American Board of Plastic Surgery? 
Surgeons certified by the American Board of Plastic Surgery must undergo strict certification that requires at least three years of general surgery training, two years of plastic surgery training, passage of written and oral exams, and adherence to a stringent code of medical ethics. By visiting CertificationMatters.org, you can type in any physician's name to see if they're board-certified. "Not only will you see if they're boarded, but in what field they are boarded," explains Seattle plastic surgeon Dr. Shahram Salemy. "Some general surgeons or dermatologists, for example, may call themselves plastic surgeons and try to perform these procedures."

    Where will my surgery be performed?
Your surgery should be done in an accredited outpatient surgery center or a hospital. A surgery center that is accredited has met requirements for patient safety. Certification by the American Association for the Accreditation of Ambulatory Surgery Facilities (AAAASF), the Accreditation Association for Ambulatory Health Care (AAAHC), or Medicare are all acceptable.

LEARN MORE: How to Tell If an Operating Facility Is Accredited

    Do you have hospital privileges to perform this procedure?
Ask your surgeon if he or she is also allowed to perform breast augmentations in the hospital. Even if you're getting the procedure done in an outpatient surgery center, it's an extra layer of confidence. Hospital privileges mean other doctors have checked the surgeon's training and credentials.

    What sort of anesthesia can I expect during my procedure?
There are three main types of anesthesia used during breast augmentation: general (you're asleep), local (the specific surgical site is numb), and IV sedation/"twilight anesthesia" (your level of consciousness is altered). There are benefits and risks associated with each one. Talk to your doctor about your options.

LEARN MORE: What Is "Twilight Anesthesia?"

    Will anesthesia be given by a board-certified anesthesiologist or nurse?
Your anesthesia should always be administered by a board-certified anesthesiologist. He or she should be present for the duration of your procedure, as well as during your recovery immediately after," explains Toronto plastic surgeon Dr. Jerome Edelstein.

   What are the risks associated with my procedure?
As with any procedure, it's imperative to weigh the benefits versus the risks of breast augmentation. Make sure you've done your research before signing on the dotted line.

LEARN MORE: What Are the Risks of Breast Implants?


   How often do you see breast augmentation complications in your practice?
No plastic surgeon is perfect, which means every doctor has dealt with some sort of complication. Often, issues that arise have nothing to do with the skill of the plastic surgeon, but instead with the way an individual's body decides to heal. Knowing how often your surgeon sees complications will give you the knowledge to confidently decide whether or not you'd like to follow through with the procedure. 

   If a complication does occur during or after my surgery, how will it be handled?
If you're getting breast augmentation in an outpatient surgical center, your surgeon should have admitting privileges at a local hospital in case of a serious complication.

   How many breast augmentations do you personally perform each year? 
While it's not necessary to select a plastic surgeon who's been practicing for 20 years, in general, the more experience the better. Choose a physician whose level of experience you feel comfortable with.

   Can I see before-and-after photos of previous patients? 
Insist on looking through as many before and after photos you can. (Some doctors may even have videos.) Look for patients who have similar torso and breast shapes, so you can get a better sense of how your surgeon will tailor the procedure to your body type. If possible, "speak with some of the doctor's patients, which can be really helpful for many people," adds. Dr. Salemy.

MORE: See Before-and-After Photos From RealSelf Doctors

   Am I good candidate physically and emotionally for breast augmentation?
Certain habits or emotional states might make you a poor candidate for breast augmentation. Are you unwilling to give up smoking? Do you suffer from body dysmorphic disorder? Be honest with your doctor. Not doing so could result in serious complications down the line. 

LEARN MORE: Why You Need to Stop Smoking Before and After Surgery

RELATED: Dead Nipples Are a Real Thing — Top Doctors Reveal the Dangers of Not Telling the Truth

   What will be expected of me to get the best results?
Your doctor will discuss the steps you need to take before and after surgery in order to ensure the greatest results. Can you stop smoking? Can you take the time off of work that you need to recover? If not, you may need to reconsider your surgery.

   How long will my recovery be and will I need help? 
It's important to know what to expect after surgery and how long it will last: When can you pick up your kids? When can you start driving again? When can you return to work? At the bare minimum, you will need a caregiver to drive you to and from your surgery, stay with you for 48 hours after your procedure, and drive you to your first post-op appointment. In some cases, you may need someone to stay with you for the first week.

   Do you think saline or silicone breast implants are better for the look I want? 
There are pros and cons to both saline and silicone implants, as well as times when each might be more appropriate to use than the other. You and your doctor must have a dialogue in order to choose which is right for you. 

LEARN MORE: Saline vs. Silicone: Which Type of Implant Is Better?


   Which implant size, shape (round or teardrop), and texture are right for me?
While deciding whether to use saline or silicone, you'll also need to choose which size, shape, and texture are right for you. Each individual's preference and body type will require something different. Below, LA plastic surgeon Dr. Steven Teitelbaum explains the difference between teardrop implants and regular silicone implants.

LEARN MORE: Which Implant Is Right For Me? 

 
   Which incision locations do you suggest?
"There are three incisional approaches that are commonly used," says North Carolina plastic surgeon  Dr. Michael Law. "At the border of the areola, in the underarm area, and in the crease at the bottom of the breast. Each has advantages and disadvantages, and each is ideal for a particular kind of preoperative scenario." While the location is mainly up to the patient, many plastic surgeons favor under the breast incisions. This location accommodates the largest variety of implants, while leaving the least noticeable scar.

   Should I go for subpectoral (under the muscle) or prepectoral (over the muscle)? 
Surgeons generally agree that under the muscle placement provides the best long-term results, however there are cases when over the muscle is preferable. "[With under the muscle placement], the implants are better protected, rates of capsular contracture are typically lower, and if you have saline implants or are very thin, rippling of the implant is less detectable," explains Denver plastic surgeon Dr. Manish Shah. "I typically only put implants over the muscle if patients use silicone implants or are extreme athletes (eg. body builders, martial artists, etc). The pectoralis muscles in these women are so strong that they push the implants down and out from the center creating a large gap and breasts that are too low."

LEARN MORE: Under or Over? Advantages and Disadvantages


   What happens if I'm not satisfied with how my breasts look after surgery?
Each surgeon has his or her own policy regarding revision surgery after breast augmentation. Assuming adequate healing, many doctors will charge a reduced surgical fee, however the implants, anesthesia, and facility costs will remain fixed. Ideally, these details should be outlined prior to the original procedure. The best way to avoid having to undergo a revision is make sure you have an honest relationship with a surgeon you trust, and that both or you are on the same page before entering the operating room.

   Will I be able to breastfeed after augmentation?
Implants shouldn't limit your ability to breastfeed, nor will they pose any threat to the health of your infant.

LEARN MORE: Is It Safe to Breastfeed After Getting Implants?


   Will pregnancy and breastfeeding change the shape of my new breasts?
While your implants won't be affected, changes will occur to the underlying muscles of the breasts. Stretching and shrinking during pregnancy and breastfeeding may result in a looser appearance. "This can be improved with a breast lift," says Seattle plastic surgeon Dr. Mary Lee Peters. "With the implants in place, you will most likely not experience much of a loss in volume."

   Lastly, will the person doing my consultation be the same person doing my surgery?
Now that you've discussed your options, desires, and expectations, it's important that this person is same one who will be performing your surgery. Seattle plastic surgeon Dr. Richard Rand advises, "I do all my own consultations and you should look for this in a doctor." 

Did we leave anything off our list? Let us know in the comments section below!

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