It’s highly unlikely, your surgeon is marking up the cost of anesthesia, operating room, or the cost of the implants. That leaves the only variable cost being the surgeon speech, which you did not include. $13,000 seems very typical for the geographic area. In the end, there are three variables that determine the outcome of breast augmentation surgery. Those three variables are.1) the patient’s candidacy for the procedure(not everyone is an ideal candidate for breast augmentation)2) the choice of implants3) technical aspects of implant placement. When patients are dissatisfied, or have issues with breast augmentation’s after surgery, the problems can almost always be explained by one or more of the above three variables. There isn’t all that much patients can do regarding their own candidacy for the procedure. For example, women who have divergent breasts are going to have the divergence be amplified by getting breast implants. What patients do you have control over is provider selection and implant choice. Individuals who choose excessively large implants, will have a higher rate of revisions, complication, and undesirable side effects. The following are some general recommendations on provider selection. To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body or facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider. There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures. The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery. Best, Mats Hagstrom, MD