Small Implants - How can I avoid paying anymore consultation fees and find a doctor that supports my aesthetic goal?

It is important to remember that you are seeking a partner during consultation. Our job as surgeons is to guide not dictate. We can offer insights and opinions. However, the patient has the final say.

Disagreements can occur. As a surgeon, while difficult, when visions do not align it is often for the best to decline to operate.

With regards to your specific question, it is best to limit yourself to 3 consults ("Too many cooks in the kitchen can spoil the broth"). This can allow for 2 different visions and a tie-breaking vote.

Small breasts are always an option. The tendency to go larger stems from experience (the most common patient regret post op is not having gone larger). However, if you cannot come to an agreement, repeat consultation is recommended.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

I am very surprised that you cannot find a plastic surgeon who would accommodate your choice for a small implant/lift. Most surgeons, once they have had the opportunity to provide you with all of the information about their recommendations for the proper size implants that they feel is best, are happy to put the patients choice 1st, as long as the patient understands what that choice would deliver to them. As most surgeons charge a consultation fee for their time, you may try canvassing your area with phone calls and asking if you could get a firm commitment from the surgeon to agree to a certain size implant prior to being seen. You may still have to pay the consultation fee for that surgeon, but it will save you from going to multiple other surgeons. I hope this helps.

In person evaluation needed for definitive answer; Do I need a breast lift? You might not need one. I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA