Breast Augmentation Price: Is it Negotiable?

This is a good question, and it deserves a detailed answer.

First of all, make sure you are comparing surgeons properly. That "low-price" cosmetic surgeon may actually be a dermatologist, family practitioner, or other non-surgeon who has decided to open up a cosmetic surgery practice and operates in a non-accredited, non-credentialed, non-peer-reviewed facility. This kind of "cosmetic surgeon" may spend more on marketing and "appearances" than on your safety. It may not be clear to you that this doctor has bypassed all of the proper surgical residency training, plastic surgical fellowship training, written and oral examinations leading to American Board of Plastic Surgery certification, and office surgical facility accreditation (AAAASF or JCAHO). However, the "real" plastic surgeons in your community DO KNOW, and perhaps low price is the only way this doctor can compete with the properly-trained, properly-board-certified, and properly-accredited surgeons in the community.

The perverse reality is that sometimes these "psuedo-plastic surgeons" even charge MORE than their "real" competitors, in an effort to be perceived as "better." These con artists even go out of their way to boast of themselves as "cosmetic surgery 'specialists'" rather than "general plastic surgeons" who are derisively described as "fixing burns" or "taking care of bedsores." (Of course, what they don't tell you is that their cosmetic surgery "training" consisted of a couple of two-day courses given by other non-surgeons, or spending time with another con artist doctor to learn how to fool the trusting public.) If this sounds extreme or "bogus" I can tell you of a Dermatologist in my city who tried to put in breast implants in his office exam room under local anesthesia, used up to toxic levels of lidocaine, and only got one implant in (he had to stop because of agonizing levels of patient pain). Two days later he tried again to get the remaining implant in, again reached toxic levels of lidocaine trying to stop the severe pain of improperly-performed surgery, and again failed to get the second implant in. 10 days later I had to remove the existing implant (under proper anesthesia) which had bleeding and early infection present. Lawsuit pending.

So let's assume you have done your homework and consulted with only ABPS-certified plastic surgeons. There will still be discrepancies in costs. Sometimes this is because a plastic surgeon works at a hospital (this will be most plastic surgeons, who do a multitude of reconstructive and cosmetic surgeries--remember, we have COMPLETE training; that's what the circular American Society of Plastic Surgeons logo denotes). Make sure your cost quote is complete. I have seen many patients who come in with the surgeon's quote, only to find out that it does not include the hospital operating room costs, costs of the implants, or the anesthesia provider's costs--those bills are sent separately! And then there's the big surprise that the "low" cost wasn't a complete quote, or that it was only an estimate, and didn't include the "extra" 15 minutes that the surgeon took to do the procedure (extra charges not included in the "estimate").

Other ABPS plastic surgeons may work out of a stand-alone hospital-owned or privately-owned surgical center, where costs are more tightly controlled, volume of elective surgeries higher, and frankly, profits better. These plastic surgeons may be able to charge a bit less and deliver an overall superior procedure from start to finish, also avoiding exposure to "sick" patients and bad bacteria!

Some plastic surgeons (superbly-trained and skilled reconstructive experts) just don't do much cosmetic surgery, and have to price these procedures accordingly.

Other plastic surgeons have gradually steered their practices towards elective cosmetic surgery, even though they have completed the same full training, certification, and accreditation of their reconstructive colleagues. This may be out of interest, talent, insurance reimbursement pressures, or a host of other factors, but these plastic surgeons have become the cosmetic surgery specialists in a competitive sea of non-surgeons, Derm surgeons, ENT surgeons, facial plastic surgeons, and REAL plastic surgeons who have chosen different paths within cosmetic and reconstructive procedures. Now there's REAL price competition.

The best and brightest ABPS-certified plastic surgery stars who specialize in cosmetic surgery may well be so busy they never have to "discount" their prices. (Or, they may just publicly state that to keep up appearances!) For some in some locations that indeed is true. God bless their good fortune in these past years of economic woe! For the rest, there has indeed been the same harsh economic reality we all have faced. Even the most successful surgeons and practices saw price competition, discounts, and patient "shopping." Some practices saw these times as an opportunity to increase their expertise and experience by offering modest discounts or incentives, while still maintaining top-notch quality, staffing, and procedural details. Most well-run businesses (including surgical practices) saw these past few years as an opportunity to become even more efficient, quality-oriented, and patient-centric when their competitors were not only cutting prices, but "cutting corners!"

So, is it "rude or disrespectful" to ask for a discount? Maybe, if the surgeon's ego is bigger than his or her awareness of reality. I have been in private practice for 24 years, and I still offer professional discounts to doctors, nurses, medical students, armed forces personnel and other select individuals close to my heart. The "flip-side" reality is that I do the vast majority of my highly-skilled and attentive-to-detail surgery for the very best price I can deliver. I choose to do charity work overseas during my cleft lip and palate mission trips. My partner chooses to do charity work in our community with disadvantaged and at-risk youth. Most plastic surgeons do some form of charity or pro bono work--BUT we're not the dollar store or a used car lot!

While you make good points about re-business and the like, even plastic surgeons have fixed (increasing) costs. You really don't want the surgeon who is "cheapest." You probably don't want the surgeon who is the most costly either (usually just a "cover" for average work masquerading as "the best"). You want the best surgeon you can find, regardless of the exact cost. Re-do surgery is not only expensive, but you have to take off your own work and activities a second time! Ask that "low-price Charlie" what their re-do or touch-up surgery policy is. Who pays for re-operation for bleeding? All this needs to be considered.

Remember, the bitterness of poor quality remains long after the sweetness of low price is forgotten.

Thanks for your question!
Most surgeons have a set fee that are not negotiable. Schedule a few consultations with board certified plastics surgeons to discuss options and fees. Best wishes!

Hi there and thank you for the question, 
This is obviously a very tough subject and often requires a longer more detailed discussion along with education... but to answer this succinctly 
Most stable and well respected practices do not negotiate as they have a firm handle on their expenses and are not devoid of patients.
If you find you are involved in  a practice that negotiates either its newer, they do not have a firm handle of expenses, they need more patients, there pre and post op care requirements vary etc etc 
I regularly inform patients to not get involved in practices that price negotiate because they often don't have the best reputations or experience. 

Discount policies for cosmetic surgery vary from practice to practice and depend upon a multitude of variables. It's important to understand that fee quotes for breast augmentation should include the surgeon's fee, anesthesia charges, facility fees, implant costs, and pre and post-operative care. These costs can be dramatically impacted by the surgeons overhead and levels of local competition.It's not unusual for physicians to discount breast augmentation for a variety of reasons. In some cases, discounts are given when patients have had previous procedures. Discounts are often given for combination procedures as well. Occasionally, plastic surgeons discount specific categories of patients. For example, discounts are often given to healthcare workers and military personnel.For these reasons, it never hurts to ask for a discount, but it's important not to be offended if the answer is no. In some highly competitive environments, the fees may have already been cut to their lowest possible levels. Under these circumstances, the surgeon may not have the latitude to lower his fees any further.

Some doctors allow a limited amount of
negotiation on the quoted price of their surgery. Still, the maximum discount
you can expect to receive is a couple hundred dollars if that. Because the
price of a breast augmentation surgery in your area can range substantially
according to the expertise and prestige of the surgeon you are consulting, I
would advise that you consult at least three surgeons to get a better
assessment of how much your breast augmentation will cost you before moving
forward. Rest assured, still, that most offices will gladly help you set up
payment plans to make the surgery more feasible and may offer financing
solutions such as CareCredit.

Usually, pricing for cosmetic surgery has a
little wiggle room.Most plastic
surgeons would be open to some negotiation on fees, but usually there needs to
be some reason to consider giving a discount.Frequently, the surgeon will give a discount for military service, for
patients in the medical profession or if you are having multiple procedures at
the same time.I would caution you not
to decide on price alone.Sometimes
there is a reason that one surgeon charges less than another.One may use a lesser quality or “off brand”
implant or may not have an anesthesiologist to give your anesthesia or may not
operate in an accredited facility.These
things would lower the price, but certainly would not improve the quality of
your results!Just be smart and research
the surgeon you choose and the facility where it is to be done.Don’t worry that it would be rude to ask
about consideration in the price but realize that there may be a reason for the
fee being what it is.

The trend is that the more experienced and established the plastic surgeon the last chance for negotiation.However, if your schedule permits flexibility so that on short notice you could have the surgery when convenient for the surgeon (e.g. if one of his patients surgery is cancelled at the last minute, or during any slow period) then you may be able to negotiate price to some extent. Also Saline implants cost less than silicone ones. Breast Augmentation prices vary greatly because the surgery itself encompasses a wide range of techniques that can be performed to different extents. It might be possible to meet your price point but be careful that this does not mean a less experience surgeon and therefore less quality surgery. My recommendation is to first find qualified surgeons that are board certified by the American Board of Plastic Surgery you trust, then compare prices between them. Factors that influence the price include:1. Location - Will it be performed in a hospital with an overnight stay, an independent out- patient facility or a doctors office? Geographical location also has a significant influence.2. Type of Anesthesia - IV sedation or General Anesthesia? Will a board certified anesthesiologist or a nurse anesthetist be used, or an RN?3. Experience and training of your surgeon. The best trained (and longest) would be a surgeon board certified by the American Board of Plastic Surgery4. Length and Complexity of Surgery - how difficult will your surgery be and how long, etc . Will other procedures also be done like a breast lift, lipo on the sides of your breast/chest wall, etc be also performed

When looking at different breast augmentation prices there are many factors as to why you see different prices. Most doctors that charge more would like you to think it is because they are better trained or give you a better result. This is not the case. typically there are many factors that contribute to what a doctors charges1)does the doctor have their own surgery center pr have to use a hospital. If they have to use the hospital this can add several thousand dollars to the cost which is passed on to the patient. The doctors that have to use a hospital will try to tell you its safer but the reality is this has never been shown scientifically and all Board certified plastic surgeons are required to operate in certified surgery centers. So those with their own centers have facilities with the same set of standards as the hospital and at times are certified by the same agency. So most Surgeons with their own surgery center pass the discount on to their patient.2)Time in the Operating room. The less experienced, indecisive a surgeon or the fewer cases a plastic surgeon does per year the longer they will take in the operating room to perform the procedure. Thus the more they are charged by the hospital or anesthesia staff. The more specialized the plastic surgeon is with breast augmentation the more efficient he is with the procedure so the less time it take and the less it will cost. Not to mention the more they do the less they pay for the same implants. Again most surgeons should pass this savings on to the patient.3)Experience.. the more experienced sometimes the more the Doctor feels they can demand for their services. What you should look for, is to make sure they are a Board Certified Plastic Surgeon. They should also be a member of the American Society of Plastic Surgery as well as a member of the American Society of Aesthetic Plastic Surgery (which is the most prestigious cosmetic society a plastic surgeon who performs cosmetic breast augmentation can belong to).4) Lastly sometimes geography comes into play when in certain regions of the country the cost for staffing and facility are much higher than in others.I perform over 1000 breast augmentations per year. And I am a member of the above societies as well as a member of the lead surgeons. We have our own surgery center and charge what we feel to be an honest cost of only 3000$ for saline and 4000$ for silicone breast augmentation and this includes all cost..

I do not think that you are being disrespectful in asking for a discounted price, but most practices will have a policy about what discounts can be given. I happen to have a small discount for military personal for my services. But for the most part, the price is the price. I would not suggest using the cost of services as your primary means of deciding upon a surgeon. The most expensive surgeon in town is not necessarily the best. And the least expensive surgeon is not necessarily the one that is able to offer the most value. 

i don't think that asking whether prices are negotiable is disrespectful. that being said, i will have patient try to nickel and dime to get the "lowest price possible."  the truth is, there are surgeons out there who may not be fully trained plastic surgeons who will do this procedure for very little money.  however, their results will be variable.  go with someone you like and you trust.  don't sweat a few hundred dollars in the end.  you are not buying a car - where no matter which dealership you go to you will get the same exact car - you are entering in to a relationship.  make your decision carefully.  price is only one of the many factors involved.

Negotiating cost of surgery happens.  How you go about it will determine whether you and your surgeon reach an agreement that is mutually acceptable.  There are many costs that are outside the surgeon's control: implants, facility, anesthesiology which often comprises a significant costs.  In addition, if you plan to finance the cost of surgery, then the financing company (example Care Credit) requires their share of the price which can be significant.  Your surgeon probably has no wiggle room with the other fees, but may working with his/her fees if you pay upfront with cash/check  vs financing.  Good luck.