Introduction Even with the utter volume of easily accessible information on plastic surgery interventions, patients looking for a breast augmentation still manage to think of relevant issues to discuss with their surgeons. Of course, there are some patients who come to the initial consultation without any idea about the surgery, such as what to expect, how it can be performed, and the qualifications of a suitable candidate for the procedure. Other patients do their research prior to the meeting and thus, are more informed about what the breast augmentation surgery entails. While different patients will have varying inquiries regarding the operation, there are a few questions that should be asked no matter how prepared or informed a patient may be. Here are some answers to ten essential questions asked by patients before breast augmentation surgery: 1. What is the purpose of the pre-operative consultation? Keep in mind that not all surgical interventions for breast augmentation are alike. Plastic surgeons may perform the operation using different techniques, each with its own distinct impact on the final result of the surgery. During the pre-operative consultation, it is important to concentrate on three main aspects: The surgeon should discuss which types of mammary implants are available and recommended for the patient, the location of the incisions, the placement of the implant, and whether a breast lifting procedure will also be necessary. Moreover, it is crucial to carefully analyze the potential side effects and complications before deciding to undergo the procedure. To avoid any mishaps, the patient should make sure that the surgeon who will conduct the breast augmentation procedure is a board-certified plastic surgeon, and highly experienced in this type of surgery. Unfortunately, there are doctors who do not specialize in plastic surgery yet they perform breast augmentation procedures without adequate training and experience. The success of a breast enhancement procedure is highly dependent on the plastic surgeon’s ability to provide a solution that resolves all of the patient’s concerns as a unit (the shape of the breasts, the degree of the asymmetry or breast ptosis, etc.). In addition, the cost of the intervention is determined by several factors, including the price of the breast implants, the complexity of the surgery and so on. The patient should discuss all of these factors with the surgeon during the pre-operative consultation. 2. What are the ideal dimensions of the breasts? This is, of course, a matter of personal taste. An individual’s ideal breast size is heavily influenced by beauty and social trends. In order to achieve a proportionate figure after the surgery, the right dimensions for the breasts should be determined after considering the shoulders, waist and the structure of the body. The likelihood of becoming a suitable candidate for augmentation also depends on the amount of skin on the body. This means that thin women may have smaller implants compared to women with a larger frame. The decision to undergo the procedure should be made after thorough consideration of the plastic surgeon’s professional and expert opinion which will be based on a comprehensive examination of the breast, along with an evaluation of the type of breast and the quality and texture of the skin. 3. Is it possible to have a breast augmentation surgery to correct breast asymmetry? Breast asymmetry can be determined by comparing the size of the breasts through one of multiple sophisticated methods of analysis. The plastic surgeon makes use of these techniques to decide the suitable procedure for each patient. Mild asymmetry characterized by a difference in size can be corrected only by introducing breast implants with different proportions. 4. Where does the surgeon place the incision for inserting the implant? Is it visible? There are three main approaches to the insertion of the mammary implant: the incisions can be performed along the inframammary fold, in the armpits or around the areola. Today, most women choose the inframammary incision which is closed using intradermic sutures that are absorbable by the body. Sterile adhesive strips are then applied over them. Wherever an incision is performed, a scar is consequently left behind. The good news is that the scarring is minimal and masked by the natural folds of the body. On the other hand, it must likewise be noted that the trans-axillary and the periareolar incisions involve more side effects and complications. 5. Should the implant be placed over or under the pectoral muscle? Each method has its own advantages and disadvantages but the appropriate placement of the implants depends on the surgeon’s recommendations. Many plastic surgeons prefer the submuscular placement for women with thin skin on the upper side of the breast. This is because the implants are covered by muscles on the upper part of the breasts and are less likely to be seen or felt. 6. What is the type of anesthesia required for the breast augmentation? The breast augmentation surgery can be performed either under general anesthesia or with local anesthesia in conjunction with sedation. This decision is made at the request of the patient and according to the recommendation of the anesthesiologist. 7. What is the length of the recovery period following the surgery? Under normal circumstances, the breast augmentation surgery lasts for about an hour depending on the complexity of the case and whether other plastic surgery procedures are performed simultaneously. After the surgery, the patient will experience mild pain for a few days up to a week. After this, the patient can resume routine activities. The recovery after the breast augmentation surgery doesn’t take as long as many patients expect. The recovery time is dependent on the placement of the implant relative to the pectoral muscle. When the breast implants have been positioned under the pectoral muscle, the recovery period tends to be longer compared to the subglandular position. 8. What are the potential complications after the surgery? The post-operative complications can be divided into complications directly associated with the intervention and complications related to the aesthetic result. The possible complications that may develop after breast augmentation surgery include: Infection: Mild infections and severe infections can occur after the operation despite preventive methods such as taking antibiotics. It is imperative that the patient maintains the cleanliness of the surgical wound to avoid infections. Sensitivity: The patient might experience a temporary loss of sensitivity around the nipple area but nipple sensation should return to normal after a few months. Permanent loss of sensitivity may also occur in very rare cases. Bleeding: This complication usually occurs immediately after the surgical intervention. Symptoms such as progressive swelling, pain and a sensation of pressure will require an additional surgical intervention to correct the problem. Seroma accumulation: A seroma is an accumulation of clear fluid in the spaces surrounding the implant. It may have different manifestations on the breasts or it may be exhibited by a painful and discomforting sensation. In the majority of cases, there is no need for surgical correction as these fluids will simply be reabsorbed by the body. Fortunately, the frequency of the occurrence of complications is quite low; hence, the number of corrective surgeries is extremely reduced. Aside from the aforementioned potential complications, there are also issues related to the healing process. The patient might encounter issues with the cicatrization (scar formation) of the incision and even wound dehiscence (opening of the margins of the incision). Local treatments can be used to fix this. Corrective surgery is required only after the implant becomes visible as a consequence of wound dehiscence. Aesthetic complications: As a result of various factors, changes in the appearance of the implants and the breasts can occur, such as the rippling effect. Furthermore, breast sagging is possible after breast augmentation surgery. This is a natural condition that develops over the years, but the extent of sagging becomes worse when big implants are inserted in breasts with soft and thin skin or if the patient has previously undergone breast lifting surgery. 9. Does breast augmentation have side effects? Aside from the potential complications of the breast augmentation surgery, there are specific side effects associated with the implants. Capsular contracture, or the hardening of the breast tissue, is a particular side effect that only occurs when implants have been used. While the side effect does not occur as often as it used to, the patient should be aware of the fact that a revision surgery will be needed to remedy the condition and the removal and replacement of the implants might be necessary. 10. Will I be happy with the results of the surgery? While there is no guarantee that the result of the breast augmentation will be entirely what you have expected, there are ways to ensure that you will get a satisfactory result after the surgery. First, you should only agree to have a board-certified and highly experienced plastic surgeon to perform your procedure. Knowing your surgeon’s credentials and experience will help you feel more at ease when discussing the details of your surgery and this sense of trust will also make it easier for you to follow your surgeon’s preoperative and postoperative instructions. Conclusion Preparing for the surgery and post-operative care are both highly important factors to the results of your surgery. If the patient is not willing to listen to the surgeon’s instructions during the recovery period and avoid certain things, then the results of the surgery might be affected or unsatisfactory. Not even the most experienced plastic surgeon can guarantee that you will have the breasts you have always dreamed of. Most of the time, the surgery provides impressive results, but you still have to do your part as the patient to ensure that the final results are the best possible.