Steps to be taken before getting a breast augmentation

Breast augmentation is the most popular form of breast surgery and a very common request. When a woman undertakes this procedure, many factors need to be considered.

Being in a good state of health is a prerequisite for surgeries in general and in particular breast augmentation. Ladies should be at their goal weight and weight stable for 6-12 months. A healthy diet and lifestyle compliment this surgery well. A Body Mass Index of 18 – 25 is most desirable and achieves the best results.

At a pre-operative consultation, several important questions should be answered:
  • Why do I want a breast augmentation?
  • What size do I want to be?
  • Am I happy with the shape of my breasts?
  • How do weight changes, breast-feeding and pregnancy affect my result?

In addition, several important factors such as current and future breast health and screening need to be considered.

Women should be well informed of all their options regarding all aspects of their potential surgery.
  • Silicone vs. Saline implants – Since the reintroduction of silicone, over 10 years ago, it has become the most popular choice.
  • Round vs. anatomical implants
  • Textured vs. smooth implants – Textured implants offer greater versatility with regards to implant placement location.
  • Subglandular vs. Submuscular implants
  • Choice of incision

An inframammary fold incision remains the most common choice by far, followed by periareolar and transaxillary incisions coming a distant second and third.

Unrealistic expectations will lead to dissatisfaction post surgery and therefore it is important to discuss this in detail with your surgeon. Making a personal choice with reasonable and attainable goals will ensure a good result.

A woman embarking on a surgery of this nature with ulterior motives such as promotion at work, saving a relationship or competing for attention with others, would be destined for disappointment.

Understanding the surgical process is important. Informed consent is crucial to the practice of modern surgery. Being well informed about every detail of your surgery is an imperative.
  • A proper pre-operative consultation with measurements and photographs would facilitate good planning and decision making, and ensure the ‘look’ you would like is achieved.
  • Being well prepared for your anaesthetic is essential. A healthy lifestyle and cessation of smoking 4 weeks prior to your surgery will ensure this.
  • The details of recovery need to be discussed and understood since post-operative behaviours can affect long-term outcomes. For example, full return to strenuous activity takes 4-6 weeks, moderate activities such as driving should be delayed for 7-10 days and post surgical garments should be worn for a month after surgery.

Although possible complications are not the most pleasant of conversations to have, these need to be discussed and understood. Insurance for post surgical complications can be offered and assures peace of mind.

Costs generally carry the most weight in the decision making process for most patients. This is often a bad principle. The old adage of: “you get what you pay for” really applies to this type of surgery.

Popular surgery such as breast augmentation will be a topic of conversation and controversy anywhere in the world. Gathering information sensibly from friends and colleagues is a wise idea. Using unfiltered sources, such as social media and Internet search engines, for example, Dr Google, will give incredibly distorted perspectives.

The person who answers all your questions the best should ultimately be the surgeon you choose to perform your breast augmentation.


Dr Anton Potgieter trained at Wits University and worked at Baragwanath Hospital before starting private practice at Sandton Mediclinic. He has special interests in breast surgery and paediatric plastic surgery.

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