Depending on the breast cosmetic surgery you are considering or that has been prescribed, your initial visit or consultation may be somewhat different.
If you are electing to have cosmetic surgery of the breast to enhance the shape or appearance of your breasts, to improve your quality of life, or to treat disease, your initial visit with your cosmetic surgeon will be a consultation. You will meet with your cosmetic surgeon, and in many cases with a patient counselor or nurse who will guide you through the consultation process and subsequent perioperative course. However, you should never undergo any procedure without first meeting and consulting with the surgeon who will be treating you. Most consultations begin by discussing your medical history, and your short- and long-term goals for plastic surgery of the breast. You will be asked specifically about what you wish to accomplish, and you will be informed about the treatments that can accomplish your goals. If you are not given photographic results of your recommended procedure(s) to review, you should ask to see pictures of the actual results the surgeon you are consulting with has achieved. During your consultation, you will be examined so that your surgeon can evaluate your anatomy and physical condition, and determine how to best achieve your goals. Photographs of you will likely be taken for reference. The process of your procedure will also be discussed in detail.
During your consultation or in a subsequent visit, orders will be given for lab tests and medications. Specifics regarding anesthesia, location of procedures, itemized costs, patient obligations, and the recovery process will also be discussed. In addition, sequelae, which are the aftereffects or secondary results of your procedure, will be discussed. These include things you should expect as a result of the procedure, such as bruising and scars. Your physician should also directly define possible known risks, including unpredictable or unfavorable outcomes, and possible complications of the procedure you are considering. Despite a physician’s personal safety record with any given procedure, known risks and complications must be fully disclosed. You will then be asked to sign informed consent documents. All of the components of a cosmetic surgery consultation will occur during one or more visits, depending on your case and the physician’s customary practices. A nurse or patient coordinator may guide you through the process. But decisions about procedures to be performed will be determined by you and the cosmetic surgeon. Surgery to Diagnose or Treat Disease You may find that your consultation experience with a general surgeon or cosmetic surgeon to diagnose or treat breast disease is very similar to that of a consultation for elective cosmetic surgery of the breast. In many cases, a nurse or patient advocate will guide you through the process.
In all cases, your current and baseline test results should be available prior to or at the initial visit. Much like a cosmetic surgery consultation, your medical history will be discussed and condition examined. Your surgeon may require additional testing prior to surgery, or the surgery may be diagnostic itself, for example, a needle biopsy. After the results are analyzed, your surgeon can then prescribe a course of treatment. This should include some insight as to the physical appearance and condition of your breast(s) following treatment, and the state of your health and general prognosis. Unlike most cosmetic surgery consultations, taking photographs or reviewing photographs for reference is not regularly practiced. But don’t overlook asking to see your surgeon’s results, particularly if your breast cosmetic surgery will be disfiguring. Surgeons with good aesthetic outcomes after ablative breast cosmetic surgery will likely be very pleased to share their results with you. When a course of treatment is prescribed, your focus will likely be on the prognosis of your health. But don’t overlook asking specifically about what treatment for breast disease will do to the physical appearance of your breast, and about your options. For example, many women may be candidates for immediate reconstruction (reconstruction of the breast performed at the time of mastectomy) and by law have the right to insurance coverage for reconstruction.
Skin-sparing mastectomy and lumpectomy are also possible options. Just as all physicians do not make it a practice to share photographs with you when treating breast disease, neither will all physicians discuss your options or your rights to reconstruction. You need to be your own best advocate and ask all the questions you want and need to have answered.
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