The initial consultation is extremely important to review the patient's medical history, goals and expectations as well as build mutual trust and rapport. Numerous before and after photos are reviewed. The procedure is explained and the alternatives discussed. The breasts are examined to ensure that expectations can be met, as well as to review the surgical plan, implant size and incision/scar placement.

An ideal candidate for routine breast augmentation generally will have all the breast tissue above the inframammary crease (the crease under the breast) and the nipple in the middle of the breast. If the breast tissue and/or nipple is at the level of the inframammary crease or lower, additional procedures may be needed.

Appropriate implant size will be determined by taking into account the patient's request for cup size and physical examination including the width of the breast, distance from the crease under the breast to the areola and the thickness of soft tissue coverage. The surgeon will offer the patient a range of implant sizes that will accommodate the patient's request for cup size in relation to their physical examination. For those patients who desire the most natural result, the size of the implant used will be determined by their physical examination and available soft tissue coverage. When an implant is placed that is larger than the breast and surrounding tissues can adequately cover, the more there can be rippling that can be felt and visibly seen. For example, a woman with a medium frame and a "B" cup breast can accommodate a larger implant than a petite woman with an "A" cup breast. Breast implants will be more palpable (more easily felt) if there is inadequate soft tissue coverage (skin, breast tissue, muscle) in relation to the size of the implant used. Other causes for a palpable implant may include subglandular placement (over the muscle) and textured implants.

It is also important to understand that breasts are not symmetrical. Often different size implants are used to help improve symmetry. Every effort is made to make the breasts symmetrical and as close as possible to the desired size, however no guarantee as to the exact size, shape or symmetry can be made by any surgeon.

Prospective patients are encouraged to try on various size implants to help with determining size as well as to speak with previous patients about their surgery and results. Plastic and cosmetic surgeons are always available for questions. Following the initial consultation and after appropriate time for reflection and decision-making, an appointment is scheduled for routine preparation and informed consent. Additional questions and concerns are also addressed. Routine blood analysis and medical clearance is required prior to surgery.