Meeting with the surgeon

What is a surgical consult?

Your first  appointment with the surgeon is called a surgical consult. During the surgical consult, the surgeon will ask about your goals for surgery and provide you with information about your surgical options. It’s also an important opportunity for you to ask questions. 

What to expect during your surgical consult

Before the appointment for your surgical consult, you’ll receive information about what to expect during this appointment. Each surgeon does things a bit differently, but generally the surgeon will:

• Ask questions about your gender, general health and family history
• Conduct a physical exam of your breasts and underarm area (you will be asked to remove your shirt and undergarments)
• Record your breast and nipple measurements
• Take preoperative photos of your breasts 
• Check your blood pressure
• Ask you to get blood work done before surgery
• Explain potential risk and complications 
• Explain possible surgical outcomes
• Give instructions for aftercare, including return to physical activity

As part of the consult, the surgeon will recommend what they feel is suited to your body shape and goals. Their recommendation may not align with what you had hoped for. If this happens, you can:

• Discuss your preferences with the surgeon.
• Reach out to your primary care provider A person’s main health care provider in non-emergency situations such as check-ups and referrals. Family doctors, general practitioners (GPs) and nurse practitioners (NPs) are all primary care providers. for help to come up with a new plan. 
• Request a second opinion. If you want to pursue a second opinion:
  • Contact Trans Care BC if your referral was sent to the Trans Care BC Central Waitlist.
  • Contact your primary care provider if your referral was sent directly to the surgeon.

Depending on your age and risk factors, the surgeon may also ask for a blood test, electrocardiogram (ECG), an anesthesia consult or other investigations.

And finally, the surgeon’s office will call you later with your surgical date.

Preparing for a surgical consult

Being as prepared as possible for your surgical consult will ensure you have the information you need to make the best decisions for yourself.  

A few things you can do to prepare include:

• Understanding the procedure by reading our information on surgical options, risks and complications.
• Searching online for before-and-after photos of the implant type, size and placement you’re seeking. Find photos of people who have a body similar to your own.
• Preparing a list of questions (see below) and bring along a pen and notebook to the appointment. You may also want to ask a support person to attend the appointment and take notes so you can focus fully on the conversation. 
• Preparing a complete list of any current medications and supplements (including traditional medicines, herbs, vitamins, minerals, etc.) including the dose and frequency.

Sometimes this appointment may take place on Zoom (or a similar platform). It’s still helpful to prepare in advance and have a list of questions and a way to take notes.

Here is a list of questions you may want to ask your surgeon:

• Based on your goals, what would be the ideal size of implant for you? 
• Why do they recommend this particular size range for you? 
• Based on your goals, what would be the ideal type of implant for you? Why do they recommend this particular type?
• Based on your goals, what would be the ideal placement (subglandular, subpectoral) for you? Why do they recommend this particular position? How will this affect where your breasts sit on your chest?
• Based on your goals, what would be the ideal shape (round or teardrop) for you? Why do they recommend this particular shape?
• Do they have photos of surgical outcomes of other patients who had this surgery (both successful and unsuccessful outcomes)? 
• What are the complication rates for this surgery? 
• What are the chances that you might need a revision A follow-up procedure or adjustment to a previous surgical operation or treatment to correct or improve its outcome. with this type of surgery? 

Next steps after your consult

If you choose to go ahead with surgery, the surgeon’s office will:

1. Apply for MSP The Medical Services Plan (MSP) is a B.C. government health plan that pays for physician services and referred services that are considered medically necessary, such as specialists (surgeon, psychiatrist, etc.), diagnostic x-rays, or laboratory services, for all BC residents. Some residents qualify for premium assistance for physiotherapy, chiropractic, naturopathy, massage therapy and acupuncture. funding — If your surgery is eligible to be covered by MSP, the surgeon’s office will apply for MSP funding. It may take 6-8 weeks for your surgeon to receive notice of a funding decision from MSP. They will contact you once they receive this information.
2. Complete the operating room booking package — Once funding has been approved (or if you are pursuing private-pay surgery), the next step is for the surgical team to fill out the operating room booking package. This is done when someone is medically ready A state where an individual is physically and psychosocially healthy enough to undergo a medical procedure or treatment without significant risks or complications, as assessed by health care professionals. to proceed with surgery. 
3. Get your surgery date — Once your surgery date has been finalized, the hospital or surgical centre will reach out to you to confirm your surgery date and location.