Preparing for Your Breast Reduction Consultation: A Comprehensive Checklist

Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney

The first consultation matters more than most patients realise. It’s where the surgeon assesses what’s actually going on, where you find out whether reduction is the right path, where the Medicare conversation either qualifies you or doesn’t, and where you start to gauge whether the surgeon you’re meeting is someone you’d trust to operate on you. Arriving prepared means you get more out of the time. Arriving underprepared means you leave with as many questions as you came in with.

Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) with over a decade in private practice. He has performed more than 1,000 breast procedures and consults from his Sydney clinics in Bondi Junction and Manly. The article that follows walks through what to do before the GP referral, what documents and information to bring to the first consultation, what to ask the surgeon, and how the AHPRA two-consultation process actually unfolds across the weeks leading up to surgery.

Why Preparation Matters

Two reasons preparation pays off.

The first is practical. The first consultation has a defined time window, usually 45 minutes to an hour. If you spend the first 15 minutes hunting for documents you forgot to bring, or trying to remember when your symptoms started, that’s 15 minutes the surgeon doesn’t have for proper examination and discussion. Coming in with documents organised and a clear timeline of your symptoms gets you straight into the substance of the conversation.

The second is bigger. Surgery is a significant decision. The AHPRA two-consultation requirement exists precisely because cosmetic surgery decisions shouldn’t be made under time pressure or sales pressure. Coming prepared lets you use the consultations the way they’re designed: as proper clinical assessments where you have time to think, ask follow-up questions, and arrive at a decision that reflects what’s right for you rather than what felt expected on the day.

What I tell patients in clinic: treat the first consultation as a fact-finding mission, not a commitment point. The decision about whether to proceed comes later, after time to reflect on what was discussed.

Step One: Before You Get the GP Referral

Since the AHPRA cosmetic surgery reforms came into effect in July 2023, every patient must obtain a GP referral before the first consultation with a Specialist Plastic Surgeon. This isn’t a formality. The referral letter shapes how the consultation unfolds, particularly for patients pursuing reduction with potential Medicare eligibility.

Before you visit your GP, take some time to organise your own thinking. Write down:

• When did your symptoms start? Approximate timeline matters. “Several years” is less useful than “since my second pregnancy in 2019.”
• What symptoms do you experience? Be specific. Not just “back pain” but “lower back pain that worsens by mid-afternoon, particularly on days I’m walking or standing a lot.”
• What have you tried? Physiotherapy, pain medication, supportive bras, weight changes. Dates and durations matter.
• What’s the impact on your daily life? Difficulty exercising, restricted clothing choices, posture concerns, intimacy issues, sleep disruption.
• Family history. Any breast cancer history in the family is worth mentioning. Genetic factors affect surgical planning.

Bring this written summary to your GP appointment. It helps the GP write a referral letter that reflects your actual clinical picture rather than a brief summary written under appointment time pressure.

What the GP referral letter should ideally cover:

• Your medical history relevant to surgery
• Current medications, including any blood thinners or medications affecting wound healing
• Documented symptoms attributable to breast weight (essential for any potential Medicare eligibility)
• Conservative management you’ve tried (physiotherapy, pain medication, supportive bras)
• Any imaging that’s been done (mammograms, ultrasounds)
• Reason for the referral

Some GPs are familiar with the documentation requirements for plastic surgery referrals. Some aren’t. If your GP hasn’t written this kind of referral before, your written summary genuinely helps them get it right.

Step Two: Documents to Bring to the First Consultation

Pack these into a folder or envelope before the appointment. Easier than scrambling for things on the day.

Essential documents:

• GP referral letter (the practice will need a copy for the file)
• Medicare card
• Private health insurance details, including your level of hospital cover and the policy number
• List of current medications, including dose, frequency, and how long you’ve been on each
• List of any allergies, particularly drug allergies and reactions to anaesthetic if you’ve had previous surgery
• Past surgical history, including the procedures, approximate dates, hospitals, and any complications

Helpful additional material:

• Imaging reports for any breast imaging you’ve had within the past 24 months (mammograms, ultrasounds)
• Records from any previous plastic surgery consultations if you’ve consulted with another surgeon previously
• Specialist letters from other treating doctors if relevant (oncologist, breast surgeon, rheumatologist, endocrinologist)
• Photos taken at home, dressed and undressed, that document your anatomy in different bras and clothing (these supplement clinical examination, particularly useful for symmetry assessment)

For symptom-driven reduction patients specifically:

• Symptom diary if you’ve kept one, even informally
• Physiotherapy or chiropractic records documenting treatment for breast-weight-related symptoms
• Photographs of bra strap grooving or skin issues in the inframammary fold if these are present

The symptom documentation matters because Medicare item number eligibility depends on documentation. The clinical examination at consultation captures your current findings, but historical evidence of symptoms over time strengthens the case where eligibility is being assessed.

Step Three: What to Wear and What Photos to Bring

A practical consideration that often gets overlooked. The consultation includes a clinical examination, which means you’ll need to undress to the waist for parts of it. Wearing something easy to remove makes this less awkward.

What to wear:

• A button-up or zip-up top rather than a pullover
• A bra you wear regularly (not a special one, since the surgeon needs to see what you actually wear day to day)
• Comfortable clothing generally

Photos to bring (taken at home before the appointment):

The clinical examination at consultation is the primary assessment tool. Photos taken at home supplement it, particularly because they capture your anatomy in your typical posture and clothing rather than the slightly artificial setting of clinic. Useful photos include:

• Front view, no bra, arms at sides
• Front view, no bra, arms above head (shows breast position changes with movement)
• Side view (both sides), no bra
• Three-quarter view (oblique), both sides, no bra
• Front view in your everyday bra
• Side view in your everyday bra
• Photos of bra strap grooving or skin issues in the inframammary fold if present

Take photos in good natural light, against a plain background, with your phone or camera held at chest height. Have someone else take them if possible (mirror selfies don’t capture the same information). The photos go into your patient file and inform the surgical planning conversation.

What photos not to bring: someone else’s photos of “the result I want” pulled from social media. These are unhelpful for several reasons. The patient in the photo has a different starting anatomy. The photo may have been edited. The result you see at one timepoint may not be the long-term result. And aesthetic preferences vary enough that what looks ideal in someone else’s photo may not look ideal on your frame. The conversation about what’s possible for your specific anatomy is more useful than reference photos of unrelated patients.

Step Four: Questions to Ask the Surgeon

Coming in with a list of questions is normal and welcome. Sample questions worth asking:

About the surgeon:

• How many breast reduction procedures do you perform each year?
• What hospitals do you operate at?
• Are you available for emergency post-operative concerns, or does someone else cover after-hours?
• Will you personally conduct all my consultations, or will I see different staff at different appointments?
• Are you a Specialist Plastic Surgeon (FRACS), and is your AHPRA registration current?

About my specific case:

• Based on your examination, what would you recommend for me?
• Why this approach rather than the alternatives?
• Approximately how much tissue do you anticipate removing?
• What incision pattern would suit my situation, and why?
• Could my situation potentially qualify for Medicare item number 45520 or 45523?
• What’s the expected recovery timeline for my specific procedure?

About risks and complications:

• What are the most common complications you see, and at what rates?
• What happens if a complication develops? Who do I call, and what’s the process?
• What’s your revision rate, and what does revision involve?
• How does my specific medical history affect my surgical risk?

About the practical process:

• What does the cost include, and what additional costs might come up?
• When do I pay, and what payment options exist?
• What’s the cooling-off period between consultations and surgery?
• What’s the follow-up schedule after surgery?
• What pre-operative preparation is required (smoking cessation, weight stability, medication adjustment)?

Questions that signal a good consultation:

If the surgeon is willing to discuss:

• Realistic expectations rather than guaranteeing specific outcomes
• Risks and complications honestly rather than minimising them
• Why a particular approach is right for you rather than offering whatever you ask for
• The two-consultation requirement and cooling-off period without trying to rush them

These are signs of a properly professional consultation. AHPRA-compliant surgeons should engage with all of these topics openly.

Red flags to be aware of:

• Pressure to book surgery on the day of the first consultation
• Promises of specific outcomes
• Reluctance to discuss complication rates
• Suggestion that you skip the cooling-off period
• Patient representatives or coordinators conducting consultations instead of the surgeon
• Marketing-driven language about appearance rather than clinical assessment of your situation

If any of these appear, that’s information about whether this is a surgeon you want to work with.

Step Five: What Happens at the First Consultation

The first consultation typically runs 45 minutes to an hour and follows a defined structure.

Initial discussion (15 to 20 minutes). Review of your medical history, current medications, GP referral letter, and the reasons you’re considering surgery. The surgeon will ask about your symptoms, what you’ve tried, and what your goals are. This is where your written summary and symptom history pay off.

Clinical examination (15 to 20 minutes). Physical examination of the breasts, including assessment of size, shape, position, tissue quality, skin elasticity, and chest wall measurements. Photos may be taken for the file (with consent). The examination informs the surgical plan and the procedure recommendation.

Discussion of options (15 to 20 minutes). The surgeon presents what they recommend and why, discusses the alternatives, and explains the procedure including expected recovery, scarring, risks, and realistic outcomes. This is where your prepared questions come in.

Practical next steps (5 to 10 minutes). If reduction is appropriate and you’re proceeding with assessment, the surgeon outlines the next consultation timing, any pre-operative tests required, the documentation needed for Medicare item number application if relevant, and the cooling-off period framework.

What you don’t do at the first consultation: book surgery. AHPRA requirements mandate at least two consultations before any surgery is booked, with at least seven days between the final consultation and the surgery date. The first consultation is for assessment and discussion, not commitment.

Step Six: Between Consultations

The interval between the first and second consultation is genuinely important. This is when the cooling-off framework actually does its work.

What to do during this period:

• Sit with the recommendation. Notice what feels right and what doesn’t. The first consultation can be information-heavy, and your reactions sometimes settle differently after a few days.
• Discuss with people you trust. Partner, close friends, family. Their perspective adds context, though the decision is ultimately yours.
• Write down additional questions that come up. The second consultation is partly for these follow-up questions to be answered.
• Research the surgeon independently. Verify AHPRA registration. Look at the practice’s policies on complications and revision surgery. Check independent review platforms.
• Don’t make the decision under deadline pressure. If you find yourself feeling rushed, that’s a signal to extend the timeline rather than push through.

What not to do:

• Don’t research surgical horror stories obsessively. Plastic surgery has risks, and being aware of them is important, but going deep into worst-case-scenario reading rarely helps decision-making and often produces unwarranted anxiety.
• Don’t rely on social media for clinical guidance. Patient experiences on social platforms vary enormously and aren’t representative of typical outcomes.
• Don’t make the decision based primarily on cost. Surgery is a one-time decision with long-term consequences. The cheapest option isn’t always the right one.

The minimum interval between consultations is set by AHPRA, but you can extend it. If at the second consultation you’re still uncertain, additional time is reasonable. The right answer for you is more important than the timeline.

Step Seven: The Second Consultation

The second consultation is where the decision-making conversation finalises. Typical structure:

Review of any developments since the first consultation. New questions, new information, anything that’s changed.

Confirmation of the surgical plan. The surgeon confirms the procedure, the approach, the expected outcomes, and the recovery timeline. Any adjustments based on the first consultation discussion are made now.

Detailed informed consent. The risks and complications are reviewed in detail. Specific risks relevant to your case are discussed. Realistic expectations are confirmed.

Practical scheduling. Surgery date, hospital, pre-operative tests, time off work planning, and any specific preparation requirements (medication adjustments, smoking cessation, weight stability).

The cooling-off period starts. From the second consultation to surgery is at least seven days under AHPRA requirements. For most patients, the interval is longer to allow proper preparation.

By the end of the second consultation, you should have a clear surgical plan, a date, an itemised quote, and full understanding of the recovery and follow-up commitments. If anything is unclear, ask now rather than later.

Frequently Asked Questions

Do I need a GP referral before my breast reduction consultation?

Yes. Since July 2023, AHPRA requires every patient considering cosmetic surgery to obtain a GP referral before the first consultation with a Specialist Plastic Surgeon. The referral letter should cover your medical history, current medications, and the reasons you’re considering surgery. For breast reduction specifically, documentation of symptoms attributable to breast weight is particularly important if Medicare item number eligibility may apply.

How many consultations do I need before breast reduction surgery?

A minimum of two consultations is required under AHPRA cosmetic surgery guidelines, with at least seven days between the final consultation and your surgery date. The first consultation is for assessment, examination, and discussion of options. The second is for confirmation of the surgical plan and detailed informed consent. Some patients have additional consultations if they need more time to consider, ask follow-up questions, or address specific concerns.

What should I bring to my first breast reduction consultation?

Bring your GP referral letter, Medicare card, private health insurance details, list of current medications and allergies, past surgical history, any imaging reports from the past 24 months, and photos taken at home documenting your breasts from front, side, and oblique angles. For symptom-driven reduction patients, also bring physiotherapy or chiropractic records and any symptom diary you’ve kept. Wear a button-up or zip-up top for easier examination.

What questions should I ask the surgeon at my consultation?

Useful questions cover the surgeon’s experience and credentials, recommendations for your specific case, expected outcomes and timelines, risks and complication rates, costs and payment, and follow-up arrangements. Ask about the cooling-off period and whether the surgeon will personally conduct all your consultations. Be alert to red flags like pressure to book on the day, guarantees of specific outcomes, or reluctance to discuss complication rates.

Can I have breast reduction surgery on the same day as my consultation?

No. AHPRA requirements mandate at least two consultations before surgery is booked, with at least seven days between the final consultation and the surgery date. This cooling-off framework exists to ensure patients have time to consider their decision without pressure. Surgeons or practices that suggest skipping these requirements are not operating in line with current Australian regulatory standards.

Consult with Dr Scott J Turner in Sydney

Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) consulting at his Bondi Junction and Manly clinics in Sydney. Surgery is performed at accredited private hospitals in Sydney, including Bondi Junction Private Hospital, Delmar Private Hospital in Dee Why, and East Sydney Private Hospital.

Every consultation is conducted personally by Dr Turner. There are no patient representatives or coordinators standing in for the surgeon. A minimum of two consultations is required before any surgery is booked, in line with AHPRA requirements. Consultations are unhurried, focused on careful clinical assessment, and structured around honest discussion of what surgery can and cannot achieve in your specific situation.

If you’re considering breast reduction surgery, the next step is to obtain a GP referral and book an initial consultation. Contact the practice on [email protected] or via the contact page to begin the process. For more detail on the procedure itself, see the breast reduction page, the Medicare and breast reduction guide, and the recovery guide for the full week-by-week recovery picture.