Breast Augmentation & Mastopexy

Patient Information & Consent

SIGN ONLINE

As a digital practice, all our consents and required documentation are completed and signed online. Before undergoing surgery at Inigo Cosmetic you will be required to complete two (2) forms. The information included on this page is part of the consent process. It is important that you read this information carefully, as proposed by your surgeon and agreed upon by you.

Once you are ready to sign your consent, please click the links at bottom of the page.

WHAT IS A BREAST AUGMENTATION & MASTOPEXY?

A breast augmentation refers to a procedure in which implants are surgically inserted into the body for cosmetic or reconstructive purposes.

A mastopexy refers to a procedure in which excess skin is removed to tighten surrounding tissue and to reshape and support the new breast contour. This operation can also reduce the size of the areola, the darker skin around the nipple.

There are both risks, and complications associated with this operation.

ALTERNATIVE TREATMENTS

Alternative forms of non-surgical management consist of not undergoing a breast augmentation & mastopexy.

BREAST AUGMENTATION & MASTOPEXY RISKS & COMPLICATIONS

Every surgical procedure involves a certain amount of risk and it is important that you understand these risks and the possible complications. In addition, every procedure has limitations. An individual’s choice to undergo a surgical procedure is based on the comparison of the risk to potential benefit. Although the majority of patients do not experience these complications, you should discuss each of them with your surgeon to make sure you understand the risks, potential complications, and consequences.

Breast Implant Associated Anaplastic Large Cell Lymphoma

BIA-ALCL is a rare cancer of the immune system. It is not breast cancer, which forms from cells in the breast, but instead a cancer that grows in the fluid and scar tissue that forms around a breast implant. Less commonly, BIA-ALCL can take the form of a lump in the breast or a lump in the armpit.

BIA-ALCL has been known to occur as soon as one year after the operation and as late as 37 years after the operation. The average time to diagnosis is within 8 years of the operation.

All reported cases of breast implant associated cancer in Australia involve patients who have had a textured implant at some point in their life. Based on current evidence, experts do not think breast implant associated cancer is related to either the contents (saline/silicone) or shape (round/teardrop) of the implant.

The risk of developing BIA-ALCL is approximately 1-in-87,000 (based on data supplied by Mentor). The risk of developing BIA-ALCL increases with increasing texturing of the implant. To date, there have been few recorded cases of BIA-ALCL with smooth implants or implants from the Motiva range.

Most cases of BIA- ALCL are resolved by removal of the implant and the capsule surrounding the implant. Unfortunately over the last 10 years, four Australian women have died from breast implant-associated lymphoma.

It is important to know the symptoms of breast implant associated cancer. The most common symptom is swelling of a breast caused by fluid build-up around the implant, but in some cases it may appear as a lump in the breast or armpit. However, as this is a rare disease, changes in your breast are unlikely to be breast implant associated cancer. For example, swelling immediately after your breast implant surgery is normal. But you should raise all concerns with your surgeon, including the possibility of breast implant associated cancer.

Medical experts do not recommend removing your breast implants if you do not have symptoms of BIA ALCL, even if your implants are no longer supplied in Australia. This is because BIA ALCL is a rare cancer with excellent cure rates if it is detected early.

The risk of developing BIA ALCL is lower than the risks associated with an anaesthetic and surgery. The complication rate of revision surgery involving implant removal or replacement is also higher with each revision procedure.

Read the latest updates from the Therapeutic Goods Administration

Capsular Contracture

When a breast implant is inserted, a scar capsule forms around it as part of the natural healing process. This capsule may sometimes tighten and compress the implant, causing the breast to feel firmer than normal. Capsular contracture can occur to varying degrees. Severe cases may cause discomfort or changes in the breast appearance; and may require surgery to remove the scar tissue and/or remove or replace the implant. Mild cases may be resolved with medication and/or massage.

The risk of capsular contracture is significantly increased with the use of smooth implants (approximately 1-in-10) – however to date, there have been no recent studies performed and this percentage is not accurate.

Implant Displacement or Malposition

Implants may move from their desired position. This may be due to capsular contracture, poor skin elasticity, ageing, pregnancy, smoking, large volume implants, overuse of the pectoral muscles, or stretching of the breast pocket over time.

It should be noted that implant displacement is more common with smooth implants or implants from the Motiva range. This may be due to the thin capsule that forms around the outside of the implant.

Change in Nipple and Skin Sensation

You may experience a loss or increased sensitivity of the nipples and the surrounding breast that usually resolves in 6 to 8 weeks. Partial or permanent loss of the nipple and skin sensation is rare.

Areola Spreading

The areola may stretch and become visibly larger and wider. This is due to the stretching of the surrounding breast tissue and skin elasticity. Additional procedures to reduce the size of the areolas may be performed.

Asymmetry

Breast asymmetry naturally occurs in most women before surgery. Changes to the nipple shape, size, or symmetry may also occur after surgery; this may require additional surgery to correct.

Skin Contour Irregularities

Contour and shape irregularities may occur. Visible and palpable wrinkling may occur. One breast may be smaller than the other. Nipple position and shape may not be identical. Residual skin irregularities at the ends of the incisions or “dog ears” may occur. This may improve with time, or may require additional surgery to correct.

Skin Laxity

Patients with significant skin laxity will continue to have the same lax skin after surgery. The quality or elasticity of the skin will not change after surgery, and will in fact, get worse over time due to the ageing process. This may occur quicker for some than others.

Size

Bra and cup sizing vary from brand to brand. There is no guarantee of achieving a particular cup size.

Infection and Breast Implants

Although infection is unusual after this type of surgery, it may appear in the immediate post-operative period or at any time in the future after the insertion of implants. Infections with the presence of breast implants are harder to treat than infections in other areas of the body. Treatment may include antibiotics.

Rarely, an infection may develop around the implant. Rarely, an infection may develop elsewhere in the body and spread to the implant. If an infection does not respond to antibiotics, the implant may have to be removed. In extremely rare instances, life-threatening infections, including toxic shock syndrome have been noted after breast surgery.

Individuals with an active infection in their body should not undergo surgery. It’s important to notify your surgeon of any other infections, such as ingrown toenail, insect bite, or urinary tract infection. Infections in other parts of the body, may lead to an infection in the operated area.

It is important that you understand the signs and symptoms of infection and notify the clinic as soon as possible of any concerns. Preventative antibiotics may need to be considered for future dental or surgical procedures.

Dental Work

Due to increased risk of infection, patients must not undergo any dental work (including filings or teeth cleaning) six weeks before and six weeks after surgery. If after this time period dental work is required, prophylactic antibiotics may be required.

Nipple Piercings

Nipple piercings increase the risk of infection which can spread to the implant; this can occur at any time.

Treatment may include, antibiotics, possible removal of the implant, or additional surgery. Inigo Cosmetic does not recommend nipple piercings and breast implants.

Not Lifetime Devices

Breast implants are not lifetime devices and will not last forever. Rupture can occur because of trauma to the chest, but more commonly it occurs spontaneously with no apparent cause. Surgery will be required to replace the implant if desired.

Unsatisfactory Result

Although good results are expected, the precise degree of improvement cannot be guaranteed. There is no warranty expressed or implied, on the results that may be obtained. The outcome’s subjective nature also means dissatisfaction is a possible outcome regardless of the successful outcome of the surgery. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. It may be necessary to perform additional surgery to achieve your desired results.

ADDITIONAL RISKS & COMPLICATIONS

  • A mastopexy does leave permanent, noticeable scars on the breasts – with appropriate postoperative care these will fade over time.
  • The revision rate for a full mastopexy is 1 in 4 (based on best practices worldwide). This means that 1 in 4 patients will need an additional procedure to touch up or correct a complication.
  • This may be a revision under a local anaesthetic (such as resizing the areola). Or this may be a revision under a full general anaesthetic (such as performing the lift again).
  • The rate of revision largely depends on the patients’ skin quality and elasticity. For example, if a younger patient, requires a full lift then it can be concluded that the skin quality was suboptimal to begin with – which is what led to the reason the lift was required in the first place.
  • It is impossible to determine the skin quality and elasticity prior to surgery, some patients may wish to undergo an additional lift at 8 months postoperative, some patients may wish to undergo an additional lift at 19 months postoperative, some patients may wish to undergo an additional lift at 10 years postoperative.
  • Larger implants may affect the outcome of the lift – it may put more weight on the incisions and cause the skin to sag faster.
  • Due to the weight of the implants and the surgical incision, there can be wound breakdown at the T-Junction (the area underneath the breast). If this occurs, then more frequent dressing changes are required. If the wound progresses, then surgical intervention to remove the tissue may be required.
  • If patients require a mastopexy with their breast augmentation they WILL NOT achieve the same result as someone who has undergone a primary breast augmentation.

GENERAL SURGERY RISKS & COMPLICATIONS

Surgical Anaesthesia

Both local and general anaesthesia (including sedation) carry risks and complications. These may include injury and even death.

Allergic Reactions

Local allergies to tape, stitches, topical preparations, or injected agents can occur. Serious life-threatening, systemic reactions including shock (anaphylaxis) may occur in response to the drugs used during surgery and/or medication prescribed after surgery. Allergic reactions may require additional treatment.

Cardiac and Pulmonary Complications

Pulmonary complications may occur secondarily to both blood clots (pulmonary emboli), fat deposits (fat emboli) or partial collapse of the lungs after general anaesthesia. Pulmonary emboli can be life-threatening or fatal in some circumstances.

Inactivity and other medical conditions may increase the incidence of blood clots. Notify your surgeon of any history of blood clots or swelling in the legs prior to surgery. Cardiac complications are a risk with any surgery and anaesthesia, even in patients without symptoms.

If you experience shortness of breath, chest pain, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalisation and additional treatment.
Shock

In rare circumstances, surgery can cause severe trauma, particularly when multiple or extensive procedures are performed. Although serious complications are infrequent, infections or excessive fluid loss can lead to severe illness and even death. If surgical shock occurs, hospitalisation and additional treatment are required.

Pain

Pain of varying intensity and duration may occur and persist after surgery. Chronic pain may occur as a result of trapped nerves in scar tissue or due to tissue stretching.

After your surgery you will be given a full course of prescription pain medication. We DO NOT provide repeat scripts for schedule 8 narcotics, benzodiazepines, or other drugs of dependence.
Bleeding

If a bleed occur during surgery, it may require emergency transfer to a tertiary facility. A bleed that occurs after surgery is often known as a hematoma; this usually occurs within the first 3 weeks but can occur at any time. It may require emergency intervention to drain accumulated blood.

In breast implant surgery, hematoma may contribute to capsular contracture, infection or other problems.

If a blood transfusion is necessary to treat blood loss, there is the risk of blood-related infections such as hepatitis and HIV (AIDS).

Increased activity too soon after surgery can lead to increased chance of bleeding. It is important to follow pre and postoperative instructions. Heparin medications that are used to prevent blood clots in veins can produce bleeding and decreased blood platelets. Unless cleared by your surgeon, avoid herbal supplements, aspirin, anti-inflammatory medications for at least 14 days before and after surgery.

Healing Issues and Wound Separation

The surgical area may not heal normally or may take a long time to heal. Areas may become necrotic (die). Wounds may separate after surgery. This may result in colour changes, shape changes, swelling, bleeding, or infection. It may require frequent dressing changes or further surgery; resulting in prolonged recovery and additional expense.

Issues with healing are more common in patients who smoke, have used steroid drugs, after chemotherapy/radiation to the treatment area, diabetes or other medical conditions, after massive weight loss, or excessive heat or cold therapy.

Damage to Deeper Structures

There is the potential for injury to deeper structures including nerves, blood vessels, muscles, and lungs (pneumothorax) during any surgical procedure. The potential for this to occur varies according to the type of procedure being performed. Injury to deeper structures may be temporary or permanent.

Fat Necrosis

Fatty tissue found deep in the skin might die and may result in areas of firmness within the skin. Additional surgery to remove areas of fat necrosis may be necessary. There is the possibility of contour irregularities in the skin that may result from fat necrosis.

Seroma

Although swelling usually occurs after surgery. Excessive fluid may accumulate following surgery, trauma or vigorous exercise. This may require drainage.

Lymphedema

Persistent swelling (lymphedema) can occur in the legs after surgery.

Venous Thrombosis

Thrombosed veins, which resemble cords, occasionally develop in the area of the breast or around IV sites, and usually resolve without medical or surgical treatment. It is important to discuss with your surgeon any birth control pills you are taking. Certain high estrogen pills may increase your risk of thrombosed veins.

Skin Sensitivity

Bruising and swelling normally occurs after surgery. Although uncommon, swelling and skin discolouration may persist for long periods of time and, in rare situations, may be permanent. Itching, tenderness, or exaggerated responses to hot or cold temperatures may occur after surgery. Usually this resolves during healing, but in rare situations it may be permanent.

Nerve endings may become involved with healing scars during surgery. While there may not be a nerve injury, the small nerve endings during the healing period may become too active producing a painful or oversensitive area due to the small sensory nerve involved with scar tissue. This can usually be resolved with non-surgical intervention.

Sutures

Most surgeries involve sutures, these may be dissolvable or may require removal by a medical professional. There are usually multiple layers of deep internal sutures. You may notice these sutures after your surgery. Sutures may spontaneously poke through the skin, become visible or produce irritation.

Scarring

All surgery leaves scars, some are more visible than others. Abnormal scars may occur within the skin and deeper tissues. Internal scarring may result in excessive firmness to the area. Scars may be asymmetrical or a different colour to the surrounding skin. Scars may require additional treatment to correct. This may include, laser, IPL, topical creams, skin needling, or surgical intervention.

ADDITIONAL ADVISORIES 

Breast Cancer

Breast implants do not increase the risk of breast cancer. Patients with a personal or family history of breast cancer may be at a higher risk of developing breast cancer than a woman with no history. All women should perform self-examination of their breasts, have regular mammograms, and seek professional care should a lump be detected.

Second-Generation Effects

There is insufficient evidence to suggest children born of mothers with breast implants are negatively affected.

Immune and Unknown Risks

A small number of women with breast implants have reported symptoms similar to those of known diseases of the immune system, such as systemic lupus erythematosis, rheumatoid arthritis, scleroderma, and other arthritis-like conditions.

To date, after several large epidemiological studies of women with and without implants, there is no scientific evidence that women with breast implants have an increased risk of these diseases.

These diseases appear no more common in women with implants than those women without implants. The effect of breast implants in individuals with pre-existing immune system and connective-tissue disorders is unknown.

Large Volume Breast Implants

The placement of excessively-sized breast implants, disproportionate to the frame of the patient, or exceeds the normal dimensions of the breast, produce irreversible tissue thinning, implant displacement (bottoming out), and visible/palpable rippling. This can result in the need for additional surgery and expense.

Breast Implant Technology

The technology of breast implant design, development and manufacture will continue to progress and improve. Newer or future generations of implants may be better than those currently available.

Sentinel Lymph Node Mapping Procedures

Breast surgery procedures that involve cutting through breast tissue, similar to a breast biopsy, can potentially interfere with diagnostic procedures to determine lymph node drainage of breast tissue to stage breast cancer.

Breast Feeding

A study measuring elemental silicon (a component of silicone) in human breast milk did not indicate higher levels from women with silicone-filled gel implants when compared to women without implants. Cow’s milk contains higher levels of elemental silicon as compared to human milk.

Breast implants should not affect your ability to breast feed.

Sun Exposure

Surgical incisions are susceptible to damage from UV rays for up to 12 months following surgery (even if covered) and may result in pigmentation issues.

Travel Plans

Any surgery holds the risk of complications that may delay healing and delay your return to normal life. There are no guarantees that you will be able to resume all activities in the desired timeframe.

Long-Term Results

Subsequent alterations in the appearance of your body may occur as the result of ageing, sun exposure, weight loss, weight gain, pregnancy, menopause, smoking, drug & alcohol use, or other circumstances not related to your surgery.

Female Patient Information

Many medications including antibiotics may neutralise the preventive effect of birth control pills, allowing for conception and pregnancy.

Intimate Relations After Surgery

Activity that increases your pulse or heart rate may cause additional bruising, swelling, or bleeding. This may require additional surgery. Refrain from intimate physical activities as instructed on the postop instructions.

Mental Health and Elective Surgery

All patients who undergo elective surgery must have realistic expectations which focus on improvement rather than perfection. Complications or less than satisfactory results are sometimes unavoidable and stressful. Although many individuals may benefit psychologically from the results of elective surgery, effects on mental health cannot be accurately predicted.

SMOKING & NICOTINE PRODUCTS

Smoking, second-hand smoke, the use of tobacco or nicotine products (patch, gum, or nasal spray), greatly increases the risk of surgical complications. Risks include, tissue necrosis, delayed healing, wound breakdown, infection, scarring, hematoma formation, bleeding, increased or prolonged bruising and skin colour changes. This may require additional surgeries with expense.

Patients with breast implants are at a higher risk of developing capsular contracture. Patients with breast implants and poor wound healing issues are at a greater risk for requiring implant removal.

Patients must abstain from smoking and/or the use of nicotine products for at least 6 weeks before and after surgery (ideally 12 weeks).

The clinic may request a nicotine test prior to surgery. If the test returns a positive result your surgery will be cancelled, and the total cost of hospital and anaesthetic fees for the scheduled surgery will be forfeited and not returned.

The clinic is able to recognise the signs of poor wound healing which result from smoking/ nicotine products and may request a nicotine test. If a secondary surgery is required, patients are required to pay an additional surgeons’ fee of $1000. This is separate to third-party fees.

REVISIONS AND ADDITIONAL OPERATIONS

Every surgical procedure has associated risks and complications. The practice of medicine and surgery is an art, not an exact science. Although good results are expected, they are not guaranteed. There is no warranty expressed or implied, on the results that may be obtained.

In some situations, it may not be possible to achieve optimal results with a single surgery. Additional surgeries may be necessary at some time in the future and it is impossible to predict when.

When working with tissue and skin, results can be unpredictable and it is unknown how your tissue may respond or how you will heal after your surgery.

Results may depend on: skin quality, genetics, environmental factors, smoking, alcohol & recreational drug use, sun exposure, hormonal influences, general health of your body, ageing, pregnancy, stomach sleeping, implant size, implant texture, implant shape, and patient compliance.

If you develop a complication as a result of your original surgery you may need a revision. This will require further expenditure, which may include:

  • Hospital fee with general anaesthetic: $2200 – $9000, dependant on time required.
  • Clinic fee with local anaesthetic: $500 – $1500, dependant on time required.
  • Implant/s: $600 – $2000 (if applicable).
  • Surgical fee based on situation and complexity: $500 – $4000.

Patients who are not in a good financial position to be able to afford a potential revision should NOT undergo surgery.

POSTOP INSTRUCTIONS

For a successful outcome – it is vital that you follow the postoperative instructions that have been provided to you.

IMPLANT SIZING

Implant sizes should be chosen no later than 2 weeks prior to surgery. Changes to implant sizing requires a second consultation.

Changes made to implant sizes within the 2 week period may result in postponing surgery and subsequent fees associated. This is not applicable for patients out of town who have had an initial virtual consultation.

SUPPORT PERSON

It is the patient’s sole responsibility to provide a support person for the ongoing care after surgery. If a support person and a health care professional needs to be arranged this will incur additional fees.

DISCLAIMER

Informed-consent documents are used to communicate information about the proposed surgical treatment along with disclosure of risks and alternative forms of treatment(s), including no surgery. The informed-consent process attempts to define principles of risk disclosure that should generally meet the needs of most patients in most circumstances.

However, informed-consent documents should not be considered all-inclusive in defining other methods of care and risks encountered.

You may be provided with additional or different information that is based on all the facts in your case and the current state of medical knowledge. Informed-consent documents are not intended to define or serve as the standard of medical care.

Standards of medical care are determined based on all the facts involved in an individual case and are subject to change as scientific knowledge and technology advance and as practice patterns evolve.

  • The surgeon has provided me with medical advice, and I have agreed based on that advice to undergo the recommended surgical procedure of BREAST AUGMENTATION & MASTOPEXY.
  • I have received the BREAST AUGMENTATION & MASTOPEXY Patient Information & Consent Document which I have read and understood IN FULL.
  • I understand that I cannot have surgery if I am pregnant, breastfeeding and/or under the age of 18 and confirm that I am not pregnant, breastfeeding nor under the age of 18.
  • I consent to the administration of any anaesthetics that are considered necessary or advisable by the surgeon. I understand that all forms of anaesthesia involve risk and the possibility of complications, injury, and sometimes death.
  • I have been advised by the surgeon and I recognise and understand that during the operation, unforeseen conditions, which may not be known to the surgeon at the time the procedure has commenced, may require different procedures than those stated above.
  • I authorise and agree to the surgeon performing any such procedures that are in the exercise of his professional judgment necessary and desirable.
  • The surgeon has explained the limitations of surgery and the risks involved in these surgical procedures, and I understand and accept these risks.
  • I have had the opportunity to explain my goals to the surgeon and I understand which desired outcomes are realistic and which are not. I understand that there are no warranties implied or guaranteed about my outcomes.
  • I consent to the disposal of any tissue, medical devices or body parts that may be removed during surgery.
  • I consent to the utilisation of blood products should they be deemed necessary by the surgeon and I am aware that there are potential significant risks to my health with their utilisation as explained in the Information Document.
  • I consent to the collection and storage of my personal medical information and for it to be disclosed for my ongoing care or if required by law.
  • I consent for appropriate portions of my body to be photographed or filmed before, during, and after the procedure for marketing, medical, scientific or educational purposes, provided my identity is not revealed.
  • The surgeon is a Cosmetic Surgeon; therefore, Medicare rebates or Private Health Insurance rebates do not apply. I understand that most cosmetic procedures are not covered by Medicare.
  • All my questions have been answered, and I understand the inherent risks of the procedure that I have consented to undergo, as well as those additional risks, possible complications, benefits, and the alternative treatments available to me.
SMOKING
  • I understand that patients who smoke or use tobacco or nicotine products (patch, gum, nasal spray, or vaping) are at a greater risk for significant surgical complications.
  • I understand that if I am currently smoking or use nicotine products, or if I have not abstained for the recommended amount of time, additional risks and complications will apply as explained in the Patient Information & Consent Document.
  • I understand and accept that the clinic may request a nicotine test prior to surgery. If the test returns a positive result my surgery will be cancelled, and the total cost of hospital and anaesthetic fees for surgery will be forfeited and not returned.
  • I understand and accept that the clinic may request a nicotine test at any stage during the recovery period. If the test returns a positive result and if a secondary surgery is required, I will be required to pay an additional surgeons’ fee of $1000.
COVID-19
  • I understand that any symptoms of COVID-19 must be reported to the clinic. If I do not report symptoms my surgery will be cancelled and I will be responsible for the associated hospital and anaesthetic fees.
  • I understand that if I need to cancel or reschedule my surgery due to COVID-19, I will NOT be financially penalised – provided the clinic has been notified with supporting documentation.
REVISIONS AND UNEXPECTED OUTCOMES
  • I understand that my result may be unsatisfactory as the precise degree of improvement cannot be guaranteed. The outcome’s subjective nature also means dissatisfaction is a possible outcome regardless of of effectiveness of treatment.
  • I understand that ALL surgical procedures carry risks, complications, and unforeseen problems that may require further expenditure. I accept and recognise that the fees paid are for a performance of the surgery only, and not a guaranteed result.
  • I understand most cosmetic procedures have a 5% – 10% chance that a revision procedure is required to “touch up” or correct a complication that may have occurred: consistent with best practices worldwide.
  • I understand the revision rate for a full mastopexy is between 17% – 25% (consistent with best practices worldwide).
  • I understand that smooth breast implants carry an increased risk of capsular contracture (1 in 30).
  • I understand that smooth breast implants or Motiva implants carry an increased risk of implant displacement.
  • I will be financially responsible for fees associated with any future procedure. This may include (but not limited to): airfares, accommodation, carer, time off work, loss of income, medications, pathology, diagnostic investigations, surgical garments.
  • I understand that I may require imaging studies in the future to determine the condition of my breast implants which will be my financial responsibility – MRI (Magnetic Resonance Imaging) scan or US (Ultrasound).
  • If I require any future procedure, I will be responsible for the cost of third-party fees associated with hospital, anaesthetist, and implants (if required) – these prices are listed below.
    • Hospital fee with general anaesthetic: $2200 – $9000, dependant on time required
    • Hospital fee with local anaesthetic: $500 – $1500, dependant on time required
    • Implant/s – If required $600 – $2000, dependant on brand
    • Surgical fee based on situation and complexity $500 – $4000
  • I understand that the surgeon’s fees are separate to aforementioned third-party fees. If a future procedure is required outside of the 12-month postoperative period, further expenditure will be required.
  • I accept that the need for, and timing of revisions will be determined solely by the clinic.
  • I understand and accept that where subsequent revision procedures become necessary all subsequent revision procedures provide results lower than results of a primary surgery.
  • I understand that any future procedure that I require or elect to have, is not covered by the original quote or fees previously paid.
  • I acknowledge that I have been informed of the risks and consequences associated with surgery. I accept responsibility for all clinical decisions, along with the financial costs of all future treatments.
ACCOUNTS AND PAYMENTS
  • A $1000 booking deposit is required to be collected at the time of booking in order to secure my surgical date and time. This amount is NON-REFUNDABLE.
  • I understand payment is required in full, 14 days prior to surgery. If payment has not been received, surgery will be cancelled and I will lose my booking deposit. An additional booking deposit may be required to reschedule.
  • ALL rescheduling, for whatever reason, will be determined solely by the clinic.
CANCELLATIONS AND RESCHEDULING
  • I understand that if I, for any reason, cancel my surgery more than 21 days prior to the date, all payment made, minus the $1000 booking deposit will be refunded.
  • I understand that if I, for any reason, cancel my surgery less than 21 days prior to the date, the booking deposit + 50% of the payments made will be refunded. The remaining 50% will be forfeited and not returned to me.
  • I understand that if I, for any reason, fail to attend my surgery without providing notice, all fees will be forfeited and not returned to me.
  • I understand that if I, for any reason, reschedule my surgery, this must be done more than 21 days prior to the date.
  • I understand that if I, for any reason, reschedule my surgery less than 21 days prior to the date, the booking deposit + 50% of the payments made will be forfeited and not returned to me. Additional payment will be required to reschedule.
  • I understand that if the clinic needs to reschedule my surgery, I will be financially responsible for any out of pocket expenses associated with surgery, including but not limited to: airfares, accommodation, travel.
IMPLANT SIZES
  • I understand that if I, for any reason, wish to change my implant size less than 14 days prior to surgery, my surgery may be postponed, I may forfeit my $1000 booking deposit, and additional payment may be required reschedule.
REMOVAL OF IMPLANTS
  • I understand a breast explant may not resolve my symptoms of Breast Implant Illness (BII) and associated pain, discomfort, or any other breast implant related issues I am currently experiencing.
  • If I elect to undergo removal of breast implants, the clinic will NOT perform a breast re-implantation at a later date.
DISPARAGEMENT CLAUSE
  • I agree that I will not make any disparaging comments about the surgeon that may cause hurt or embarrassment, damage their reputation, or defame them.
  • This includes any comment or statement published either orally or writing on any digital, print, electronic or online media, including my own or third party internet sites, private or public forums without the written consent of Inigo Cosmetic.
CONFIRMATION OF CONSENT
  • I hereby provide my fully informed consent to the surgeon to perform the surgical procedure, BREAST AUGMENTATION & MASTOPEXY.
  • I understand this is purely, ELECTIVE COSMETIC SURGERY. I accept responsibility for the clinical decisions, along with the financial costs of any future procedures to revise, optimise, or improve outcomes.

SIGN YOUR CONSENTS ONLINE

Before undergoing surgery, you are required to complete the following two (2) forms. These forms are signed online. These do work best in a Chrome web browser; if you are unable to complete these forms please contact the clinic.

Hospital Admission Consent

Breast Augmentation Consent & Mastopexy