Consent Form for Breast Augmentation

Removal and replacement of implants (25% 10 years)

Need for redo, reoperation or revision (5-15%)

Risks are increased by obesity, smoking, immunosuppression, steroids and diabetes

I understand that some of these complications can result in the need for further hospital admissions and further surgery. Further surgery, anaesthetic and hospital fees may be required for reoperation.

I understand that the appearance of my breasts will change naturally over time following the surgery.

I have been shown a powerpoint presentation about this operation and also have been given written information.

I understand the expectations, risks and alternatives to this surgery. I have had the opportunity to have my questions regarding the procedure answered.

Consent Form for Breast Augmentation

Patient Name

Date of Birth

Email address