Breast Augmentation Consultation Process Sydney

Talk to someone who had breast augmentation a decade ago and her story may not match yours at all. The rules have changed since then. From 1 July 2023, the Medical Board of Australia’s guidelines for practitioners who perform cosmetic surgery have required a set series of steps before any cosmetic operation goes ahead.

It’s easy to see these steps as extra paperwork. They’re better understood as protection. Each one exists to give you time, information and a genuine chance to change your mind, which is exactly what you’d want before surgery.

This article walks through each stage in order, so you know what to expect when you book a breast augmentation consultation with A/Prof Bish Soliman (AHPRA MED 0001679053) in Sydney.

Do I need a GP referral for breast augmentation?

Yes. Under the Medical Board of Australia guidelines, everyone seeking cosmetic surgery must have a referral. Ideally, this comes from your usual GP. If that isn’t possible, another GP or a specialist medical practitioner can refer you.

There’s one important condition. The referring doctor must work independently of the surgeon who will operate, and must not perform cosmetic surgery or non-surgical cosmetic procedures themselves.

Why does this matter? Your GP usually knows your medical history better than anyone. A referral appointment gives you a chance to talk about your general health, any medications or conditions that might affect surgery, and your reasons for considering it, with a doctor who has nothing to gain from your decision either way.

Your GP can send the referral through the practice’s GP referral page. You can also complete patient registration before your first appointment, which saves time on the day.

Why you need two pre-operative consultations

The guidelines require at least two consultations before cosmetic surgery. At least one of these must be in person with the surgeon who will perform your operation. The other can be in person or by video.

A few rules sit around these consultations:

Your first consultation must be with the operating surgeon, or with another registered health practitioner who works with them. It can’t be with a patient adviser or sales agent.
You won’t be asked to sign consent forms at your first consultation.
You can’t consent to surgery until you’ve had an in-person consultation with the surgeon who’ll operate.

In practice, the two appointments tend to do different jobs.

The first consultation is mostly about listening and assessment. A/Prof Bish will ask what you’d like to change and why, take your medical history, and examine you. He’ll talk through the options that could suit you, including other approaches and the option of not having surgery at all. The guidelines require surgeons to discuss those alternatives. They also require the surgeon to ask whether another practitioner has previously declined to operate on you.

The second consultation is where the plan comes together. You’ll go over the details again, including implant choice, incision and placement, recovery, and the risks and complications of surgery in the short and long term. You’ll also receive written information about costs. If you then decide to go ahead, this is where informed consent is given.

If you’re having an implant, the guidelines also require that you receive the TGA-approved patient information leaflet for that device before surgery, and a patient implant card afterwards.

It’s worth saying clearly that a surgeon must decline to operate if they believe surgery isn’t in your interests. A good consultation is a two-way assessment, not a formality before a booking.

Psychological screening and body dysmorphic disorder

Every cosmetic surgery patient must be screened for body dysmorphic disorder (BDD) using a validated psychological screening tool. This is a Medical Board requirement for all patients, and the process and outcome must be recorded in your medical file.

BDD is a mental health condition in which a person becomes intensely preoccupied with a perceived flaw in their appearance, often one that others can’t see or consider minor. It matters here because, as the guidelines put it, underlying psychological conditions such as BDD may make someone an unsuitable candidate for cosmetic surgery.

For most patients, the screening is a short questionnaire and a conversation. Nobody is assuming anything about you by asking. Every patient completes it, in the same way everyone has their blood pressure taken.

The consultation will also cover your motivations more broadly. That includes internal reasons (how you feel about your appearance) and external ones (for example, feeling you need to please someone else). If the screening suggests significant underlying psychological concerns, the guidelines require referral to an independent psychologist, psychiatrist or GP for evaluation before any decision about surgery is made. That GP can’t be one who provides cosmetic procedures.

The seven-day cooling-off period

After you’ve had your two consultations and signed your consent forms, there must be a cooling-off period of at least seven days before surgery can be booked or a deposit paid. Apart from initial consultation fees, no money should be payable until that period has passed.

The guidelines also say informed consent must be given at least seven days before the day of surgery, and reconfirmed on the day itself.

Use the time. Reread your written information, talk it over with people you trust, and write down anything you’re unsure about. If you’d like a second opinion, this is a good moment to get one. Changing your mind at this stage is completely acceptable.

Patients under 18

Additional protections apply to anyone under 18. Before any cosmetic surgery, a patient under 18 must be referred to and evaluated by an independent psychologist, psychiatrist or GP. The cooling-off period is also much longer: at least three months between giving informed consent and the surgery being performed. The surgeon must also assess the patient’s capacity to consent and, as far as practicable, consider the views of a parent or guardian.

These requirements apply to cosmetic surgery

The referral, two-consultation, screening and cooling-off rules described above apply to surgery performed for cosmetic reasons. The guidelines state plainly that they don’t apply to reconstructive surgery.

What changes if your surgery is reconstructive?

Breast reconstruction after a mastectomy is medically indicated. Its purpose is to restore the shape of the breast after cancer treatment or disease, which is why it sits under different funding and regulatory arrangements, with a referral and consent process of its own. Most reconstructions are planned together with your breast surgeon and the rest of your cancer care team. Medicare may cover part of the cost if you meet the relevant criteria.

Some breast procedures sit on the boundary, for example surgery to correct a significant developmental difference between the breasts. Whether a particular operation is treated as cosmetic or reconstructive depends on the reason for it. A/Prof Bish will explain at your first appointment which pathway applies to you.

If you’re considering reconstruction, see breast reconstruction (DIEP flap) for more information.

What to bring and what to ask at your consultation

A little preparation makes the appointment far more useful. Try to bring:

Your referral from your GP or specialist.
Any breast imaging or screening results, such as recent mammograms or ultrasounds, and details of past breast lumps, biopsies or surgery.
A list of your medications and supplements, including any blood thinners, hormonal medications and herbal products.
Your medical history, including previous operations and anaesthetics, and whether you smoke or vape.
Your plans for the future, if you’re thinking about pregnancy or breastfeeding.

And some questions worth asking:

Given my body shape and breast tissue, what kind of result is realistic?
Which risks apply most in my case, and how often do they happen?
What will the first few weeks of recovery look like, and when could I get back to work or the gym?
Will my implants need replacing at some stage, and what would a revision operation involve?
Who else will be involved in my care, and where will the surgery take place?
What does the quote include, and what might cost extra?

You’re also entitled to know your surgeon’s registration type and qualifications. You can check any practitioner’s registration on the public register through Ahpra’s cosmetic surgery hub. The hub also runs a Cosmetic Surgery Hotline (1300 361 041) for anyone who wants to report a concern.

Your surgeon for breast augmentation in Sydney & North Shore

A/Prof Bish Soliman is a Specialist Plastic and Reconstructive Surgeon and an AHPRA Registered Medical Practitioner (MED 0001679053). He’s Sydney-based and has a particular focus on complex microsurgical reconstruction, including breast reconstruction, alongside aesthetic surgery of the face, breast and body, and skin cancer surgery. He currently holds two consultant microsurgery positions in major Sydney tertiary referral hospitals.

That background shapes how he approaches consultations. Working across both reconstructive and cosmetic breast surgery means a careful assessment, a frank discussion of risks and alternatives, and time to decide are simply part of how he practises. You can read more about his training on the About Us page.

Qualifications

FRACS (Plastic Surgery). Fellow of the Royal Australasian College of Surgeons.
MS (Plastic Surgery). Master of Surgery.
MBBS (Hons 1). Bachelor of Medicine and Bachelor of Surgery, First Class Honours.
BCom. Bachelor of Commerce.
AHPRA specialist registration in Plastic Surgery. MED 0001679053.

Verify his credentials independently

Consultation locations

The Woollahra Clinic. Level 1, 156 Edgecliff Road, Woollahra NSW 2025
West Pennant Hills. 31 Castle Hill Road, West Pennant Hills NSW 2125
North Shore Health Hub. Tower A, Level 3, Suite 5/7 Westbourne Street, St Leonards NSW 2065

To start the process, ask your GP for a referral, then contact the practice or call 1300 372 474 to arrange your first consultation.

FAQs

Is there a cooling-off period before breast augmentation?

Yes. Under Medical Board of Australia guidelines, after you’ve had two pre-operative consultations and signed consent, at least seven days must pass before cosmetic surgery can be booked or a deposit paid. You can’t consent until you’ve seen A/Prof Bish Soliman in person. For patients under 18, the cooling-off period is at least three months.

Do I need a referral for cosmetic breast augmentation?

Yes. You need a referral, preferably from your usual GP, or from another GP or specialist if that isn’t possible. The referring doctor must work independently of your surgeon and must not perform cosmetic procedures themselves. This gives your GP a chance to discuss your health and reasons for surgery with you first.

Why do I need psychological screening before breast augmentation?

Every cosmetic surgery patient must be screened for body dysmorphic disorder using a validated tool, because conditions such as BDD may make surgery unsuitable. It’s a standard requirement, not a judgement about you. If concerns arise, you may be referred to an independent psychologist, psychiatrist or GP before any decision about surgery is made.

Do these rules apply to breast reconstruction?

No. The Medical Board guidelines covering referral, two consultations, psychological screening and cooling-off apply to surgery performed for cosmetic reasons. Breast reconstruction after mastectomy is medically indicated and follows a separate funding and regulatory pathway, with its own referral and consent process. Your surgeon will explain which pathway applies to you.

How long does it take to get from referral to surgery?

That depends on your circumstances, but you won’t be making the decision on the day you walk in. First comes an independent referral. After that, you need at least two pre-operative consultations (one of them in person), and then at least seven days must pass after consent before surgery can be booked. Clinic availability and the time you take to think things over can stretch this out, so plan for a few separate steps.

Medical references

Last reviewed: October 2026.

This article is general information only and is not a substitute for individual medical advice. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. Individual results vary.

The Breast Augmentation Consultation Process in Sydney & North Shore: Referral, Two Consultations and the Seven-Day Cooling-Off Period