Dr Ronel Gowar, a plastic surgeon with a special interest in breast care and reconstruction advises:

Iwas once sent a patient who had had a breast reduction done by her GP. The GP actually performed these procedures in a freestanding medical centre, not one attached to a hospital. When the patient came to me she had two completely different-sized breasts and the nipples were at completely different heights. It looked like someone had photoshopped two different women’s breasts onto her chest.

I also had a patient who’d had a breast augmentation done by someone who wasn’t a plastic surgeon. Within a year or two, she had complications with the implants, so she came to see me. She was worried about the breasts not looking or feeling the same, and there was substantial bulging on the one side – in the area above the nipple, which we call the upper pole. On examining her, the first thing I noticed was that the nipples weren’t at the same height, and that her breasts were different shapes. When I opened them up I discovered that the one implant had actually been placed upside down (which explained the abnormal bulging), and the other implant had been placed back to front, so the side that was flat was facing out and the curved part of the implant that is supposed to give you projection was actually facing the ribs.

Stories like these are the reason people need to recognise the difference between a registered plastic surgeon and doctors who call themselves cosmetic surgeons. What often happens is that doctors do small diploma courses or certificates elsewhere in the world that are not recognised by the Health Professional Council of South Africa (HPCSA), and then they market themselves as cosmetic surgeons.

A plastic surgeon has to undergo formal training which is monitored by the HPCSA, and is subjected to a very rigorous screening process to even be accepted into the training programme. It’s important that the professional you choose is registered with, or is a member of, the Association of Plastic, Reconstructive and Aesthetic Surgeons of Southern Africa (APRASSA).