Question 1

How do I book a consultation with Dr Hoffmann?

Accepted Answer

Use the Request an Appointment form on the Contact page. Share your name, contact details and a short note about what you'd like to discuss. The rooms will reply within one business day to set up a time.

Question 2

What should I bring to the first consultation?

Accepted Answer

Bring a list of your current medications and supplements, any relevant medical history, and — for facial or breast concerns — one or two photographs of yourself from a few years ago if you have them. No formal referral is required.

Question 3

How long is the first consultation?

Accepted Answer

Plan for about 45 minutes to an hour. It includes a discussion of what you'd like to change, a clinical examination, and — if surgery is appropriate — a written surgical plan you can take home. A formal quote from the rooms follows within a day or two.

Question 4

What does a consultation cost, and how do I pay?

Accepted Answer

The consultation fee is R 1 200, payable in cash on the day of your appointment. The rooms do not have card facilities for consultations, so please bring the fee with you. Surgical fees are quoted separately in writing before anything is booked.

Question 5

Do you accept medical aid?

Accepted Answer

Consultations are paid privately in cash and are not billed to a scheme. Purely aesthetic surgery is likewise not covered by South African medical aid and is paid privately. Where a procedure has a reconstructive or functional component (e.g. functional rhinoplasty for a breathing problem), that portion may be submitted to your scheme. The rooms will separate cosmetic and reconstructive components in the written quote.

Question 6

Is a video consultation possible if I'm not in the city?

Accepted Answer

A short video call can help you decide whether it's worth travelling for a full in-person consultation. It's not a substitute for the definitive planning visit — every operation is planned after an in-person examination.

Question 7

How do I prepare for surgery once I've booked?

Accepted Answer

You'll receive a written pre-operative sheet covering medications to stop, nicotine cessation, fasting, what to bring, and how to organise your first week at home. Follow it carefully — most recovery problems trace back to skipping steps on this list.

Question 8

How do I choose the right plastic surgeon for what I want done?

Accepted Answer

The right plastic surgeon for you is the one whose training, day-to-day operating list and consulting style match the operation you are considering. In South Africa the first check is straightforward: the surgeon must be registered with the HPCSA as a Specialist Plastic and Reconstructive Surgeon, and typically a member of APRASSA. Anything less specific — 'cosmetic doctor', 'aesthetic physician' — is a different qualification. The second check is fit. A surgeon who does mostly hand and burn work is not the best person for a primary rhinoplasty, and the reverse is equally true. Ask how often the surgeon performs the exact procedure you want, at which hospital, and who does the anaesthetic. The third check happens in the room. A good consultation is unhurried, examines you carefully, explains what surgery can and cannot change, and is comfortable saying no when a procedure is not in your interest. If you leave the room feeling sold to, that is information. If you leave feeling heard, examined and given a written plan, that is also information. Dr Hoffmann sees every prospective patient personally, examines them, and provides a written surgical plan. No quotes are given over the phone.

Question 9

What questions should I ask during a plastic surgery consultation?

Accepted Answer

Bring a written list — nerves make good questions vanish. The essentials cover training, the operation itself, the recovery, and the plan for anything that does not go smoothly. On training: 'Are you registered with the HPCSA as a Plastic and Reconstructive Surgeon? How often do you perform this specific procedure?' On the operation: 'Which technique do you plan for me, and why that one? How long will I be under anaesthetic? Where will the incisions sit?' On recovery: 'What does week one look like? When can I drive, work, exercise? What painkillers will I need?' On complications: 'What are the specific risks for me? What is your revision rate for this procedure, and who pays if a revision is needed? Who do I contact after hours in the first two weeks?' On fit: 'Am I a good candidate for what I want, or would you advise against it?' A surgeon willing to talk you out of an operation is usually the one worth going back to.

Question 10

What is the difference between a plastic surgeon and a cosmetic surgeon?

Accepted Answer

A Specialist Plastic and Reconstructive Surgeon in South Africa has completed medical school, at least two years of internship and community service, and then a further five to six years of accredited surgical training culminating in a national specialist exam and HPCSA registration in the specialty. Aesthetic surgery is one part of that broader specialty, which also covers reconstruction, hand surgery, congenital anomalies and burns. 'Cosmetic surgeon', 'cosmetic doctor' and similar titles are not protected specialist registrations in South Africa. A doctor using them may have taken short courses in specific techniques but has not completed the full specialist training in surgery. This is not a marketing distinction — it determines how long the person has trained, what they are permitted to do, and how they are regulated when something goes wrong. Always ask for the exact HPCSA registration category.

Question 11

What are the most common aesthetic surgery procedures?

Accepted Answer

Aesthetic surgery is a small handful of well-established operations rather than a menu of trends. The three most requested in this practice are rhinoplasty (refining the shape and function of the nose), breast augmentation (implant-based increase in size and shape), and body contouring (liposuction, abdominoplasty, and combined procedures after weight change or pregnancy). Each is planned as an individual operation, drawn and measured before surgery. Expect an examination, a discussion of what surgery can realistically achieve for your anatomy, and a written plan that includes the technique, the anaesthetic, the recovery window and the risks. There is no such thing as a standard result. Two patients requesting the same procedure will have different anatomy and different plans. That is why quotes and time-off estimates are only given after the consultation, never before.

Question 12

Can I negotiate the price with a plastic surgeon?

Accepted Answer

A written surgical quote in South Africa is usually made up of four distinct fees: the surgeon, the anaesthetist, the hospital and theatre, and the implants or consumables. The rooms can explain exactly what each fee covers and how the total was arrived at. What is fair to ask about is payment structure — whether the deposit can be staged, whether a package fee is available for combined procedures, and whether follow-up visits are included. What is not fair to expect is a surgeon competing on price against another quote. A meaningfully discounted surgical fee usually means shorter theatre time, cheaper implants, less follow-up, or an inexperienced team. If cost is a limiting factor, say so at the consultation. There are often smaller, staged or non-surgical options that address part of the concern within a realistic budget.

Question 13

How long is recovery after cosmetic surgery?

Accepted Answer

Recovery is best thought of in three overlapping windows. The first week is about wound healing, swelling and rest. The second to fourth week is about returning to normal daily life — driving, desk work, social activity. Weeks four to twelve are about returning to full exercise and letting the tissues settle into the final shape. For rhinoplasty, the external splint usually comes off around day 7, most bruising resolves within two to three weeks, and the fine shape of the nose refines over 6–12 months. For breast augmentation, patients are typically back to desk work within a week and cleared for full upper-body exercise around week 6. For abdominoplasty, expect at least two weeks off work and 6–8 weeks before core exercise. The single biggest variable is you: sleep, nutrition, no smoking, no alcohol in the first two weeks, and doing exactly what the post-operative sheet says. Recovery is not passive.

Question 14

What should I avoid saying to a plastic surgeon at consultation?

Accepted Answer

The consultation is a private medical conversation. You can be direct, emotional, uncertain, or contradict yourself — a good surgeon expects that. What makes the consultation harder is not honesty, but three specific things. First, hiding medications, supplements, recreational drug or nicotine use. All of these affect anaesthesia, bleeding and wound healing. Second, showing photographs of a celebrity and asking to look like them — anatomy does not transfer between people, and a good surgeon will steer you back to what your own face or body can plausibly become. Third, minimising a previous mental health history that is directly relevant to the outcome. The other thing to avoid is a rehearsed script. Say what is bothering you, in your own words, and let the surgeon examine and plan from there.

Question 15

What are red flags when choosing a plastic surgeon?

Accepted Answer

Warning signs cluster in three areas: how the practice sells to you, how the surgeon speaks about outcomes, and how the operating environment is described. On selling: same-day booking discounts, deposits requested before a proper consultation, and pushy follow-up from a 'patient coordinator' rather than the surgeon. On outcomes: guaranteed results, no discussion of risks, dismissive responses to your questions, or images of results that do not resemble the surgeon's actual work. On the operating environment: an unclear answer about which hospital or day clinic will be used, no named anaesthetist, or theatre in an environment that is not properly accredited. Every aesthetic operation in this practice happens in a fully licensed hospital with an independent specialist anaesthetist. One more red flag: any surgeon who is willing to operate on you today without an examination first.

Question 16

How much does cosmetic surgery cost in South Africa?

Accepted Answer

A written surgical quote in this practice includes the surgeon fee, the anaesthetist fee, the hospital and theatre fee, and where relevant the implants or consumables. Precise numbers depend on the procedure, the hospital, the length of theatre time and the implant chosen. Rhinoplasty, breast augmentation and abdominoplasty all sit within a broad range that is best communicated in a formal quote after examination, rather than as a headline figure that will not match your case. Ballpark ranges given over the phone are almost always wrong for the individual patient. For self-funding patients, the rooms will provide a single written quote covering every fee, including one or two follow-up visits. There are no hidden add-ons at discharge.

Question 17

What can I realistically expect from cosmetic surgery?

Accepted Answer

A well-planned aesthetic operation refines the shape or proportion of a specific area within the limits of your anatomy. It does not stop the tissues from ageing, guarantee symmetry to the millimetre, or change the way any specific person will react to how you look. In line with HPCSA guidance, this practice does not publish patient before/after photographs. Instead, expected outcomes are discussed in the consultation with anatomical drawings, measurements and clear language about what the operation is likely to change and what it will not. Two honest expectations: first, the final shape settles over months, not days — swelling, scars and tissue redraping all take time. Second, no result can be guaranteed. Every surgeon has revision rates, and every patient's biology is slightly different. A written surgical plan should reflect that, not paper over it.

Question 18

How can I finance cosmetic surgery in South Africa?

Accepted Answer

Purely aesthetic surgery is not covered by South African medical aid. Patients most commonly pay from savings, a personal loan or a dedicated medical-credit facility (several South African providers offer these on standard credit terms). Where the procedure has a reconstructive or functional element — for example, scar revision or repair of a functional nasal problem alongside a rhinoplasty — that portion may attract medical-aid cover as a Prescribed Minimum Benefit or under scheme rules. The rooms will separate cosmetic and reconstructive components in the quote so you can approach your scheme accurately. Staging is another honest option: sequencing procedures over 12–24 months rather than combining everything into one theatre visit. That spreads cost and reduces recovery load.

Question 19

Is cosmetic surgery worth the cost?

Accepted Answer

The patients who tend to feel a procedure was worth it share three things: they have thought about it for years rather than months, they can name the specific concern in one sentence, and they have realistic expectations of what the operation will change. The patients who tend to regret it share the opposite: a recent life event has driven the decision, the concern is diffuse ('I just want to look better'), or they expect the surgery to fix something outside the operation itself. A good consultation will explore all three honestly — and it is entirely appropriate to leave the room having decided not to proceed. There is no obligation to book after a consultation, and no better time to change your mind than before surgery.

Question 20

Are there non-surgical alternatives to cosmetic surgery?

Accepted Answer

Non-surgical options — injectable fillers, botulinum toxin, energy-based skin devices — can be excellent for fine wrinkles, early volume loss and skin quality. They are not equivalents to surgery when the underlying issue is skin excess, structural shape or true volume change. For example, mild upper-face lines respond well to appropriate non-surgical treatment. Heavy upper eyelid skin does not — the surgical answer is an upper blepharoplasty. Small tip refinements in a nose sometimes suit a targeted non-surgical treatment; changes in bony profile or breathing require rhinoplasty. Dr Hoffmann will tell you honestly at consultation when a non-surgical route is likely to give you a better result for the concern you have described, and when it will simply delay a decision without solving anything.

Question 21

How do I prepare for cosmetic surgery?

Accepted Answer

Physical preparation starts weeks in advance. Stop all nicotine, including vapes and nicotine replacement, for at least four weeks before and four weeks after surgery — nicotine measurably impairs wound healing. Stop non-essential supplements and any medications the rooms flag on the pre-operative checklist. Eat protein-rich meals and hydrate normally in the last week. Practical preparation is about the first week at home. Have loose front-buttoning clothing, a firm pillow for the bed, easy-to-reach food, phone chargers within arm's reach and a lift home organised. Fill any prescribed medication before the surgery date. Arrange help with young children or pets for at least the first 3–4 days. Mental preparation is often overlooked. Expect a low mood day around days 3–5 as bruising peaks and the excitement wears off — it passes. Keep the follow-up appointment even if you feel fine. Do not compare your day-3 photos to anyone's healed result.

Question 22

Why does HPCSA specialist registration matter for cosmetic surgery?

Accepted Answer

The Health Professions Council of South Africa (HPCSA) is the statutory body that registers doctors and holds them to a code of professional conduct. Registration as a Specialist Plastic and Reconstructive Surgeon requires accredited postgraduate training, national exams and ongoing continuing professional development. In practical terms, HPCSA specialist registration is the check you can rely on: it means the surgeon has completed the recognised training path, is legally permitted to perform the surgery, and can be held to account through a defined complaints process if anything goes wrong. Dr Hoffmann is registered with the HPCSA as a Specialist Plastic and Reconstructive Surgeon (HPCSA No 261190) and a member of APRASSA (Association of Plastic and Reconstructive Surgeons of Southern Africa).

Question 23

How do I get through the first two weeks of recovery?

Accepted Answer

Week one is about swelling, wound care and rest. Sleep propped up on two pillows (or in a recliner after face procedures). Ice on a schedule, not just when it hurts. Take painkillers regularly for the first 48–72 hours rather than waiting for pain to break through. Move — but gently. Short, frequent walks around the house from day one reduce the risk of blood clots and stiffness. No lifting, driving or bending as instructed. Keep dressings dry until the follow-up unless the sheet says otherwise. Week two is about slow re-engagement. Most patients feel steadily better each day. Do not judge the result yet — bruising is still resolving, swelling still evolving, and the shape has not settled. Photograph yourself at week 1, week 4, month 3 and month 6 for a much more honest comparison than the mirror at day 5.

Question 24

Which cosmetic procedures are the hardest to recover from?

Accepted Answer

Recovery difficulty is not the same as risk. The operations most patients describe as physically demanding in the first 2–3 weeks are abdominoplasty (tummy tuck) and combined body-contouring procedures — usually because they involve larger areas, longer operative time and restrictions on standing upright and core use. Breast augmentation, upper blepharoplasty and rhinoplasty are generally rated as moderate — uncomfortable rather than painful, with steady day-on-day improvement. Small procedures such as scar revision or minor local work sit at the easier end. The single biggest predictor of an easier recovery is honest planning: enough time off work, a helper at home for the first 3–5 days, and no attempt to 'push through' when the post-operative sheet says rest. Recovery is part of the operation, not an afterthought.

Question 25

Will my plastic surgery result look natural?

Accepted Answer

Almost everyone who sits down in the rooms says a version of the same sentence: they want a change, but they do not want anyone to know they had surgery. That is a reasonable request, and it is decided at the planning stage rather than in theatre. 'Natural' is really shorthand for two things: proportional to your own anatomy, and free of the tell-tale signs of over-correction. A rhinoplasty that leaves a nose looking too small for the face, or breast augmentation that ignores the width of the chest, is technically completed but not natural. Restraint at the planning stage — one to two millimetres less, one implant size smaller, one procedure at a time — is usually the difference. The philosophy behind this practice is that the best result is the one nobody can point to. This is also why the consultation is unhurried and drawn on paper. A written plan you can look at and think about at home is more likely to lead to a natural, considered result than a decision taken in the room.

Question 26

Am I too young or too old to have cosmetic surgery?

Accepted Answer

It is one of the most common questions in the rooms, from patients in their late teens and from patients in their seventies. The honest answer is that age is a poor predictor on its own. There is no universal minimum or maximum age for aesthetic surgery. What matters is that the tissues are mature enough for the operation, that health allows safe anaesthesia, and that the decision has been considered rather than reactive. For most facial procedures, we look for skeletal maturity — usually late teens or early twenties. Breast surgery in younger patients requires confirmed development and a thoroughly considered decision. On the older end, fit patients in their 60s and 70s routinely have successful aesthetic and reconstructive surgery, subject to a proper anaesthetic assessment. The question at consultation is not 'are you the right age?' but 'is this the right operation for this anatomy, at this stage of your life, for the reasons you have described?'

Question 27

Can I combine multiple cosmetic procedures in one operation?

Accepted Answer

Combining procedures can make sense when the operations are in similar regions, use the same anaesthetic, and the total theatre time remains safely within limits — for example, breast augmentation with an abdominoplasty after childbearing, or upper and lower blepharoplasty together. Combining is not sensible when total theatre time becomes long, blood loss adds up, or recovery restrictions from one operation conflict with another. In those cases, staging over 3–6 months gives a safer anaesthetic, a cleaner recovery and often a better final result. This is a decision made together at consultation, based on your anatomy, health and life circumstances — not on package pricing.

Question 28

What makes someone a good candidate for aesthetic surgery?

Accepted Answer

The characteristics that make surgery straightforward are consistent across procedures. Physically: good general health, no untreated conditions that affect wound healing or anaesthesia, stable weight, no smoking. Anatomically: the concern is one that surgery can specifically address, with a clear operative plan. Psychologically: the decision has been thought about for months rather than days, the goals are specific and realistic, and the reason for surgery is your own rather than someone else's. A recent divorce, a new relationship, or a difficult year is not a good reason to book surgery in the next six weeks. None of this is judgement — it is the same list every ethical surgeon works through, because the patients who match it consistently do best.

Question 29

What are the most common myths about plastic surgery?

Accepted Answer

Myth one: 'You can look like this photo.' Anatomy does not transfer between people. A photograph is a useful reference for a conversation, not a target. Myth two: 'Scars will be invisible.' Every incision leaves a scar. Good surgical planning hides it in a natural crease, along a hair-bearing edge, or in a discreet position. It fades but does not vanish. Myth three: 'The result is permanent.' Implants, tissues and skin all continue to age with you. Most operations give a long, stable improvement but not a frozen state. Myth four: 'Bigger is better value.' The most common reason for a second operation in this practice is over-correction at the first — a larger implant, a smaller nose, a tighter face than the anatomy could carry. Restraint costs less in the long run.

Question 30

Why don't you show before and after photos on the website?

Accepted Answer

The Health Professions Council of South Africa places clear limits on how doctors may advertise their services. Public display of patient before/after photographs and testimonials — particularly in a way that promises specific outcomes — is restricted, because it is very difficult for a member of the public to interpret those images accurately. Photographs of another person's result cannot tell you what your own result will look like. Two patients with what looks like the same starting point can have very different anatomy underneath. Instead, this practice discusses expected outcomes with drawings, measurements and honest language in the consultation itself. Where you are considering a specific operation, ask what the surgeon's revision rate is for that procedure, what the range of outcomes has been, and what would be planned specifically for your anatomy. Those are the honest questions — and they give you more information than any gallery.

Question 31

Does medical aid cover cosmetic surgery?

Accepted Answer

Cost is often the second question after safety, and the answer differs depending on why the operation is being done rather than what it is called. South African medical schemes do not cover purely cosmetic surgery — for example, a rhinoplasty performed only to change appearance, or a breast augmentation to increase size. These are paid privately. Where surgery has a functional or reconstructive element, some cover may apply. Examples include scar revision for functionally limiting scars, and correction of nasal breathing problems performed alongside cosmetic rhinoplasty (a septorhinoplasty). The reconstructive portion is submitted to the scheme; the cosmetic portion is quoted separately. The rooms will provide a written breakdown that separates cosmetic and reconstructive components so you can engage your scheme with accurate information rather than an all-in cash quote.

Question 32

What are the risks of cosmetic surgery?

Accepted Answer

Every operation carries general risks: the risks of anaesthesia, bleeding, infection, delayed wound healing, scarring, altered sensation, asymmetry, and — in a small proportion of cases — the need for revision. These are discussed in every consultation and listed on the consent form you sign. Each procedure also carries specific risks. Rhinoplasty: altered breathing, small irregularities in the bridge or tip, prolonged tip swelling. Breast augmentation: capsular contracture, implant rupture, changes in nipple sensation, need for future revision. Body contouring: seroma, contour irregularities, wound-edge problems, longer-term skin laxity. Results vary between individuals and no outcome can be guaranteed. A surgeon who does not walk you through these risks in detail is not doing informed consent properly.

Question 33

Can I have a virtual consultation instead of coming in?

Accepted Answer

A brief virtual conversation can help you decide whether it is worth travelling for a full consultation — you can describe your concern, hear about the general approach, and get a sense of fit with the surgeon. It is not a diagnostic or planning session. For any operation to be planned honestly, an in-person examination is required. Skin quality, tissue thickness, bone structure, breathing, symmetry, scars and posture all inform the plan in ways that a camera does not capture. Quotes are not issued from a video call. Out-of-town patients often combine a first in-person consultation with a scan of imaging on the same day, and use follow-up video calls for post-operative check-ins where clinically appropriate.

Question 34

How do I set up my home before surgery?

Accepted Answer

The most useful piece of furniture in the first week is a recliner or an armchair with a footstool — most facial and breast patients sleep more comfortably slightly elevated than flat. Beside it: water, phone charger, medication, a small notebook for questions, and easy snacks. Clothing: front-buttoning shirts, loose bottoms, slip-on shoes. No pull-over tops for the first 1–2 weeks after breast or facial procedures. Support: line up help for the first 3–5 days — meals, lifts, childcare, pets. Fill prescribed medications before surgery day so you do not have to leave the house to collect them. Freeze a few home-cooked meals in the week before surgery. Small preparations remove most of the stress from week one.

Question 35

When can I return to exercise after cosmetic surgery?

Accepted Answer

Movement matters from day one — short, easy walks around the house or garden reduce the risk of blood clots and speed healing. What has to wait is anything that raises blood pressure, strains healing tissues or risks a knock. Typical windows: gentle walking straight away; brisk walking or stationary bike at 2–3 weeks; light resistance and low-impact cardio at 4–6 weeks; full training including running, heavy weights, upper-body work and contact sport between weeks 6 and 8. Rhinoplasty is the exception — contact sport is held back longer than general training to protect the bony work, and Dr Hoffmann gives you a date at your post-operative review rather than a generic one. These are guides, not permission slips — the surgical team will give you a specific timeline at each follow-up based on how the tissues are actually settling.

Question 36

What is the difference between revision and touch-up surgery?

Accepted Answer

A touch-up is a minor refinement, sometimes anticipated during the original surgical plan — for example, a small scar revision, a fat-graft top-up, or a minor asymmetry correction under local anaesthetic. These are usually short procedures with quick recovery. A revision is a more substantial second operation performed to correct or improve a previous surgical result — for example, revision rhinoplasty, implant exchange, or capsulectomy. Revisions are more complex than the original operation because they work through altered anatomy and previous scarring. Whether either is needed depends on how the tissues have healed and how you feel about the result once it has fully settled — usually not before 12 months. Both are always discussed at follow-up before being planned.

Question 37

How long do cosmetic surgery results last?

Accepted Answer

Bony and cartilage work — rhinoplasty, chin augmentation, facial bone reshaping — is generally permanent. The shape you have at 12 months is essentially the shape you keep, subject to normal ageing of the surrounding skin. Implants have a defined lifetime. Modern breast implants are not lifetime devices; manufacturers publish a working life for each device, after which imaging surveillance and eventual exchange or removal are typical. The figure for the specific implant chosen for you is discussed and documented at your planning consultation. Skin, fat and soft tissue continue to age after surgery. A facelift does not stop ageing — it resets the clock and lets you continue to age from a different starting point. Weight change, pregnancy and hormonal changes all continue to affect body-contouring results. The most durable results usually come from restrained planning rather than large one-off changes.

Question 38

Why do surgeons keep asking about my expectations?

Accepted Answer

Two patients can have technically identical operations and finish with very different levels of satisfaction — because one expected a small refinement and got a small refinement, and the other expected a dramatic change and got a small refinement. This is why the consultation spends so much time on what you specifically want to change, why now, and what you understand the operation can and cannot do. Aligning expectations before surgery is not a formality; it is the single most reliable predictor of how you will feel about the outcome at six and twelve months. It is entirely appropriate — and encouraged — to take the written surgical plan away, sit with it, and come back with more questions before booking.

Question 39

How can I check on a surgeon beyond what's on their website?

Accepted Answer

You can independently verify a surgeon's HPCSA registration on the HPCSA public register — it will show their name, registration number and specialty. Membership of APRASSA is a further indicator of specialist standing. Hospital privileges matter: a surgeon should be able to name the hospital or hospitals at which they operate, and those facilities should be accredited private hospitals or licensed day clinics — not unnamed rooms. Beyond the paperwork, the way the practice handles a first phone or email enquiry tells you a great deal: whether questions are answered clearly, whether you are pressed for a deposit before consultation, whether the surgeon (not just a coordinator) sees you at the first visit.

Question 40

How do I know if a surgeon has enough experience for my procedure?

Accepted Answer

Experience is best measured procedurally, not in total years. A surgeon who has done thousands of hand cases is not automatically the right choice for a rhinoplasty. Ask specifically how often the surgeon performs the exact operation you are considering, and how long they have been doing that operation. Ask about revision rates for that procedure — a considered answer with a specific number is a good sign. 'None' is not a credible answer for any surgeon; every honest practice has a small revision rate. Sub-specialty focus is often a stronger indicator than raw volume. A surgeon who has narrowed their aesthetic practice to a handful of procedures they perform routinely is typically a safer choice than one who advertises every operation on the market.

Question 41

How much is the consultation fee and what does it cover?

Accepted Answer

A first consultation in this practice includes a detailed discussion of what you want to change, a full clinical examination of the relevant area, discussion of surgical and non-surgical options where relevant, and — if surgery is appropriate — a written surgical plan followed by a formal quote from the rooms. The consultation fee is quoted by the rooms at the time of booking, so you know the amount before you attend. It is not deducted from any surgical fee, but it is the only consultation fee you will pay for the same concern — follow-up planning discussions before surgery are included. There is no obligation to proceed after a consultation. You can take the written plan away, think about it, and either return to book or decide not to.

Question 42

How does anaesthesia affect the safety of cosmetic surgery?

Accepted Answer

Every operation in this practice is performed with a specialist anaesthetist — a doctor who has completed a full anaesthesia specialist training and is HPCSA-registered in the specialty. The anaesthetist is present throughout the operation, manages your airway, monitors every vital sign, and controls your pain during and immediately after surgery. The choice of anaesthesia (general, sedation, regional or local) is made by the anaesthetist and the surgeon together, based on the operation, its length and your medical history. You will have a pre-operative discussion with the anaesthetist before surgery — this is the appropriate time to ask about your specific concerns. Ask any surgeon quoting you for an aesthetic operation who the anaesthetist will be, and confirm they are a specialist anaesthetist. This is a non-negotiable safety standard.

Question 43

What types of anaesthesia are used for cosmetic procedures?

Accepted Answer

Local anaesthesia numbs a small area and is used for minor procedures like small scar revisions. Sedation adds a mild sleep-like state on top of local numbing and suits procedures such as eyelid surgery in selected patients. Regional anaesthesia numbs a larger area and is used for some hand and limb work. General anaesthesia is used for the majority of aesthetic operations — rhinoplasty, breast augmentation, abdominoplasty and larger body-contouring cases. It is administered by a specialist anaesthetist and is very safe in fit, well-prepared patients. The choice is not primarily about cost or preference; it is about the safest, most comfortable option for the specific operation you are having. The anaesthetist will discuss this with you at the pre-operative visit.

Question 44

Why does the hospital or day clinic matter?

Accepted Answer

A properly accredited facility has trained theatre nursing, resuscitation equipment, a recovery area, back-up staff, and — critically — the systems to escalate care if something unexpected happens during or after your operation. These are not optional extras. They are the difference between a manageable complication and a serious one. In this practice, every aesthetic operation is performed at an accredited private facility — Netcare Sunward Park Hospital, Centurion Day Hospital, or Life Brooklyn Day Hospital. Operations are not performed in rooms or informal settings, regardless of how minor the procedure looks on paper. If any surgeon proposes to operate on you in a non-accredited environment, treat that as a serious warning sign.

Question 45

Should I travel for cosmetic surgery?

Accepted Answer

Out-of-town patients from within South Africa and internationally are welcome. What makes travel work is honest planning of the whole recovery, not just the surgery. Rule of thumb: plan to stay in the same city as the surgeon for at least one week after facial or breast surgery, and closer to two weeks after abdominoplasty or larger body-contouring work. Do not fly on the day the dressing comes off. Confirm with your travel insurance whether cover applies after elective surgery. Where possible, first consultation is in person, followed by scheduled follow-up visits after surgery. Video follow-ups can supplement — never replace — in-person post-operative checks in the first six weeks.

Question 46

Does the surgeon's communication style really matter?

Accepted Answer

A surgical relationship is not a single transaction. It is an initial consultation, a decision, an operation, a recovery, and typically a year of follow-up. Whether you feel comfortable sending a photograph of a swollen wound at day 4, asking a small question at week 6, or raising an honest concern at month 6, depends almost entirely on how the surgeon communicated at the first meeting. The consultation is a test on both sides. You are also assessing whether this is a doctor you want to hear from at your most vulnerable, and whether they will be direct with you when the answer to your next question is 'not yet' or 'not this operation'. Trust your read of that first conversation more than any brochure.

Question 47

How do I look after my scars after surgery?

Accepted Answer

For the first six weeks the priority is a clean, dry, well-supported wound. Follow the dressing plan exactly. Do not soak in a bath, swim, or use hot water directly on the wound until cleared. Support garments (for breast, abdominoplasty and body work) are part of scar care, not optional. From about week 3–6, scar management begins: silicone gel or silicone sheeting used daily for at least three months, gentle massage once fully healed, and consistent sun protection — SPF 50, physical cover, no direct sun on the scar for at least six months. Ultraviolet exposure on an immature scar is the single most reliable way to leave it darker permanently. Scars mature over 12–18 months. What looks red or firm at three months usually flattens and pales substantially by twelve. If a scar becomes raised, itchy or thickened, tell the rooms — early intervention is much more effective than late.

Question 48

Should I get a second opinion before cosmetic surgery?

Accepted Answer

Second opinions are entirely normal and often encouraged. Elective surgery is not urgent; you have time. Any surgeon who reacts poorly to the idea of a second opinion has answered a useful question about themselves. The strongest reasons to get one: the first surgeon's plan feels different to what you asked for, you were pressed to book quickly, the risks or recovery were not clearly explained, or you simply want a second, independent read on a large decision. Bring the first surgeon's written plan to the second consultation. Agreement between two specialists strengthens your confidence. Disagreement is also useful — it usually surfaces a specific anatomical or planning question that a third conversation can resolve.

Question 49

How is pain managed after cosmetic surgery?

Accepted Answer

Modern post-operative pain management uses several methods together. During surgery, long-acting local anaesthetic is infiltrated into the operative area, which provides several hours of good pain control after you wake up. In the first 24–48 hours, regular paracetamol and an anti-inflammatory keep pain from building. Stronger short-term opioid pain relief is prescribed for the first few days if the operation warrants it. The most common mistake is waiting for pain to become severe before taking the next dose. Regular, on-schedule pain relief in the first 48–72 hours is far more effective than reactive dosing. Most aesthetic patients are off stronger painkillers within a week and managing on paracetamol and an anti-inflammatory beyond that. If pain is worsening rather than steadily improving after day 4, contact the rooms — it is not typical and needs review.

Question 50

How do I know if I'm ready — mentally — for surgery?

Accepted Answer

Wanting to change a specific feature — a nasal profile, breast size, an abdominal contour after childbirth — is a normal, reasonable reason to consider surgery. Body dysmorphic disorder is different: an intense, disproportionate preoccupation with a perceived flaw, often accompanied by significant distress, repeated mirror-checking, and dissatisfaction with any result no matter how good. Ethical surgical practice screens for this at consultation with direct, non-judgemental questions about how long the concern has been present, how much it interferes with daily life, and how you have responded to previous efforts (surgical or non-surgical) to address it. Surgery is rarely helpful in true body dysmorphic disorder and can make things worse. In those cases the appropriate next step is a discussion with a psychologist or psychiatrist, not the theatre. This is a supportive conversation, never a dismissive one.

Questions patients ask, answered honestly.

The essentials

All the questions

Still have a question about your own case?

Questions patients ask, answered honestly.

The essentials

How do I book a consultation with Dr Hoffmann?

What should I bring to the first consultation?

How long is the first consultation?

What does a consultation cost, and how do I pay?

Do you accept medical aid?

Is a video consultation possible if I'm not in the city?

How do I prepare for surgery once I've booked?

All the questions

Choosing a surgeonHow do I choose the right plastic surgeon for what I want done?

Consultation & planningWhat questions should I ask during a plastic surgery consultation?

Choosing a surgeonWhat is the difference between a plastic surgeon and a cosmetic surgeon?

Consultation & planningWhat are the most common aesthetic surgery procedures?

Cost & medical aidCan I negotiate the price with a plastic surgeon?

RecoveryHow long is recovery after cosmetic surgery?

Consultation & planningWhat should I avoid saying to a plastic surgeon at consultation?

Choosing a surgeonWhat are red flags when choosing a plastic surgeon?

Cost & medical aidHow much does cosmetic surgery cost in South Africa?

Risks & realistic expectationsWhat can I realistically expect from cosmetic surgery?

Cost & medical aidHow can I finance cosmetic surgery in South Africa?

Risks & realistic expectationsIs cosmetic surgery worth the cost?

Consultation & planningAre there non-surgical alternatives to cosmetic surgery?

Consultation & planningHow do I prepare for cosmetic surgery?

Choosing a surgeonWhy does HPCSA specialist registration matter for cosmetic surgery?

RecoveryHow do I get through the first two weeks of recovery?

RecoveryWhich cosmetic procedures are the hardest to recover from?

Risks & realistic expectationsWill my plastic surgery result look natural?

Consultation & planningAm I too young or too old to have cosmetic surgery?

Consultation & planningCan I combine multiple cosmetic procedures in one operation?

Consultation & planningWhat makes someone a good candidate for aesthetic surgery?

Risks & realistic expectationsWhat are the most common myths about plastic surgery?

Choosing a surgeonWhy don't you show before and after photos on the website?

Cost & medical aidDoes medical aid cover cosmetic surgery?

Risks & realistic expectationsWhat are the risks of cosmetic surgery?

Consultation & planningCan I have a virtual consultation instead of coming in?

RecoveryHow do I set up my home before surgery?

RecoveryWhen can I return to exercise after cosmetic surgery?

Risks & realistic expectationsWhat is the difference between revision and touch-up surgery?

Risks & realistic expectationsHow long do cosmetic surgery results last?

Risks & realistic expectationsWhy do surgeons keep asking about my expectations?

Choosing a surgeonHow can I check on a surgeon beyond what's on their website?

Choosing a surgeonHow do I know if a surgeon has enough experience for my procedure?

Cost & medical aidHow much is the consultation fee and what does it cover?

Anaesthesia & safetyHow does anaesthesia affect the safety of cosmetic surgery?

Anaesthesia & safetyWhat types of anaesthesia are used for cosmetic procedures?

Anaesthesia & safetyWhy does the hospital or day clinic matter?

Consultation & planningShould I travel for cosmetic surgery?

Choosing a surgeonDoes the surgeon's communication style really matter?

RecoveryHow do I look after my scars after surgery?

Consultation & planningShould I get a second opinion before cosmetic surgery?

RecoveryHow is pain managed after cosmetic surgery?

Risks & realistic expectationsHow do I know if I'm ready — mentally — for surgery?

Still have a question about your own case?