In any operation on the breast, the plastic surgeon considers the three "S's". They are size, shape, and symmetry. These considerations are paramount whether one is reducing a breast, reconstructing a breast, or augmenting a breast.

The advent of anesthesia in the early 19th century-the first demonstration of Ether in 1846 by Morton at the Massachusetts General Hospital-allowed the surgical disciplines to flourish. Complex and painful surgery which would not be possible under "a glass of whiskey and biting down on a bullet" became routine in the middle 20th century. However, anesthesia was not refined at that stage and complications related to anesthesia itself were commonplace. These complications included adverse outcomes for patients including confusion, stupor, nausea and vomiting, strokes, and death.