The breasts undergo important development during puberty due to hormonal and metabolic changes. Their size and shape can change rapidly, which plays an important role in shaping the body’s overall contour. Patients who choose to undergo mastoplasty often present with breast asymmetry, hypertrophy, hypoplasia, deformities resulting from obesity or massive weight loss, or other imperfections. Although the patient may have already decided to proceed with surgery, the plastic surgeon must perform a thorough physical examination to identify all related issues. After this, careful surgical planning is essential. It should be conducted with the patient in a standing position to accurately assess the breasts and any associated abnormalities. Once the operation is scheduled, I prefer to perform the preliminary markings one day before surgery, while the final surgical markings are completed in the operating room.