BACKGROUND: Most patients who desire breast augmentation have higher expectations than the outcomes that can be achieved. The purpose of this article is to propose strategies for coping with each patient's expectation, and selecting the most appropriate surgical method. METHODS: Data were retrospectively reviewed for 138 women who underwent breast augmentation between July 1, 2012 and June 30, 2014. The augmentation methods were selected based on the patients' expectations. According to each expectation, we recommended the optimal procedure and material for each patient, and performed the augmentation in accordance with this as much as possible. The patients were asked postoperatively whether they were satisfied with their outcomes. RESULTS: Most patients (85%) were satisfied with their results during the mean postoperative follow-up period of 21.4 +/- 7.6 months (range, 8-32 months). The remaining, dissatisfied patients (15%) accepted their final results after receiving explanations or additional procedures. CONCLUSIONS: We classified common expectations of breast augmentation patients into nine categories. To minimize the gap between expectations and outcomes, we preoperatively provided realistic explanations about the limitations of the chosen materials and surgical methods with each patient. We then performed breast augmentation in consideration of the patient's expectations. Consequently, we were able to appropriately deal with each patient's expectations.