Breast Augmentation In-Depth | The Plastic Surgery Clinic
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Breast Augmentation

Breast Augmentation

Breast Augmentation Quick Look

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"Worth It" Rating

98% say it's "worth it"
Procedure Duration

Surgery Length

2 Hours



Discomfort Factor


Synopsis of Surgery

Breast Augmentation is an elective surgical procedure that enlarges and enhances the breasts through the placement of sterile silicone gel or saline implants into the breast tissue.


4 weeks until resuming physical exercise.

5-7 days off from work/household duties.


General Anesthesia

Alternative Names

Boob job, TA, IM.

Perhaps you want a fuller, more shapely look to enhance your natural beauty. Or maybe you want to restore your youthful perkiness after breastfeeding or major weight fluctuations. Or you may have already undergone a breast augmentation surgery but are looking for a change, you may want to go bigger or smaller, or change your implant placement with a revision breast augmentation. Whatever your motivation, plastic surgeons Dr. Lista, Dr. Ahmad and Dr. Austin will listen to you and help you choose the best breast augmentation surgery for you.

World Renowned Leaders in Breast Augmentation Surgery

With over 400 breast augmentations performed a year, Dr. Lista is one of the most experienced breast augmentation surgeons in Canada. For Dr. Lista, Dr. Ahmad and Dr. Austin, their philosophy for every breast enlargement patient is to make her look and feel as natural as possible.

In order to meet that objective, Dr. Lista, Dr. Ahmad or Dr. Austin meets with each breast implants patient to discuss her unique expectations, questions and concerns.

With their vast experience and patient-focused approach, Dr. Lista, Dr. Ahmad and Dr. Austin have earned a reputation for being exceptionally gifted Toronto breast augmentation surgeons.

As world renowned experts in the field of breast augmentation, Dr. Lista, Dr. Ahmad and Dr. Austin frequently publish articles on the topic in peer-reviewed journals, such as the prestigious Journal of Plastic and Reconstructive Surgery.

What is Breast Augmentation?

A small incision, usually an inch in size, is placed in an inconspicuous spot to allow insertion of the implant. Depending on the type of implant selected, there are up to four spots where an incision can be placed: around the lower edge of the areola, in the armpit, under the breast crease, or in the belly button. As highly accomplished Toronto breast implant specialists, Dr. Lista, Dr. Ahmad and Dr. Austin have a great deal of experience with all of these techniques. We will discuss with you which technique best suits your body and your lifestyle. The patient always has the final say on where the incision will be placed.

Most augmentation operations are performed at The Plastic Surgery Clinic. All surgeries at The Plastic Surgery Clinic are performed by Dr. Lista, a certified specialist in plastic surgery, or one of his highly skilled surgeons. This means that patients benefit from the knowledge and experience of a highly trained plastic surgeon. There is always a surgeon on call for patients to contact if they are worried that they might be experiencing any difficulty. Dr. Lista is Past Chief of Plastic Surgery at the Trillium Health Center (The Mississauga Hospital) so your operation can also be performed at the hospital if you prefer.

The following images are presented for educational purposes only and should be interpreted subjectively. They do not represent the opinion or view of any patient regarding their result, and they are not intended to suggest the result that may be achieved by any other patient. The images are presented as factual guidelines and merely represent results that have been achieved by others. No two patients are alike and no two results are necessarily alike. Only a personal consultation with your surgeon can provide you with a reasonable expectation of the results you may achieve from any specific procedure.

Where Breast Augmentation is Performed

Your breast enlargement can be performed right on site in the state-of-the-art facilities of The Plastic Surgery Clinic. If you prefer, you can also choose to have the surgery at one of the hospitals where our highly skilled plastic surgeons, Dr. Lista, Dr. Ahmad and Dr. Austin, enjoy privileges. These include the Mississauga site of the Trillium Health Centre, where Dr. Lista was Past Chief of Plastic Surgery, and the University Health Network, where Dr. Ahmad continues to provide his services.

No matter where you choose to have your surgery, there is always a surgeon on call to respond to your concerns. In addition, a board-certified anesthesiologist will administer your anaesthetic, stay with you during the entire operation, and will be there as you wake up.

Breast augmentation takes one to two hours. You will need to arrange for a friend or relative to come and pick you up and stay with you for 24 hours.

You will have two small drainage tubes that are removed at the clinic the day after surgery. These tubes help reduce swelling and hardening by removing any blood or fluid that may collect around the implant.

Sitting Up Breast Augmentation

One of the unique techniques we utilize at The Plastic Surgery Clinic is to perform our breast augmentation operations with the patient sitting up. We have a special operating room table which allows us to perform the surgery in the sitting position. In this way we can see exactly how the breasts will look when the operation is done. For Dr. Lista, Dr. Ahmad and Dr. Austin the most important consideration in performing breast augmentation is creating a breast which looks natural. Creating a breast with a beautiful shape, that suits the patient’s body and looks natural is our most important goal. We achieve this result by making sure the breasts look good in the position that they are most likely to be seen, which is with the patient in the upright position.

When we have our first consultation with our patients at our clinic in Mississauga or Toronto, we spend a lot of timing trying to understand our patient’s goals. What size and shape of breast is our patient looking for? With sizers in a sports bra, the patient will have brought to the consultation, we spend a lot of time determining her goals. We want to understand exactly what she wants and what she is hoping to achieve with breast implant surgery.

On the day of surgery the patient is brought into the operating room and lays down on the operating room table. After she is put to sleep, she is gently belted into position and the operating room table is then flexed so that the patient is in the sitting position. We then perform the entire operation with the patient in the sitting position. Sitting or standing is the way the breasts are most often going to be seen.

During the operation our surgeon will stand back and examine the breast. He will often take photos and compare them to the patient’s photos. Often the surgeon will ask our experienced nurses their opinion. We are looking at size, shape, cleavage, upper pole fullness, lateral show, position of the breast crease, and symmetry. We are constantly asking ourselves if we are giving the patient the size and shape of breast that she told us she wanted.

Why Do We Do the Operation Sitting Up?

Because looking natural is our most important goal when performing breast augmentation and this can only be achieved if we know how the patient is going to look in the upright position. It doesn’t do us any good to create a great breast when the patient is laying down if she doesn’t also look great standing up.

Why do we do breast augmentation sitting up?

Not all surgeons perform breast augmentation surgery in the sitting position the way we do at The Plastic Surgery Clinic. Even though it’s a little more work for us and takes a little longer, it’s well worth the result to give the patient exactly what she’s looking for: a beautifully shaped breast, that suits her body and – most importantly of all – looks natural.

Breast Augmentation with Fat Transfer

At The Plastic Surgery Clinic we offer a number of different ways in which we can approach breast augmentation surgery. Everyone is different, and everyone has a unique vision when it comes to what they would like their breasts to look like and how they would like them to feel. That’s why at The Plastic Surgery Clinic every surgery caters to the specific needs of the individual.

Some women prefer only a small increase in size or would like a breast augmentation but would rather not have implants. Breast augmentation with fat transfer is a procedure that offers a moderate increase in breast size without the need for implants. By using a patient’s own fat harvested from other areas of the body (typically the abdomen, waist and/or thighs), our surgeons carefully inject fat into key areas of the breasts in order to improve their shape and size. 

Some advantages of a breast augmentation with fat transfer include:

  • Shorter recovery: recovery following breast augmentation with fat transfer is typically shorter than a traditional breast augmentation, averaging 2-4 days, though we recommend that patients still take one week off work to recover.  
  • Relatively no scarring: because the incisions for fat grafting are quite small, patients who undergo breast augmentation with fat transfer virtually have no scarring.
  • Two surgeries in one: breast augmentation with fat transfer simultaneously removes unwanted fat from other areas of the body, giving those areas a more attractive and leaner appearance while increasing a patient’s breast size.
  • A natural look and feel: because it’s the patient’s own fat that is used to increase the size of the breasts, the breasts will look and feel just like any natural breasts. 
  • No need for implants.

Things to think about if you are considering a breast augmentation with transfer:

  • You need realistic expectations: with any fat grafting procedure a certain percentage of the fat transferred will be reabsorbed by your body, meaning that a breast augmentation with fat transfer can really only offer about a half cup to a full bra cup increase in size.  
  • The results could be less permanent than implants: because fat is a natural part of your body it will change along with the natural aging process. Typically a breast augmentation with fat transfer is a permanent procedure and you can expect your breasts to maintain their general shape and size if you maintain a stable weight, however any dramatic weight fluctuations could affect your result.   
  • You need to be the right candidate: meaning you want a small to moderate increase in size, your breasts already maintain their shape and you have good skin elasticity (so no major sagging for example), you have minimal asymmetries, and you have small pockets of unwanted fat in other areas of your body that can be harvested.      

In certain cases a breast augmentation with fat transfer can also be combined with a traditional breast augmentation with implants in order to add/improve cleavage and to improve on spacing between the breasts.      

Preparing for Breast Augmentation Surgery

Dr Lista prefers to see all his patients at least twice before surgery. In the consultation process we spend considerable time obtaining a careful history and physical examination.

We also spend a long time discussing the patient’s desires, goals and expectations. It is important that the patient discuss with the plastic surgeon her desired size and shape of breast.

Not all expectations can be accomplished with surgery and it is important that these issues are carefully discussed before surgery. Photographs can be helpful in this regard, which allows Dr. Lista to show the patients examples of how she may look after surgery.

Size and Shape of the Breast

You have an image in mind of how you want to look – and we know how to get you there.

The first thing we do is listen: we listen to your needs; we ask you to describe your ideal look; we have you bring in photos of women whose shape you admire; we have you try on different bra sizes. Dr. Lista, Dr. Ahmad and Dr. Austin will spend as much time as you need to make sure both you and your surgeon know exactly what you want.

Once we all understand your desired outcome, that’s when acclaimed plastic surgery providers Dr. Lista, Dr. Ahmad and Dr. Austin’s expertise becomes crucial. Based on your individual body, they rely on their decades of experience to select the implants and the surgical approach that will best meet your expectations. If Dr. Lista, Dr. Ahmad and Dr. Austin think there is any reason you won’t be able to achieve your desired look, they will let you know and will explain why.

Not only will Dr. Lista, Dr. Ahmad and Dr. Austin consider the correct size of your implants, they will also consider how to make them look as natural as possible. We know that the best implants look real – like they belong to your body. That’s why Dr. Lista, Dr. Ahmad and Dr. Austin use every method at their disposal to get natural, balanced results for their Toronto and Mississauga breast implant patients.

For instance, Dr. Lista, Dr. Ahmad and Dr. Austin are some of the only surgeons who anesthetise their patients in the seated position and perform breast augmentation surgery while the patient is sitting up. This allows them to confirm during the procedure that the size looks right and the breasts are balanced.

Which breast implant shape is best? Read Dr. Lista’s blog post to find out.

Types of Breast Implants

Choosing the right type of implant for you is an important decision that you will make with your plastic surgeons. Depending on your body, your lifestyle, and your own personal preferences, you and your surgeon will decide which type of implant is best for you.


Many of our patients choose saline-filled breast implants. Saline is a salt solution that is similar to fluids that are naturally present in the body.

Since saline implants are inserted into the body empty and are filled with saline after they are placed in the body, they use the smallest incision and result in the smallest scar possible.

Cohesive Gel Silicone

Cohesive gel implants are a new generation of silicone implants that are filled with a gel that feels soft and natural, but maintains its shape well. They are less likely to ripple than saline implants, and may feel more natural. In addition, this new type of silicone is solid, so will not leak in the event of a shell rupture.

However, since cohesive gel implants come prefilled, they require a larger incision and may limit the location of the incision.

For a more in-depth discussion of the advantages and disadvantages of both types of implants and how to choose which one is best for you, please click here.

For additional information, read Dr. Lista’s blog post about cohesive gel gummy bear implants.

Cohesive gel implants are a new type of implant which can be used in some patients. These implants are useful in very thin patients who need an implant placed above the muscle. They help prevent some problems such as rippling or the ability to feel the implant which can be a problem with saline implants. These implants are different than the original silicone implant because the internal gel is solid rather than liquid. In this way the silicone will not come out of the implant in the event of a shell rupture. The choice of implant is made with the patient after a discussion with your plastic surgeon.

Breast Implant Shape

While breast implants are available in a wide variety of different sizes. Understanding the differences between these implant types is an integral step in choosing the right breast implant for your body and your operation.

Round Breast Implants

The shape most commonly used for breast augmentation in a normal breast is a round breast implant, which has the appearance of a compressed sphere. Round breast implants are available in varying levels of projection, meaning that we can choose how far forward the breast projects from the chest. The round implant is beneficial because it has been shown to have a lower complication rate than other implant shapes, and in fact round implants that have a smooth texture have been proven to have a lower complication rate when the implant is placed beneath the muscle.

It used to be commonly accepted that a teardrop shape implant would create a more natural appearance to the breast. However, recent studies have shown that both plastic surgeons and patients are unable to tell the difference between a breast with round or teardrop implants. When the initial breast shape is normal, without droopiness or deformity, round and teardrop breast implants will produce results that look the same.

Cohesive Gel Breast Implants

Cohesive gel implants have been used in Europe since 1995. They have been available in Canada through special approval by Health and Welfare Canada since approximately November 2000.

Cohesive gel implants are different than saline implants. Saline implants are filled with salt water. Cohesive gel implants are solid silicone implants. They are different than the old silicone implants which used to be filled with silicone gel.

Those older silicone implants would leak silicone gel if the outer shell broke. Cohesive gel implants are significantly different. These implants are solid like a “gummy bear.” Because they are solid they can’t leak. If the outer shell is poked with a needle, broken or even cut, the implant maintains its shape because it’s solid.

Cohesive gel implants have certain advantages when compared to saline implants in some patients. In extremely thin breast augmentation patients, these implants can help prevent rippling, a complication occasionally seen with saline implants.

The fact that these implants come in a variety of shapes as well as sizes, allows them to change the shape of the breast in patients who need an improvement in their breast shape.

Patients who need a change in their breast shape, such as tuberous breast deformity, do particularly well with these solid shaped implants . These implants come in a variety of heights, widths and projections. This can help the surgeon give a more exact result in some patients.

Another condition, which is especially helped with cohesive gel breast implants, is the “droopy” or ptotic breast. Some patients have breasts which droop either because of their natural breast shape or as a result of child bearing or breast-feeding. Cohesive gel breast implants help lift the breast because they are solid and because their rough textured surface acts like velcro in lifting up a droopy breast. This can prevent the need for a breast lift in some patients and may save them from the scars associated with a breast lift.

The photos on this page clearly demonstrate the lift that comes from cohesive gel implants. While cohesive implants can be used behind or above the pectoralis muscle, in order to get the effect of breast lifting or reshaping with cohesive implants, the implant needs to be placed above the chest muscle and right behind the breast tissue.

It is important to understand that cohesive gel breast implants are not better than saline implants in all patients. For many patients, the look that they will achieve is the same with both implants. There are some disadvantages to cohesive gel implants. Because they are solid they require a larger incision on the body. They are also significantly more expensive than saline implants.

Cohesive gel implants have complications similar to saline implants and you should read the rest of the previous breast enlargement web page to learn more about implants in general and how this procedure is performed by Dr Lista at The Plastic Surgery Clinic.

There is not one implant that is better than another implant in all patients. Cohesive implants have some advantages over saline implants in some patients. In other patients, saline implants may be better or more appropriate than cohesive. It is important for your plastic surgeon to have experience with both types of implants, through various incisions, placed above the muscle in some patients and behind in others. Dr Lista has a great deal of experience using both saline and cohesive gel implants. He spends a great deal of time with his patients determining which implant, which incision and which placement will give each patient the best and most natural result.

Choosing the Correct Implant

Choosing the right implant, the position of the implant and where the incision is placed are some of the most important decisions a woman can make when considering breast implant surgery. When we see patients at the Plastic Surgery Clinic we spend most of our time discussing these issues so every woman can make the right choice for themselves.

The two major types of implants available for use in Canada today are Cohesive Gel Silicone implants and saline implants. Saline implants have been available for over 30 years. There is no other implant that has been more thoroughly studied or has a longer track record than saline implants. Essentially these implants are an empty bag that is filled with salt water or saline. The implant is placed into the body, after creation of the pocket, by rolling the implant up like a cigar and then filling it when it is in position. We use the same solution to fill the implant that we give a patient when we start an Intravenous or IV.

The advantage of saline is that it is safe, less expensive and leaves the smallest incision and scar possible. Normal activities do not harm these implants. We have breast augmentation patients with saline implants who work as female fire-fighters, police officers, fighter pilots and personal trainers. Saline implants can occasionally leak, usually due to a defect which develops around the valve. When this occurs the saline is absorbed by the body and the implant goes flat. Replacing the implant is a fairly simple operation where the incision is opened, the deflated implant removed and a new implant inserted. The implant companies guarantee the implants for life and so will provide your surgeon with a replacement for free. You should check with your surgeon about possible surgical fees for implant replacement. In my practice we replace implants without charging any surgical fee. In fact we tell patients that if they develop a complication which can be fixed, that we will do so at no additional cost.

The risk of implant deflation is 1% per year. That means that one out of a hundred implants will deflate every year. So in 10 years a woman has a 10% chance of developing a leak; in 20 years 20%, 30 years 30%. So in fact the odds are that most women will live their entire lives without requiring a replacement.

There are some disadvantages with saline implants. These implants generally look best when placed behind the muscle. Placing saline implants above the muscle can lead to rippling and capsular contracture. Even when placed behind the muscle some women may be able to feel the implant in the bra crease area. This can give a ripply feel in the bra crease area. This problem is more likely to occur in very thin patients. Most patients however do not experience this problem.

Saline implants can be placed under the muscle through an incision in the bra crease, around the bottom edge of the areola or in the armpit (axilla). In my practice we perform the operation using any of these incisions and allow patients to choose the incision which they feel is best for them.

Cohesive gel silicone implants are the newest form of implant available in Canada. These implants have been used for breast augmentation since 2000 in Canada and for over 15 years in Europe. These implants are filled with a solid or cohesive silicone center. They are commonly called the “gummy bear” implant because if they rupture, they don’t leak. You can stick a needle in these implants, or even cut them in half, and nothing leaks out.

There are some advantages to cohesive implants. They are less likely to give the problem of rippling or palpability of the lower edge in the bra crease area. While they do not reduce the risk to zero, they do make these problems less likely. The other advantage of these implants is that they can be used above the muscle. There are some patients who need to have their implants above the muscle. Such patients are women who have breast droopiness. When a women’s breast droops, an implant cannot be placed behind the muscle without performing a breast lift. A breast lift or mastopexy leaves more scarring on the breast.

Women who are extremely thin also have the advantage of having a decreased chance of rippling and palpability of the implant when they use cohesive gel implants under the muscle. The usual way to insert cohesive gel implants is with a scar around the lower edge of the areola or in the bra crease. At The Plastic Surgery Clinic we have developed a technique of inserting cohesive gel implants under the muscle through an incision at the top of the armpit. The advantage of this technique is that when the scar heals, it does not look like a scar but rather like another normal wrinkle in the armpit.

While there are many advantages to cohesive gel implants, there are also some disadvantages. Because these implants are solid, they leave a larger scar, usually 4–5 centimeters as opposed to 1–2 centimeters with saline.

Cohesive gel implants also have a slightly higher risk of capsular contracture than saline. For most surgeons, the risk of capsular contracture with saline under the muscle is around 1%. With cohesive gel the published risk in the European studies is 5–10%. One of the implant manufacturers reported a 3 year capsular contracture rate of 4% at the recent Health and Welfare Canada hearings in Ottawa. Oddly enough however there are some patients who have capsular contracture with one implant but do not suffer from this condition when they switch to a different type implant in a new pocket.

The most important myth that needs to be dispelled about breast implants is that one implant is better than another. There are some patients who, because of their anatomy, or the shape of their breasts, need to have a cohesive gel implant. But there are many patients who have the type of chest where both saline and cohesive gel implants will give equally good results. These patients are fortunate because both cohesive gel and saline implants will give equal results, with breasts that look and feel equally good with either implant. In these patients the choice of implant becomes a personal one based on personal preference, price and size of scar.

Women who are thinking of breast implant surgery should carefully review all of their options before surgery. They should avoid any surgeon who uses only one type or even one make of implant because all implants have advantages and disadvantages. There are even differences in implant characteristics between the two major manufacturers of implants. The choice of which implant is right for you depends on the appearance of your breast before surgery, your individual anatomy and your specific needs.

Remember to learn as much as you can, ask a lot of questions and, in the end, don’t let anyone talk you into anything – go with what feels right for you.

Position of the Breast Implant

Breast implants can be placed either above or below the pectoralis muscle. There are advantages to each of these techniques and the method that is best suited for you will be made in consultation with your plastic surgeon.

Under the Muscle

Generally implants are best placed under the muscle in thin patients who have no breast ptosis (droopiness).

This technique tends to result in a soft, natural breast. Since the muscle covers the edges of the implant, it makes the implant less visible, reduces the chances of rippling, and makes it less likely that you will feel the edges of the implant.

A disadvantage is that intense movements of the pectoralis muscle can result in movement of the breast.

Over the Muscle

Implants inserted above the muscle are located immediately behind the breast tissue.

This technique is best suited for Toronto, Ontario breast augmentation patients who have more breast tissue to start with, or who have more breast ptosis (increased sagginess of the breast).

The risks of hardening, rippling and external visibility of the implant are greater with this technique.

Under the Fascia

Breast implants can be placed beneath the fascia, otherwise known as a subfascial breast augmentation. The fascia is the thin layer of tissue or membrane that envelops, protects, and gives the muscles in the body their unique shape. 

The pectoralis muscle is similarly surrounded by the fascia, and when we place the breast implant in the subfascial position we are placing it between the pectoralis muscle and the fascia. 

The fascia, although a very thin layer of tissue, is extremely strong and durable, and is an excellent pocket for the breast implant to sit and remain in place, giving the breasts a very natural overall appearance. 

There are many advantages to the subfascial placement of the breast implant, which is why most of the breast augmentation procedures that we perform are subfascial.

Some of the benefits of the subfascial breast augmentation include:

  • A natural movement of the breasts, as well as a natural overall appearance of the breasts.
  • The breast implants are correctly positioned during surgery, therefore there is no need to wait for the breast implants to drop or settle into position following the procedure.
  • Improved and more natural cleavage.
  • Lower risk of rippling.
  • Prevents the implants from being displaced.
  • Prevents the intense movement of the pectoralis muscle when the breasts move in more active individuals.
  • No damage is done to the pectoralis muscle resulting in less pain and less downtime.
  • A faster recovery time.

Breast Augmentation and Tuberous Breast Deformity

Breast Augmentation and Tuberous Breast DeformityWhile a mostly unnoticeable imbalance between the size of each breast is typical for a majority of women, more severe breast asymmetry is a concern that is commonly the result of a congenital breast condition. Falling under a range of names—most commonly tuberous breast deformity, but also including lower pole hypoplasia and constricted, conical or tubular breasts, among others—this breast anomaly typically occurs during puberty and affects breast development.

The result is not simply a smaller breast, but rather a constricted breast with a higher inframammary fold (or bra line crease) and an increased projection (or puffiness) of the areola around the nipple. The effects of tuberous breast deformity can vary widely in every case, and can even result in considerable inconsistency in the same patient, leading to a more noticeable or severe breast asymmetry. Because breast proportion can play a distinctive role in each woman’s sense of femininity, self confidence, sexuality, and overall well-being, a constricted breast appearance can affect not only her silhouette but also her self-perception.

Many women who have tuberous breast deformity wish to bring their breasts into a more symmetrical proportion while also addressing other irregularities caused by the condition. At The Plastic Surgery Clinic, both Dr. Lista, Dr. Ahmad and Dr. Austin have extensive experience correcting tuberous breasts. By using differential breast implants to create an equal volume, and by lowering the bra crease and minimizing puffiness around the nipple, our surgeons create a symmetrical, natural result. Every surgical plan is meticulously customized to each patient’s original breast shape, taking into account all of their goals and desired outcomes.

Implant Lifespan

At The Plastic Surgery Clinic, we understand that breast augmentation is a big investment. As such, we want you to feel confident and comfortable knowing that your breast implants will last you a lifetime. The truth is breast implants only need to be replaced if a problem develops. Routine replacement of implants is not required. There is a common misconception that breast implants need to be changed every decade when in fact most women will live their entire lives with their original implants. Even implant manufacturers are confident in their products’ longevity, as they guarantee their implants for the life of the patient. In the very rare event that an implant does rupture, the manufacturer will supply a new implant at no charge.

In those exceedingly rare circumstances, it’s important to note that saline or cohesive gel implants are particularly safe in the event of rupture. While implants from decades past had higher safety risks associated with rupture, today’s modern implants are safe and unharmful. Saline is a salt solution which is natural to the body and will be absorbed by the body if the implant ruptures. Cohesive gel is solid and in the event of rupture will not spread in the body.

As a highly experienced breast augmentation expert, Dr. Lista assures patients pregnancy and breastfeeding are not affected by breast implantation. Numerous large and well-controlled studies have conclusively proven that breast implants do not increase the risk of breast cancer in patients who have undergone this operation.

Ensuring Your Breast Implants Are Undamaged

At The Plastic Surgery Clinic, we strive to offer our patients the most scientifically advanced medical options available. To that end, we’re pleased to provide High Resolution Ultrasound (HRUS) technology, a cutting-edge method that allows us to monitor breast implants after they have been placed.

HRUS allows us to detect if an implant is intact or ruptured, or if there is any fluid around the implant itself. Thanks to great advances in the composition of cohesive silicone breast implants, when they rupture, the silicone stays in place without leaking anywhere else in the body. While this means that an implant rupture is safe for the patient, a broken implant does require replacement in order to prevent any further complications.

Because of these improvements to the physical integrity of the implant, ruptures can be difficult to detect. HRUS allows us to efficiently and easily assess whether or not an implant has been compromised by a rupture.

When you are a patient with us and we perform your breast augmentation surgery, you can come in for a breast exam and HRUS anytime you have concerns about your breast implants. This service, which is valued at $500, is included at no charge with your surgery and is available to you for life.

Recovery Following Breast Augmentation

After your breast augmentation surgery, a friend or relative will need to pick you up and stay with you at home for 24 hours.

You should plan to take a week off after your surgery, limiting your activities to staying home, watching TV or reading books. This important time of rest will allow your body to devote its energy to the healing process. It can be of great benefit to make arrangements in advance with a friend or family member for help with activities such as driving. If you are currently looking after small children, plan for an alternative childcare arrangement during this week to help limit the time you will need to spend on your feet. We understand it can be hard to stop completely, but staying quiet in the first week actually speeds healing and helps achieve the best results from the surgery.

About two weeks after your surgery you can start to exercise gently: walking and stairmaster is allowed, but no upper body workouts, running or high-impact workouts should be done for one month.

Some of the women who have had breast enlargement performed at The Plastic Surgery Clinic include firefighters, police officers, aerobic instructors, and skydivers – all of whom have returned to their so-called “regular” activities without difficulty!

No Pain With The Pain Relief Pump™

Pain after surgery is not only uncomfortable, it can also slow down the healing process. That’s why Dr. Lista, Dr. Ahmad and Dr. Austin take the time to anticipate patients’ pain needs in advance, to help reduce the time it takes for you to get back on your feet.

Dr. Lista introduced the revolutionary Pain Relief Pump™ to ease the pain in the first 24 hours after surgery. This MP3-sized device is worn in a belt around the waist, with a hair-thin tube connecting it to the surgical site. Completely automatically, the device regularly delivers a long-acting local anesthetic into the wound.

The result is that patients feel absolutely no pain. That means that our breast augmentation patients do not usually need to take prescription pain medicines that can be associated with significant side effects such as nausea, vomiting and allergic reactions.

Toronto cosmetic surgery patients at the Plastic Surgery Clinic now experience no pain, heal faster, feel happier, have less swelling and simply recover more quickly. The Pain Relief Pump™ has proven invaluable in plastic surgery patients and is almost exclusively available at The Plastic Surgery Clinic. We use the Pain Relief Pump™ with patients undergoing a wide range of the plastic surgery procedures we offer.

What Patients Say About the Pain Relief Pump™:

“Dr Lista, I’ve had lots of surgery in the past but I’ve never had an operation that didn’t hurt at all. The pain pump was amazing. Thank you so much for offering it to me.”

“To everyone at the clinic. You guys are amazing. I always have a bad reaction with pain pills. I was so afraid of being sick after my surgery. Instead I had no nausea and didn’t throw up once. I had no pain so I didn’t need to take any pain pills. Your anesthetic and the pump were fantastic.”

“Dr Lista and staff. Thank you so much for the fabulous care. You were all so kind and caring. I’ve never heard of anyone feeling as good after surgery as I did. I look great and feel wonderful. I’ve never heard of the pain pump but it was amazing that I had no pain. I’m telling everyone I know how great you all are.”

Find out more with Dr. Lista’s video blog on plastic surgery pain relief.

Risks & Complications

Complications are rare with breast enlargement surgery. The vast majority of our breast implant patients have no complications and are extremely happy with their results.

Nevertheless, all surgeries have their risks. The following list outlines some of the risks that do exist, as infrequent as they are.

Capsular Contracture

When implants are placed in the body, the body’s normal response is to form a lining, or capsule, around it, just as it would with any foreign object. That process is completely natural, and capsular contracture itself is also natural. A problem only arises if the capsule squeezes too much, making the soft implant beneath it feel hard. If this occurs, the capsule may need to be removed, or the implant replaced.


As with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood.


Very rarely women may develop an infection around an implant. This may occur at any time, but is most often seen within a week after surgery. In some cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.

Changes in Nipple Sensitivity

Some women report that their nipples become oversensitive, undersensitive, or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear within time, but may be permanent in some patients.

Fertility, Pregnancy and Nursing

As highly experienced breast augmentation experts, Dr. Lista, Dr. Ahmad and Dr. Austin assure patients that breast implants will not affect fertility, pregnancy, or your ability to nurse. If, however, you have nursed a baby within the year before augmentation, you may produce milk for a few days after surgery. This may cause some discomfort, but can be treated with medication prescribed by your doctor.

Implant Rupture

Very occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and movement of your breast and implant. Both saline and cohesive gel implants are particularly safe in the event of rupture. Saline is a salt solution that is similar to fluids that are naturally present in the body, and will be absorbed by the body if the implant ruptures. Cohesive gel is a solid similar in texture to a gummy bear, and in the event of rupture will not spread in the body.

If a rupture occurs, you will need a second operation to replace the leaking implant.

Breast Cancer

Numerous large and well-controlled studies have conclusively proven that breast implants do not increase the risk of breast cancer in patients who have undergone this operation. However, they may change the way mammography is done to detect cancer. When you request a routine mammogram, be sure to go to a radiology centre where technicians are experienced in the special techniques required to get a reliable X-ray of a breast with an implant. Additional views will be required. Ultrasound examinations may be of benefit in some women with implants to detect breast lumps or to evaluate the implant.

While the majority of women do not experience these complications, you should discuss each of them with your physician to make sure you understand the risks and consequences of breast enlargement and plastic surgery in Toronto.

Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

The question of whether breast implants cause breast cancer is a concern that is often on the minds of those who are thinking about having breast augmentation surgery and sometimes worries those patients who already have implants. These are justified and real concerns and all our patients as well as potential patients have the right to have these concerns addressed directly. 

Dr. Lista, Dr. Ahmad, and Dr. Austin have researched widely and published numerous papers on many facets of breast augmentation surgery, including on breast implant related illnesses. This is a topic that our surgeons travel internationally to speak about at conferences with other plastic surgeons. The relationship between implants and the risk of cancer is frequently at the forefront of their discussions and presentations. 

Dr. Lista, Dr. Ahmad and Dr. Austin would like to reiterate their position, which is solidly backed by extensive scientific research, that breast implants do NOT cause breast cancer. 

In the past several years, there has been a resurgence in the media over the concern that there is in fact a potential link between breast implants and cancer, which has caused much anxiety for many future and former breast augmentation patients. 

In fact, as recently as July 2019, Allergan recalled a particular type of textured implant called Biocell, which is a textured breast implant that is known to have a more aggressively textured surface. This textured implant in particular has been associated with the development of something called Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). BIA-ALCL is an extremely rare type of cancer otherwise known as a lymphoproliferative disease. BIA-ALCL is a condition in which an individual’s immune system cells (or lymphocytes), specifically in the area of the breast, become cancerous. BIA-ALCL is not breast cancer.

To date there have been approximately 400 cases of BIA-ALCL out of over 10 million patients who have had breast augmentation surgeries worldwide. It is believed that BIA-ALCL occurs in 1 in 10,000 cases, which is extremely rare.

There has been a lot of confusion and fear surrounding this type of lymphoma, particularly following the July 2019 Allergan recall, and particularly for those patients who currently have this particular implant. We would like to dispel the fears and clarify certain issues here:

  • BIA-ALCL, aside from being very rare, is not a silent cancer. BIA-ALCL is not a condition that can sneak up on you like breast cancer. If you are a patient who currently has the textured implant associated with the development of BIA-ALCL, you will immediately know that something is wrong. A large amount of fluid will develop around your implant, which will cause your breast to greatly swell. 
  • Diagnosis is straightforward and immediate. You doctor will take a sample of the fluid build-up surrounding your implant and run a CD30 test, which will reveal your lymphoma result. 
  • Chemotherapy and radiation, treatments that are typically required in order to cure other types of cancer, are never required with BIA-ALCL. In fact, the treatment for BIA-ALCL is quite simple, 95% of patients are completely cured of BIA-ALCL when their implant and the capsule (the collagen-fibre tissue that your body naturally forms around the implant) are removed. 
  • The recall from Allergan, DOES not mean that patients who currently have textured implants or even if they have Biocell implants need to have them removed. The recall of the textured implants from Allergan simply means that if there are still any surgeons out there that have the implants on their shelves, they need to return them, and Allergan will no longer be selling this type of textured implant.
  • The risk of removing the textured implants is greater than the risk of leaving them in. The FDA, Health Canada and all other medical organizations worldwide have recommended that textured implants not be removed unless symptoms of BIA-ALCL or BIA-ALCL itself is detected. 
  • Neither Dr. Lista, Dr. Ahmad nor Dr. Austin have ever encountered BIA-ALCL in any of their patients in their years of practice. The Plastic Surgery Clinic stopped using the textured implants associated with BIA-ALCL in 2012, when our surgeons became aware of other risks and complications resulting from these implants. The Plastic Surgery Clinic only uses smooth implants.
  • There has never been a case of BIA-ALCL in a patient with smooth implants.

At The Plastic Surgery Clinic, the health and safety of our patients is our number one priority and our surgeons will continue their mission to always be up to date on all things aesthetic, technical, and medical when it comes to breast augmentation surgery.

If you have any questions or concerns about BIA-ALCL, textured implants, or any other issues related to breast augmentation surgery, don’t hesitate to book a complimentary in person consultation with one of our expert surgeons. Talking and listening to you is one of the most important parts of our practice.

Breast Implant Illness (BII)

Recently there has been a lot of discussion around something called “breast implant illness” or BII. You may already have heard of it or you may be a patient that feels that they are currently suffering from BII. 

Here’s what we know so far about BII:

“Breast implant illness” is not a recognized medical condition.

Recently, a very small percentage of breast augmentation patients have been complaining about being affected by a broad range of symptoms such as fatigue, hair loss, brain fog, stomach pain, bloating, depression, weight gain, weight loss, anxiety, and insomnia. These patients attribute these problems to their breast implants. 

As surgeons, we recognize that the problems these patients are complaining of are real. However we are unable to scientifically draw a connection between breast implants and these symptoms. There are no medical tests we can perform to show a concrete medical basis for these problems nor can we link these problems to breast implants, as the symptoms are not consistent from patient to patient.

There is also no evidence to suggest that removing breast implants will make these symptoms better. In fact, not all patients get better if their implants are removed. If the symptoms were caused by an allergic reaction then a simple removal would be the solution, but this is not always the case.

So while we believe this condition exists, we are unable to definitively prove that breast implants are the cause. Dr. Lista has been appointed to a task force by the American Society of Plastic Surgeons to further investigate this broad collection of symptoms being described as “breast implant illness” or BII.

The good news is that this condition is extremely rare affecting less than 1% of implant patients. The vast majority of patients are delighted with their implants and achieve an excellent result with no problems at all. 

Implant Lifespan

Implants only need to be replaced if a problem develops. Routine replacement of implants is not required. Implant manufacturers guarantee their implants for the life of the patient. Should an implant rupture, the manufacturer will supply a new implant at no charge.

Safety in Case of Rupture

Saline or cohesive gel implants are particularly safe in the event of rupture. Saline is a salt solution that is similar to fluids that are naturally present in the body, and will be absorbed by the body if the implant ruptures. Cohesive gel is a solid similar in texture to a gummy bear, and in the event of rupture will not spread in the body.

Breast Augmentation Before and After Photos

Browse our breast augmentation photo gallery to view our collection of patient photos. A small selection of images are available within this gallery. During your free consultation, you will be able to look through a significant collection of breast implants patient photos and discuss these cases in detail with our plastic surgeons.

Cost of Breast Augmentation

There are several factors that contribute to the overall cost of breast augmentation. Every patient has a unique set of requirements that can be fully discussed and explained during a free consultation with our experienced plastic surgeons. While breast enlargement is not covered by most private or public health insurance plans, our patients tend to consider this procedure to be very reasonably priced. We also offer several different financing plans for the benefit of our patients. Many women feel that they have spent so long feeling unhappy with the appearance of their breasts that this cosmetic procedure isn’t simply a one-time expense but rather a permanent investment in the way they look and feel.

If you would like more information about the precise costs associated with breast enlargement, please contact us by phone or e-mail. You can also get in touch with us by filling out the Request for Information form on this page. After your free consultation at our clinic, your surgeon will be able to advise you of a more exact estimate.

Plastic Surgery Video Gallery

Breast Augmentation Videos

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Plastic Surgery Before & After Photo Gallery

Breast Augmentation Gallery

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A Newbie's Guide to Breast Augmentation

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What to Expect

The PSC Method

Step 1: The PSC Consult

Step 1: The PSC Consult

Consultations are always free. This is our opportunity to get to know you and your vision. And then share with you our expertise and recommendations based on 30+ years of experience, and thousands of satisfied patients.

One patient's experience...

My overall experience has been nothing less than beyond exceptional! [The PSC] made me feel confident and comfortable from start to finish…


Step 2: The PSC Procedure

Step 2: The PSC Procedure

You’ll arrive on the day of surgery fully prepared and confident in your outcome, because your surgeon is internationally recognized as a leader in their field. You will wake up slightly groggy and a bit uncomfortable, and head home soon after.

One patient's experience...

My overall experience has been nothing less than beyond exceptional! [The PSC] made me feel confident and comfortable from start to finish…


Step 3: The PSC Follow Up

Step 3: The PSC Follow Up

We see every patient the day after surgery. Most find their discomfort extremely manageable, thanks to the pain relief pump. Our post-op nurse will walk you through every step of your recovery and answer all your questions.

One patient's experience...

My overall experience has been nothing less than beyond exceptional! [The PSC] made me feel confident and comfortable from start to finish…


Step 1: The PSC Consult

Consultations are always free. This is our opportunity to get to know you and your vision. And then share with you our expertise and recommendations based on 30+ years of experience, and thousands of satisfied patients.

One patient's experience...

My overall experience has been nothing less than beyond exceptional! [The PSC] made me feel confident and comfortable from start to finish…


Step 1: The PSC Consult
1 The PSC Consult

You and your surgeon will customize a plan to meet your needs and desired outcome.

Step 2: The PSC Procedure

You’ll arrive on the day of surgery fully prepared and confident in your outcome, because your surgeon is internationally recognized as a leader in their field. You will wake up slightly groggy and a bit uncomfortable, and head home soon after.

One patient's experience...

My overall experience has been nothing less than beyond exceptional! [The PSC] made me feel confident and comfortable from start to finish…


Step 2: The PSC Procedure
2 The PSC Procedure

All surgeries are day surgeries, done under general anesthetic at our private hospital.

Step 3: The PSC Follow Up

We see every patient the day after surgery. Most find their discomfort extremely manageable, thanks to the pain relief pump. Our post-op nurse will walk you through every step of your recovery and answer all your questions.

One patient's experience...

My overall experience has been nothing less than beyond exceptional! [The PSC] made me feel confident and comfortable from start to finish…


Step 3: The PSC Follow Up
3 The PSC Follow Up

We see you the very next day, ensuring optimal recovery and happiness with your result.

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