Featured Question of the Week

Can I get a tummy tuck a few minutes after giving birth?

It is not recommended that women undergo an abdominoplasty right after giving birth.You must first let your body heal from childbirth and return to your pre-pregnancy weight before a good assessment of whether a tummy tuck is right for you can be performed. If you had a caesarian section birth then there is also a significant increase in risk of infection were you to have a full abdominoplasty at the same time.

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Do sizers and/or the rice test underestimate final implant size if I am going submuscular?

Both are there to guide you to the right size, but neither should be taken as a true representation of the final results as they will actually overestimate your final result. In general the implants will actually look a little bit smaller once they are inside your body vs. when they are outside your body in a sizing bra – regardless of whether you go above or below the muscle. The difference between certain sizers can be marginal so you’ll probably never know the difference after the fact. Keep in mind that 25cc difference is less than 2 tablespoons! Although having regrets after breast augmentation is rare, of those who do have regrets there are WAY more women who wish they went larger compared with those who wish they went smaller, so if you are concerned that your implants may end up looking too small, then just go with the larger of the two options you’re choosing between.

How long do I have to wait before a breast implant revision?

Generally patients should wait until at least 6 months after their first procedure before considering the results final however a full year is bet. If they are still unhappy at that point then it would be reasonable to consider a revision. Before 6 months the implants may still be dropping and fluffing and the scar tissue is still immature so there will be excess inflammation after the revision surgery which could definitely affect the results. If there is an acute complication then that changes everything of course and needs to be dealt with as soon as possible.

Looking to get breast implants, should I wait until I’m done having kids?

Pregnancy and breastfeeding can affect the appearance of your breasts, causing some volume loss and sagging. This is one reason why many women opt for the procedure after having children. If the plan is to have children and breastfeed in the near future, then it is probably best to wait on having a procedure to ensure lasting results. Breast augmentation procedures do not last forever and need revision after a period of time whether someone has kids or not, so if the plan is not to have children for a few years, there’s no reason not to do the procedure now. Many young women opt for the procedure to enhance the appearance of naturally small breasts and still enjoy their results after childbirth.

Should I get teardrop or round breast implants to get a natural look for a petite build?

Both anatomically shaped (a.k.a. teardrop) and round implants can give natural-looking breasts for women of all frames. The right implant has to be chosen for each woman depending on her specific body and what she is looking to achieve. “Natural look” means different things to different women so it’s important to discuss the specifics of exactly what you are looking for with your surgeon. While in theory, the teardrop-shaped implants should give a more natural appearance with the gentle slope at the upper half of the breast and a natural curve at the bottom, in practice it is very difficult to tell the difference between them in most cases once they’ve been put behind a woman’s natural breast tissue and she is standing upright. The choice of the implant must be individualized for each patient depending on the measurements of her body and the quality of her tissues, which means there is no cookie-cutter answer as to whether one of these is better in all cases.

What Are Some Common Signs That A Breast Implant Has A Capsular Contracture?

First, it is important to know that all breast implants have a capsule that forms around them as part of the normal healing process and most are not problematic. Capsular contracture is a problem, and is assessed based on several criteria and then classified according to the Baker grading system. There are four grades of severity, grades 3 and 4 usually require some sort of surgical management. Grades 1 and 2 are considered “normal” and generally do not require any treatment.

Capsular contracture is classified as follows:

  • Grade 1: the breast feels soft.
  • Grade 2: the capsule around the implant is palpable.
  • Grade 3: the capsule around the implant is palpable and visible.
  • Grade 4: the capsule around the implant is palpable, visible and painful.

Patients typically notice a capsular contracture when it starts to move from Grade 2 to 3 typically as the breast begins to feel harder and the implant actually starts to ride up on the chest. The edges of the implant may start to become visible as the capsule forces the implant into a more spherical shape. If allowed to progress then the breast will typically start to hurt as well.

Will Smoking Marijuana or Cigarettes Affect my Recovery from Breast Augmentation Surgery?

It is not recommended that you smoke cigarettes or marijuana while healing from your breast augmentation procedure. Nicotine products like cigarettes restrict blood flow and can have a negative effect on your healing process. Good blood supply is necessary for proper wound healing after your breast augmentation. It is best to avoid smoking cigarettes for several weeks after your procedure (and ideally use it as an opportunity to quit). Although marijuana does not contain nicotine, it can induce coughing, resulting in strain on the chest muscles and your incision sites. Marijuana can however be an effective pain medication so I don’t discourage its use in edible or vaporized form after surgery. This is something that should be discussed in person on a case by case basis before attempting to use marijuana as a postoperative pain medication.

Will going from 800cc to 1600-2000cc be difficult?

While it is probably technically possible to fill the implants to that size, I would strongly caution against it. The larger an implant is, the more likely you will have complications both early and late. Also, stretching your breast skin that much will guarantee that you will need multiple procedures down the road to address the sagging of the implants as well as to deal with the excess skin when you eventually have them removed (you’re not going to want these in your 90s!). Stretching your skin to that point may result in you needing something as extreme as a mastectomy to deal with the skin at that point. I would really advise you not to proceed with this procedure.

What are the effects if I keep wearing my sports bra after breast augmentation?

Wearing a sports bra following breast augmentation does not cause any problems and is typically encouraged for the first 6 weeks after surgery. At that point you can switch into any bra, but if you prefer sports bras then there is no issue wearing it indefinitely.

Do you need two surgeries for breast lift and augmentation?

Breast lift with augmentation is a very powerful and safe operation to overcome the “deflated” look many women experience following pregnancy or with significant weight loss. In my practice, I most commonly perform this procedure in a single operation. That said, there are several variables among patients that might create the need to stage this procedure into two separate operations. These include the severity of ptosis (drooping), thinness of skin and breast tissue, smoking history, and size/reshaping aesthetic goals.

I have nipple tattoos. Is there a type of breast lift that would work for me?

All breast lifts involve incisions around the areola so it is unlikely that the tattoo won’t be affected somewhat.

What exactly does under-the-muscle mean? How does the placement work?

A true total submuscular placement is rarely done for modern cosmetic augmentations, but during this procedure, the implant is placed entirely behind the pec muscle, which is left attached to the ribcage, and will stretch in time to take the shape of the implant. A bandeau usually is needed after surgery to force the implant into position while the muscle stretches. Most modern submuscular augmentations use a dual-plane pocket where the bottom of the muscle is actually released, dropping the implant into place behind the breast gland and eliminating the need to stretch out the muscle.

Can silicone breast implants last 30 years?

Breast implants absolutely can last 30 years, but it may not be wise to keep them that long. While breast implants do not have a specific ‘expiration date’, they are not considered lifetime devices and therefore should most likely be replaced every 10-15 years. These are subject to stress and strain from the repetitive movements of the arms over the years and the shell can lose integrity, so at the very least patients with silicone implants should have an ultrasound or MRI done by the 10 year mark.

How much downtime do I need after a breast lift with implants?

I would generally recommend that patients take about a week to recover from a combination mastopexy-augmentation (lift + implants). If you aren’t lifting anything heavy you may be ok to get back to work earlier, but it will be difficult to know until you’ve had your procedure and can see how you actually feel.

Can compression garments help mould the breasts following a breast lift?

Garments can’t actually mould the body but they can help to support it during recovery. Compression is good for liposuction but for a breast lift a supportive bra is usually all that is necessary. The “moulding” of the breasts will be done by your surgeon on the operating room table and there should not be much left to settle into place afterwards

How will I be able to tell if my breast implant has ruptured or if there is a problem with my breast implants?

It really depends on what type of implants you have. If you have saline then a rupture will be obvious because your breast will deflate. If your implant is silicone it will be more subtle and an ultrasound or MRI will be needed to assess the implant. If you are having other issues with your implant they will typically present with pain or a change in appearance in the breast that will prompt you to go see your surgeon and find out what is going on.

Will a mammogram give obscure results or rupture my breast implant?

If you have breast implants and are getting a mammogram then make sure to let the technician know. They will take special views of the breast to make sure they capture all the breast tissue in a way that is not obscured. Usually the mammogram will compress the breast tissue on top of the implant, so it would be very rare for a mammogram to damage an implant.

At what age do your breasts stop changing?

In general most women will reach full breast maturity between 18-20 years of age however the breasts continue to change over a woman’s entire life. In addition to age and gravity, things like pregnancy, breastfeeding and menopause will cause changes in the breasts as well.

Will having my nipples pierced cause any complications during a breast augmentation and/or the healing process?

For the breast augmentation they will have to be removed because they’ll interfere with my judgement of the appearance and if they’re metallic they can cause the electricity from the cautery to cause a burn to the nipple. It won’t cause a problem during the healing process but I wouldn’t recommend putting it back in for at least a few weeks after your surgery.

Will silicone implants make my osteoarthritis worse?

There is absolutely no evidence to support the claims that breast implants cause inflammatory diseases but the weight of large implants could impact hip or knee osteoarthritis depending on how bad it already is.

How do you shower after a breast lift?

This answer is very surgeon specific and depends on the dressings used. In most practices you will have traditional gauze bandages that get removed after about 5 days at which point you can shower. In some practices, such as ours, waterproof dressings are used allowing you to shower the next day!

Does getting breast implants make you gain weight?

Breast implants will cause you to gain the weight of the breast implants that are inserted, but should not cause you to gain any weight above and beyond that. While there will be some swelling initially after surgery that will definitely add to the number on the scale, this is temporary and will resolve with time. The only weight a patient gains should be the number associated with the volume of an implant. A 450cc implant, for example, will increase the patient’s weight by about 450g per side, so roughly 1 pound per breast.



What can I do to help prevent wound separation and skin necrosis following my Tummy Tuck?

The best way to prevent complications and ensure the most successful results from your procedure is to follow all the post-op care instructions given to you by your plastic surgeon. In the first week or two there is a risk of separation if you make certain quick movements but by three weeks into your recovery you should be relatively safe and it would be unlikely to suddenly develop a complication like wound separation or tissue necrosis. Your incisions should be almost fully healed at that point.

How long should I expect to have surgical drains after mommy makeover surgery?

Although I generally use a drainless approach to my abdominoplasties (which is the most likely place someone would have drains after a mommy makeover) surgical drains are sometimes required to help collect the excess fluid that the body wants to release into the surgical site. If the fluid collects too much, then if forms a pocket called a seroma which can have both medical and aesthetic effects. For those who do need drains, most can have their drains removed after about two weeks, although every patient is different.

How much arnica gel do I need after a BBL?

If you are massaging the suctioned areas and the areas where the fat was transferred to twice a day (as is my typical protocol) the honest answer is a LOT. I’ve personally contemplated contacting the company to see if they’d be willing to sell by the pint rather than a small tube.

Do stem cell butt augmentations last longer than a regular BBL?

This is not new science, this is new marketing. ALL fat transfers involve the transfer of stem cells that naturally live within the fat. These cells have been shown to rejuvenate the skin of the breast and face when transplanted, but in the butt it’s unlikely to make much difference to the overlying skin because of how thick it is. The secret to longevity is handling the fat properly to maximize how much of it gets a new blood supply in the area it’s transferred to so it will live there permanently. Stem cells have nothing to do with it and further “enrichment” of the stem cells is just a technique used to take more of your money for the exact same procedure. I’d suggest you get a consultation with a board-certified plastic surgeon near you who has a history of performing high-quality BBLs without having to resort to tricks and gimmicks to sucker unsuspecting patients in. Best of luck!

Can You Have a Baby After a Tummy Tuck?

You can have a baby approximately 12 months after your tummy tuck procedure if absorbable sutures were used for the tightening of the muscles. If you are planning to have children in the short term I would recommend waiting to have your procedure until after you’re done having children. If you know you are having children someday but not for a while then you could consider having a tummy tuck as long as you know a future pregnancy could stretch out the abdominal tissue once again, reversing the effects of your tummy tuck. If this occurs, a second tummy tuck procedure may be needed.

How much arnica gel do I need after a BBL?

If you are massaging the suctioned areas and the areas where the fat was transferred to twice a day (as is my typical protocol) the honest answer is a LOT. I’ve personally contemplated contacting the company to see if they’d be willing to sell by the pint rather than a small tube.

Does a BBL also widen your hips?

BBL is a very customizable procedure that can widen the hips if you want it to, or not if you don’t. The only way to know what can actually be accomplished in your specific case is to have a consultation to see what your options are. Make sure to bring in wish photos so you can best express what you are looking for and discuss what would be required to get you from where you currently are to where you want to be.

Can a breast reduction, tummy tuck and liposuction be safely combined in a healthy patient?

While each case is unique and every patient needs to be examined by a surgeon to know if they’re a good candidate, in general terms combining those three procedures is not a problem. It can safely be done in less than 6 hours which means that it would still be day surgery in Ontario.

How much weight can I lose from a tummy tuck procedure?

Although the tummy tuck is not a weight loss procedure, it can help patients lose several pounds in loose skin and tissue and take inches off their waistline. The amount of weight lost will depend on the patient and how much excess skin they have. You should not expect to lose a significant amount of weight from your tummy tuck alone. The best results will come to those who are already within their ideal weight range and suffer from mostly excess skin (not skin and fat) and are committed to maintaining a healthy lifestyle through proper diet and exercise after their procedure.

Is it safe to have a tummy tuck after a sleeve gastrectomy?

Absolutely! It is very common for patients who have had any sort of bariatric/weight loss surgery to undergo tummy tuck and other skin removal surgeries once they have lost the weight. When you have reached your goal weight and are stable for about 3 months then book a consultation to see what your options for body contouring are. Hope that helps!



Can Botox help to prevent teeth grinding?

Yes it absolutely can. Botox to the masseter muscle will weaken it enough to reduce grinding and clenching. Typically 30 units per side is needed as a starting dose but some patients require more. It is not a permanent solution so you will need to repeat the dosing every 3-6 months to maintain the results.



Is it possible to be allergic to silicone?

Anything is possible, but it is highly unlikely. Silicone is used in breast implants (and pretty much every other implantable medical device) because it is relatively inert to the body, meaning the body does not react to it. If someone is really worried about being allergic to silicone (or anything else) then a visit with an allergist should be able to help determine whether that is the case.

When can I start dieting after surgery? Do you really need extra calories for breast lift scar healing?

You do not need any extra calories for healing a breast lift scar. If you eat a well rounded diet with enough protein then you should not need to make any modifications to it for healing. Wait 4-6 weeks after surgery before starting any type of diet to ensure that your body has had enough time to heal the scars solidly. Hope that helps!

How long after surgery can I expect to have post-op appointments for?

It really depends on the procedure but I personally like to follow-up with every surgical patient for at least a year and ideally annually from that point on for as long as they are willing to come in for follow-ups. In particular, I try to have all of my breast implant patients follow-up annually so I can make sure that there are no issues with the implants or capsules.

What can I do to address the scars, if any, after my procedure?

Each surgeon will have a slightly different protocol for scar management, but in general it involves keeping the incisions clean and applying some pressure with a surgical tape in the first few weeks (steri-strips in my practice) followed by the use of a silicone based product (gel or sheeting) combined with scar massage and sun avoidance. It takes a full year for a scar to completely mature, so whatever protocol you use, make sure it’s something you can maintain for a while.