Anesthesia for Breast Augmentation

anesthesiologist breast augmentationOne of the top concerns for patients undergoing any type of surgical procedure has to do with general anesthesia. When I meet with women who are interested in breast implants, naturally we have a lot to talk about during the consultation process. From how to choose the right breast implants, to potential risks and complications, we talk about it all. When it comes to overall safety, there’s still one question I hear time and time again: is general anesthesia safe with breast augmentation?

The short answer is of course yes. Unless you are at a higher risk due to issues like smoking, obesity, allergies, or significant kidney, lung or heart problems, anesthesia is really very safe for patients. For the big procedures I’ve been performing for over 25 years like breast augmentation, tummy tuck, and rhinoplasty, thousands of patients at The Plastic Surgery Clinic have been put under general anesthetic. If it wasn’t a safe way to conduct surgery, it’s not something that we’d even consider offering. It’s just that simple.

During a breast augmentation operation, patients at The Plastic Surgery Clinic always have a board certified anesthesiologist by their side. This highly trained doctor administers the anesthetic, stays with you throughout the entire operation, and is there to continue monitoring you as you wake up. They will monitor your vital signs and make sure that the concentration of oxygen, carbon dioxide, and anesthetic drugs you are breathing in and out are at the right levels. They’ll also continually monitor your levels of consciousness by paying close attention to your electrical brain activity and by conducting in-person clinical observation. This way there’s always someone making sure that you’re completely comfortable, completely asleep, and completely safe every step of the way, from the operating room, to the recovery room.

breast implants anesthesiaThe other benefit of having an anesthesiologist in the operating room is that I can put my full attention towards creating the best result possible during surgery. Since I only work with the best doctors in Toronto and Mississauga, I know that I can trust them completely with your safety. It allows me to focus on creating a beautiful and natural looking breast and lets me concentrate on achieving all the goals we talked about during your consultation. In the end, you get the highest level of care and the best results possible, and really that’s what we strive to deliver to our patients every time.

A lot of people have fears about going under anesthetic, but statistically speaking, the risk isn’t in line with the worry. If you have concerns about this and about types of anesthesia used during breast augmentation, I’d love to discuss it further with you during a free consultation.


How to Choose the Right Breast Implant Size

best breast implant sizeThere is probably no other plastic surgery procedure that gives you as many choices as breast augmentation. If you decide that breast implants are right for you, you’re at the beginning of a long process of decision-making. Choosing between silicone and saline implants, under-the-muscle and over-the-muscle placement, incision placement near the breast or in the armpit… it can seem overwhelming at the start. But it doesn’t have to be!

Today, let’s talk about one of the biggest questions all of my breast augmentation patients ask: how do I choose the right breast implant size? Most of the patients I meet want to end up with a result that looks really natural, so when we work together to find the right breast implant for their body, we’re really looking to achieve a balanced proportion where it looks like she was born with that shape—not something obvious or fake-looking. Basically we want our patients to get noticed for their confidence, not for their breast implants. So when we talk about choosing the right breast implant size, we’re really talking about choosing a customized size for every woman that’s going to be big enough create a nice enhancement, but not so big that it looks unnatural.

We want you to be able to get an idea of what a given breast implant volume will look like with your body type, and that’s why we use special digital imaging software during our free consultations. We also use a range of implant sizers with a sports bra so you can get impression of the look and feel of different implant volumes. These approaches are great insofar as they help you to visualize what some number like 350cc looks and feels like in real life. At the same time, these demonstrations only give you an idea of what your outcome might be like, and it can be hard for a patient to accurately predict an end result, especially factoring in other implant characteristics like profile, shape, and placement.

Here’s where choosing the right plastic surgeon for your goals is so important. A highly qualified, experienced plastic surgeon has the right amount of knowledge and practice to understand how all of the factors of breast augmentation come together to achieve a great result. If they understand your goals and you feel that their outlook is in line with what you want for yourself, they will be able to guide you toward a breast implant volume that’s right for you. At our clinic, our philosophy is all about what looks natural. If a patient doesn’t want a natural looking result, then I advise them that I’m not the right surgeon for their procedure. I give my patients a range of sizes that will work for them based on their breast width, but I won’t let them stray beyond the range I’ve suggested. This way my patients still have a say in the decision-making process, but it’s guided by over 25 years of plastic surgery experience.

So what’s the bottom line when it comes to breast augmentation and volume? To choose the right breast implant size, the most important thing is to choose the right plastic surgeon who understands your goals and your needs.


Types of Breast Implants: Textured vs. Smooth

types of breast augmentationIf you’re considering breast augmentation and you’ve begun to research your options, you’ve probably discovered something important: when it comes to choosing the right breast implant for you, there are so many different factors to consider. Differences between cohesive gel silicone and saline breast implants are fairly commonly known, and after that you likely start looking into volume, projection and implant shape. But did you know that there are different textures for different types of breast implants as well?

The outer shell of a breast implant—whether it’s cohesive gel silicone or saline—can be perfectly smooth or rough and textured, kind of like velcro. Texturization was introduced for a couple of different reasons. When we use a teardrop shaped breast implant, for example, then we need that texturization to help keep the implant in place. Whereas the movement of a round breast implant likely won’t cause any abnormalities, if a teardrop or anatomical shaped implant moves around beneath the breast tissue, that particular shape won’t be able to stay in the right position. We don’t want our patients to have oddly-shaped, unnatural-looking breasts, so we use a textured implant with that velco-like shell to prevent it from moving around too much while still giving a natural look and feel.

The other reason texturization was invented was to help reduce the risk of capsular contracture. Capsular contracture is a complication that very rarely occurs in breast augmentation. The body forms scar tissue around the breast implants, which causes it to feel hard. It’s not the breast tissue, and it’s not the implant, but rather it’s the scar tissue that your body forms around the implant that creates this feeling. Plastic surgeons everywhere take every precaution to prevent this complication from happening with our patients, because we know it doesn’t let your breasts look and feel as natural as they should. What we discovered through significant research is that textured implants can help reduce the risk of capsular contracture.

But there’s a catch. Texturization can reduce this risk, but only when the implant is placed above the muscle. When we place the implant behind the muscle, studies show that no matter what texture you use, the rate of capsular contracture will be about the same. In that case, you always go with the implant with the lowest overall complication rate, and that’s a smooth implant.

Whether to place the implant above the muscle or behind the muscle is based entirely on what’s right for you, your goals, and your body type. Modern breast implants have been invented and designed for exactly these types of reasons. There is no standard best choice of implant that will work for everyone, but there is a best type of breast implant that can be perfectly customized to you.


Haiti: From Earthquake to Surgical Relief Mission

Haiti Child PatientIt’s an anniversary we won’t soon forget, and another milestone for a nation. January 12th of this year marked the 5th anniversary of the devastating earthquake that struck Haiti in 2010. It’s hard to believe that it’s been five years since that disastrous event, which took the lives of far too many and left hundreds of thousands of others with incomprehensible injury and untold sadness. Broken limbs, wounds, lacerations, and infections demanded immediate and highly skilled attention—demand that could not be met by a country reeling from this level of devastation. The earthquake was a disaster where the injured needed plastic and reconstructive surgery at a level never seen before.

It’s even harder to believe that it’s been almost five years since a team from The Plastic Surgery Clinic arrived in Port-au-Prince for a week long mission. Our team set out to continue the debridement, skin grafting and reconstructive procedures performed by the previous volunteer surgeons. The line of patients who needed attention was never-ending, their suffering incomprehensible, and their strength in the face of hopelessness unbelievable. The experiences from that week in mid-February have stayed with each volunteer every single day since their return. It’s not just that you can’t forget such an impactful experience. It’s that you owe it to those who lost their lives to remember, to move forward, and to continue the hard work wherever there is suffering.

That’s why we’re so glad to continue working with Artists for Peace and Justice. This incredible organization supports long-term, sustainable development in direct partnership with the Haitian people. They believe in empowering local communities, fostering economic growth, and the power of education to change a nation. They provide education, scholarships, healthcare, and other fundamental resources to a country where more than 50% of the population still lives in extreme poverty.

Haiti has come a long way since the earthquake five years ago, but there is still so much work to be done. You can contribute by donating to APJ, an organization that follows a 100% policy. Every single publicly-donated penny donated goes directly to programs in Haiti. The need for long term commitment is essential in order to create true change, and APJ is wholly committed to the ongoing project of empowering a new generation of Haitian leaders who will continue to help Haiti rebuild to become stronger than ever before.

To find out more on the 2010 Haiti Relief Mission, read Dr. Lista’s personal journal from the trip:

1.) We’re Going
2.) Our Journey Begins
3.) From Texas to Haiti
4.) Entering a New World
5.) Utter Chaos
6.) The People


New You for the New Year: Freeze Your Fat Away

CoolSculpting New Year's ResolutionFor many people, the arrival of the new year means time for reflection and time to set new goals. Last year, 62% of the general population made New Year’s resolutions according to the Journal of Clinical Psychology. When you look at how many people were able to achieve their goals, the results are a little dismal. Only 8% of those who made resolutions managed to keep them. So what are some of the options that are available to help give you a boost and set you up for success?

The resolution that tops the chart every year is always (you guessed it) weight loss. I would divide this group into two categories: those who have seen minor weight gain slowly accumulate over the years and now find themselves at a slight distance from their healthy goal weight, and those who are more significantly overweight and find that they’re endangering their health and well-being.

Today I want to talk about the most common of the two by far, the first group who wants to lose some weight but not a significant amount. What’s great about being in this group is that, by adjusting your lifestyle to focus on eating reasonable portions of healthy food and staying as active as possible, slowly but surely you’ll almost definitely drop those extra pounds. You don’t need to follow a fad diet, you don’t need any gimmicky exercise equipment, you just need an attention to creating a good balance. If you feel like you need some additional guidance, there are tons of great free apps out there that can help you in this department.

The place where many people seem to need the most help is with that last little bit of fat that just won’t go away—when they hit the dreaded plateau. You get so close to your goal weight but still you have these little pockets of stubborn fat that don’t respond to diet or exercise. We’re talking about love handles, paunches, spare tires, bra rolls, and any other unwanted bulges. When you’ve worked hard and done everything right, these persistent fat cells that interfere with your new look can be so discouraging. They’re frustrating, and they can make you feel like giving up on the healthy changes you’ve made.

Here’s the good news: we can get rid of that fat, and we can do it without surgery and without downtime. CoolSculpting is our favourite new non-surgical body contouring treatment. It’s an amazing technology that targets and freezes fat cells and allows your body to naturally eliminate them in the weeks and months that follow. The procedure itself is safe, cool, and effective. The device applies controlled cooling to the desired area of fat reduction while you lie back and relax. Many patients are so comfortable they enjoy reading, checking email, or even taking a nap. And as GQ magazine recently reported, men are really loving what this treatment can do for them too.

Some patients start to see results as little as three weeks after treatment, though the most dramatic results tend to be apparent after about two months. If you maintain your healthy lifestyle, your newly sculpted results are essentially permanent. Wouldn’t it be great to achieve your New Year’s resolution and never have to worry about it again?