Small Breast Implants & Breast Augmentation Trends

Dr. Frank Lista, MD, FRCSC

small breast implantsWhile it has always been our philosophy to deliver totally natural looking results, we still see aesthetic trends worldwide that come and go. When you think about breast augmentation, one of the most popular cosmetic surgery procedures globally, you’re bound to notice that certain approaches are more popular than others. This is one of the great things about getting invited to speak at conferences around the world – you really get a sense of what’s happening with patients who come from all kinds of different backgrounds. And while an oversized enhanced look will still always appeal to some, more and more women seem to be interested in small breast implants.

A recent survey by New Beauty investigated these trends across the United States, and the results are pretty interesting. Unsurprisingly, the go-big-or-go-home state of Texas reported the highest demand for largest implant size with volumes larger than 400cc being fairly standard. In southern California, southern Florida, and Las Vegas, most women tend to choose larger implants with a volume of about 350cc, which could typically equate to an increase of 2 cup sizes. In the Midwest, patients reported looking for naturally proportioned augmented breasts that look well balanced. Similarly, in New York, the trend is moving toward small breast implants in the mid-to-high 200cc range.

The increased interest in small breast implants makes sense for a lot of reasons. First of all, there’s the safety side of it. When you’re looking at very large or oversized breast implants, you’re also looking at an increased risk of certain complications. When a breast implant is very large, it’s also very heavy, and this added weight can lead to complications like displacement (sometimes referred to as “bottoming out”). Heidi Montag decided to downsize from her infamous 700cc breast implants for this reason in particular. While that’s on the extreme end of the spectrum, it is still important to note that these types of complications requiring secondary or corrective surgery are less likely with small breast implants. Smaller implants also tend to lead to a more comfortable recovery period than their larger counterparts.

Second of all, small breast implants make sense for a lot of women because they can create a really natural look while still enhancing the shape of breast. When you want results that look perfectly suited to your body, where someone might see them and assume you were born with those proportions, a lot of the time it’s a small breast implant that’s going to do the best job. For a lot of women I’ve spoken with over the years, knowing that their breast augmentation doesn’t look obvious or fake gives them added confidence. Not only do they feel great now that their body shape is more in line with their particular preferences, but they feel even more self-assured because it’s their little secret if they want it to be.

There are a lot of factors that contribute to the implant that’s right for you, not just the volume. A 250cc implant on one woman will look completely different on someone else, especially when you factor in profile, breast implant position, placement, shape, and type of breast implant. The best way to know what can work best for your body and your goals is to meet with an experienced, board certified plastic surgeon. That’s why consultations with me are always free.

Dr. Ahmad & Dr. Lista in a New Breast Augmentation Publication

Dr. Jamil Ahmad, MD, FRCSC


At The Plastic Surgery Clinic, Dr. Lista and I have extensive experience performing breast augmentation surgery as well as revisional (secondary) breast surgery. We are committed to education and research to advance the art and science of plastic surgery. Most recently, we were asked to contribute to the textbook Problems in Breast Surgery: A Repair Manual published by CRC Press. We were invited by the editors, Dr. Jack Fisher of Nashville, TN, and Dr. Neal Handel of Santa Barbara, CA. This new textbook is a unique resource for plastic surgeons that perform both aesthetic and reconstructive surgery of the breast – while many textbooks deal with how to perform the first (primary) surgery, this one deals with what to do when things don’t work out as planned. This 834 page resource provides detailed approaches to address suboptimal aesthetic outcomes and postoperative complications for a range of surgeries including breast augmentation, breast reduction, breast lift, and breast reconstruction. Many cases are described and the strategies that were used to correct the problem to result in the best possible outcome for the patient.

Given our extensive experience performing breast augmentation with anatomic (shaped, teardrop) implants published in a journal article in the August 2013 issue of Plastic and Reconstructive Surgery, we were asked to write several chapters on how to address complications after breast augmentation surgery with textured, anatomic, cohesive silicone breast implants. In one of our chapters, we discuss how to treat a late seroma after breast augmentation. A seroma is an abnormal fluid collection that can occur in the body and can, albeit rarely, occur around a breast implant. In another chapter, we describe a strategy to correct rotation of an anatomic implant. While a round implant has a diameter that is the same in both vertical and horizontal dimensions, an anatomic implant has a height and a width that are different. At the time of surgery, an anatomic implant must be correctly oriented to provide the best possible appearance of the breast. Infrequently, an anatomic implant can rotate requiring repositioning to the correct orientation.








Dr. Lista and I take great pride in contributing to great educational resources such as Problems in Breast Surgery: A Repair Manual as the ultimate result of sharing our knowledge and experience is improving outcomes and results for patients having plastic surgery.

Dr. Lista and I have performed a significant number of both primary and revisional breast augmentation surgeries at The Plastic Surgery Clinic. We use a patient centred approach to identify your concerns and goals to help decide what surgical approach and type of breast implant would give you the best possible result.

Liposuction Essentials: What is VASER Liposuction?

Dr. Frank Lista, MD, FRCSC

ultrasonic liposuctionNow that we’ve covered tumescent liposuction, I thought it would be a good idea to talk about another popular name that’s associated with body contouring. When patients come in for consultations about liposuction, a lot of them want to know: what’s the deal with VASER Lipo?

Essentially, VASER Liposuction is a trademarked form of liposuction that uses ultrasonic technology. Ultrasonic liposuction uses a very particular type of crystal (known as piezoelectric crystal, to be exact) to convert electric energy into rapid vibrations (ultrasonic vibrations) and heat energy. With the help of a specialized cannula, the vibrations and the heat are used to emulsify or liquefy fat cells. After this process is complete, a suction cannula is used to remove the liquefied fat. The name VASER is simply an acronym that stands for Vibration Amplification of Sound Energy at Resonance, a fairly basic description of ultrasound-assisted liposuction technology in general.

For a while in the mid 80’s and 90’s when ultrasonic liposuction was first introduced to the market, a lot of plastic surgeons either stopped using it or refused to consider using it in the first place because of its unacceptable incidence of complications and higher associated risks. Typical complications were things like burns caused by high levels of ultrasonic energy – an absolutely unreasonable standard of patient care. It was a no-brainer. We weren’t going to use this technology until it met the highest safety standards possible. If we can’t rely on something to deliver predictable, natural results in a safe way every time, we’re happy to forget about it.

Thankfully today we have what’s known as 3rd generation ultrasound-assisted liposuction and VASER Liposuction is a member of this category. This generation of technology employs a lower level of ultrasound and was specifically engineered to eliminate the problems associated with early ultrasonic liposuction. With less energy, smaller cannulas, and better distribution of energy at the cannula tip, we are able to achieve excellent extraction where the fat cells are the ones that are disrupted instead of blood vessels, nerves, and connective tissues, making the process less traumatic. This is what makes ultrasound-assisted liposuction especially good for treating particular areas of the body that are more fibrous like the upper back area. That being said, it’s not always the most effective solution for every part of the body. It’s really important that we work together during the consultation process to come up with a plan that will work best for your particular needs and goals so that we can give you the best results possible.

The bottom line is, VASER Lipo is to ultrasound-assisted liposuction as Kleenex is to tissue. It’s a recognizable brand name, but that doesn’t mean it’s the only thing that can do the job or do the job well. Without a doubt, the only real guarantee for a job well done is a highly experienced and exceptionally skilled plastic surgeon.

Meet Jenny, Our Injection & Non-Surgical Specialist

Jenny RNWe are so excited to introduce the newest member of our medical team, our injection nurse Jenny. She has extensive experience performing several non-surgical procedures, including injections for wrinkles, injectable fillers, laser treatments for skin, laser hair removal, and peel treatments. She began her career as an RN at the Trillium Health Centre and trained to become a cosmetic injection specialist. With more than five years of experience in this field, she now works with us as a full time cosmetic RN injector.

As with all of the nurses who work at The Plastic Surgery Clinic, Jenny has undergone a rigorous training process to ensure that she meets the strict guidelines and high standards set by Dr. Lista and Dr. Ahmad. This is an impressive distinction made possible by her impeccable skill and considerable experience – she is definitely one of the best. Now that she’s part of our team, she works under the direction and guidance of our head nurse injector, Diane, to deliver beautiful and natural looking results in the safest manner possible.

Thanks to the addition of Jenny’s amazing work, we are now able to respond to your appointment requests more quickly, shortening wait times to make sure that all of our patients receive the non-surgical treatments they want when they want them. Injections and fillers are in high demand and always gaining popularity, and with good reason. They are able to accomplish such a wide range of results and can be delivered with little to no down time.

It seems like we are discovering new uses for injection treatments all time; not only do they smooth wrinkles on the forehead and around the eyes, but they can also be used to target the brow to create an eyebrow lift, or to improve a “gummy smile” where too much of the gums are exposed when smiling. And we’re seeing beautiful results with dermal fillers all the time with such a wide range of applications. They’re great for restoring lost volume around the mouth or in the cheeks, but they can also augment shape and volume in the cheeks, chin, lips and more for those who want a subtle boost to their facial appearance. When it comes to those tricky smile lines around the mouth (also known as nasolabial folds or marionette lines), dermal fillers can go a long way to reduce the deeper creases that develop with age. Perhaps best of all, injections and fillers can be used in combination to create a rejuvenated facial appearance using a holistic approach. With that combination, you can take advantage of a more refreshed, youthful appearance that looks perfectly natural and balanced to the proportions of your face. Working together, they solve a wide range of concerns caused by the aging process and can be totally customized to your specific needs.

Jenny is available for appointments at both our Yorkville and Mississauga locations. We hope you can meet her and get to enjoy working with her as much as we do!

For more information about the brands we use for injections and fillers, call us toll free at 1-866-803-6415 or visit

Why Aging in Hollywood is a Game No One Wins


  • Mother and son, apparently.


When Kim Novak took the stage at the Oscars this year, the media took notice. They didn’t pay attention because of her award-winning career, including her famous and impressive performance in Vertigo in 1958. As the headlines explained the next day, their attention was drawn to the “shock” of seeing her face. Pictures of the 81 year-old actress were all over entertainment news sites and gossip blogs with accompanying articles declaring that she had had too much plastic surgery, or that she had had the wrong kind of plastic surgery, and that the way she had chosen to manage the aging process was somehow wrong, one way or another. Novak eventually posted an open letter condemning the insults, explaining that every person has a right to do what they’re comfortable with to look as good as they can.

But when you look at the way women over 30 are treated in Hollywood, is it any wonder that they feel compelled to go to any length possible to maintain a younger appearance? A recent blog post from New York magazine revealed an incredible disparity between actors and actresses, paying particular notice to the inappropriate age gap for women cast in the roles of mothers. Once women in Hollywood reach a certain age, it seems as though they’re re-categorized under an ambiguous umbrella simply understood as “old” and are often relegated to “mom roles” alongside actors who are sometimes less than a decade younger than they are.

In the new move Tammy, for example, 67 year-old Susan Sarandon stars opposite 43 year-old Melissa McCarthy. The 24 year age difference between the two could make sense for a mother-daughter pair. In this case Sarandon plays McCarthy’s grandmotherAllison Janney, the 54 year-old actress who plays Tammy’s mother, is only 13 years younger than Sarandon and 11 years older than McCarthy. As Kyle Buchanan explains, the absurd hypothetical male equivalent would work if “the 34-year-old Jason Segel starred in a comedy … where his father was played by the 48-year-old Ben Stiller and his grandpa was played by the 57-year-old Tom Hanks.”

In Forrest Gump, Sally Field is barely 10 years older than her onscreen son Tom Hanks, who played her romantic interest in a film earlier in her career. In 2009′s Star Trek, Winona Ryder is a mere 5 years older than the actor who plays her son. Unbelievably, in Oliver Stone’s Alexander, Angelina Jolie plays Colin Farrell’s mother, despite the fact that they were born one year apart in real life. If the actor who played Farrell’s father had been born in the same year as Jolie, hypothetically Bradley Cooper could have filled the role. Can you imagine a scenario in which it would seem believable or reasonable for Bradley Cooper to play Colin Farrell’s father?

We’re lucky that we’re not stuck with the precedent set by casting directors. When there’s such an immense pressure to stay as young as possible as with the entertainment industry, it’s not surprising that women feel like they have to take drastic measures and opt for unnatural looking cosmetic treatments in order to do so. We feel fortunate to live in a cultural climate where we can propose a different approach to anti-aging and advocate for a philosophy focused on natural looking results. We understand the importance of realistic expectations; it’s important to recognize that there is no way to stop the clock entirely. But what we can offer is a wide range of techniques, from non-surgical treatments to more long-lasting anti-aging procedures, that address the visible signs of aging to create a refreshed, rejuvenated appearance. We want our patients to look like themselves at their best – not like an impossible youthful standard.