The Increasing Popularity of the Buttock Augmentation Procedure

butt augmentationDr. Frank Lista, MD, FRCSC

When the American Society for Plastic Surgeons released their latest statistics for cosmetic surgery procedure trends in 2013, there weren’t too many surprises. Breast augmentation and liposuction remain the most popular surgical procedures for the body while rhinoplasty continues to lead the field of facial surgeries. Another unsurprising result? The procedure with the highest percentage change between 2012 and 2013 is the buttock augmentation procedure. The number of buttock augmentation procedures performed last year rose by over 16%, an increase that would seem to me to be consistent with the number of patients who come in for free consultations at The Plastic Surgery Clinic because they want to know more about it.

So what makes the buttock augmentation procedure so popular? It’s probably important to note that there are 2 methods for reshaping the butt. One option is the insertion of soft silicone implants to improve the shape of the behind, which can work well for different kinds of body types and is particularly good for patients who don’t have very much excess body fat. Perhaps because it’s a more surgically invasive procedure, it’s not seeing the same increase in numbers as its counterpart, the Brazilian Butt Lift. Known as BBL for short, this method uses a fat grafting technique to reshape the curves of the lower body, and this is probably why it continues to be more and more popular.

The first part of fat grafting requires liposuction on areas of unwanted fat from around the body. Stubborn pockets of fat are removed from popular areas like the tummy, thighs, and hips, which has the added bonus of contouring areas around the buttocks to really emphasize the hourglass shape we are creating. Once this tissue has been collected for remodeling, it is carefully and meticulously prepared for reuse. We are incredibly thorough in this part of the process because it’s integral to a successful result. Then we’re able to re-inject the fat into precise areas of the behind to achieve a buttock augmentation that meets the specific goals of the patient. This allows me as a surgeon a really high level of control in achieving the desired shape. Unlike with an implant that leaves a bit less room for customization, with the BBL technique I can carefully inject fat into various different locations around the buttocks to create a natural looking result that is perfectly suited to the proportion of each individual’s body.

Patients love the BBL method because it leaves little to no scarring, no large incisions are needed, and the material used is completely natural. Since it’s less invasive, recovery time is shorter and the risk of complications is lower. Our buttock augmentation patients get to enjoy the benefit of removing fat from an undesirable area while simultaneously augmenting the shape of an area they’d like to emphasize. One happy patient put it this way when explaining why she loved it so much: “it’s all me, but rearranged into the right places!”

We are all about delivering natural results that create that born-with-it look. In that respect, it doesn’t get much better than hearing a patient say “it’s all me” after everything’s said and done.

Breast Implants for Athletes: What Women Need to Know

The PSC Staff

breast implants for athletesA great blog post by Dani Shugart, published author and physique competitor, has been making the rounds lately and once we read it we knew it was worth sharing. She writes all about the topic of breast implants for women who lift weights and build significant upper body muscle. Quite a few of our patients over the years have been bodybuilders, physique competitors, or professional fitness models, and it’s not uncommon for others to fall somewhere along the athletic build spectrum. Women come in all different shapes and sizes, and it’s important that those who fit into a more muscular category know what options they have outside of the gym to build the body they want.

But to be clear, that’s only if it is in fact what they want for themselves. One thing that makes Shugart’s post particularly important is her emphasis on the fact that “women can have amazing, sexy bodies even without bigger breasts. The way she feels about that body is what really matters.” Her story is so valuable because of her understanding that this was the right decision for her life and for her body. She spent a significant portion of her life feeling like her body was mismatched and out of proportion. Not every woman feels this way, and breast augmentation is not the right decision for every woman. But for women like Shugart, who consider their options carefully, have reasonable expectations, and meet with board certified plastic surgeons to make sure they have all the information they need, the decision to get breast implants can be made with confidence, comfort, and certainty.

So here are some suggestions and important information for women who train and are interested in breast augmentation.

1.) Talk to your doctor about your fitness routine. 
When fitness is important to you, it will factor into your recovery period and your life after breast augmentation. It’s really important to be on the same page about your lifestyle and your goals. Being upfront with your surgeon will allow you to work together to create a plan that can get you back to your favourite physical activities within a timeframe that makes sense for you while also ensuring that your body has enough time to heal itself and recover safely.

2.) Exercise needs to be limited during recovery, but you won’t be off your feet forever.
Recommendations at The Plastic Surgery Clinic for recovery after breast augmentation allow for gentle exercise after 2 weeks. Our plastic surgeons generally recommend waiting one month before returning to upper body workouts, running, and high impact exercise. When your body is healing after surgery, it’s working to repair itself in a similar way to when you are injured. Think about how you would adjust your training if you sustained a significant injury and remember that recovery is a gradual process. You’ll likely be able to return to your regular routine sooner than later, but carefully following the advice of your plastic surgeon for your particular situation is always the number one recommendation.

3.) Over the muscle or under the muscle? There’s no one-size-fits-all solution.
Breast implant placement is a very common concern for women who train. Placement under the muscle can create a more natural looking shape for leaner women who don’t have a lot of breast tissue to begin with. One disadvantage is that intense movements of the pectoralis muscle can cause the implant to move at the same time, creating a look that some women dislike (though it only occurs during intense exercise of these muscles, as with bench pressing). Women who have more breast tissue to begin with can have natural looking results with an implant placed over the muscle, but this is a more rare circumstance for many of our athletic patients. Every body is different. To know which placement is right for you, come see us for a free consultation.

If you’d like to learn more from an insider’s perspective on the experience, definitely give Dani Shugart’s excellent blog post a read.

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.