Cosmetic And Reconstructive Plastic Surgery
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Choices in Breast Implant Surgery in Toronto

How do you obtain the best result from breast implant surgery?

There is no unanimous choice for the best breast implant, best surgical approach, or best plastic surgeon, but there will be a choice that is best for you. The most important decision you must make is your choice of plastic surgeon, and then work together with your surgeon to find the best operation for you.

What follows is a description of the different issues you will need to consider when you come in for consultation, and your familiarity with these topics prior to consultation will allow you to be more confident in making a decision about surgery.

Implant Type

Saline Implants: A silicone shell containing salt water, these implants are limited by an unnatural feel, and visible ripples can be a problem, especially if you have low body fat. Deflation of the implant can occur, which would require further surgery, but this is not a common problem. Saline implants are commonly used for axillary augmentation, because they can be inserted through a small incision and inflated once they are in position.

Cohesive Silicone: The use of ‘cohesive’ silicone avoids the problem experienced with liquid silicone implants, in which the silicone would leak outside of the implant. Cohesive Silicone implants can be made form-stable or anatomic, to create a less rounded, more natural appearance. The shell of cohesive implants can be textured to hopefully decrease capsular contracture, and texturing is used to keep shaped implants from rotating or displacing over time. If you are looking for a more rounded appearance, then a round textured gel implant may be best for you. Smooth cohesive silicone implants are good for revision surgery where there is already a big pocket, and can also be used for augmentation by the axillary approach.

Implant size

Should you go too big or too small? You should decide which error would make you more upset, as there is no size that will be perfect in all situations. Choose the size you want to be when you are naked, because you can always wear a padded bra to make yourself bigger when clothed. A too big implant is more likely to be trouble, as it is more painful surgery, it is more likely to cause wound complications, it can contribute to back pain, it is harder to hide behind clothing, and it will compress your natural breast tissues and leave you with saggy skin if you later choose to remove your implants or simply go smaller.

Implant Manufacturer

Canadians are fortunate in that the Poly Implant Prosthesis (PIP), a breast implant from France, was not sold in Canada, as they have been found to be flawed. The current manufacturers supplying Canada, Mentor and Allergan, both make a good quality implant that has stood the test of time. Ten-year studies have confirmed these implants do not decay over time. There is little to choose between Allergan amd Mentor saline implants, but the Allergan cohesive gel implants are favoured by some because they have less rippling than the Mentor implants.

Over vs. Under vs. Dual plane

Implants positioned over muscle allow quick recovery, and avoid any impact on muscle function (important for performance athletes), but problems like capsular contracture are more obvious, and implant ripples will show unless there is already substantial breast tissue. Implants under muscle (through an axillary approach) sit high on the chest but can be the best option for young patients. Dual plane positioning is our commonest option, with the upper part of the implant covered by muscle to control implant position and hide ripples, and the lower part of the implant positioned for ideal cosmesis under gland alone (surgery demonstration).

Incision Site

Areolar or nipple incisions can hide well in some patients, but a bad scar will be very conspicuous, sensation and breast feeding will be affected, and exposure of the implant to bacteria is more likely. Inframammary (in the breast crease) incisions are best except when patient has very small breasts and the augmented breast won’t hide the scar. Axillary augmentation is ideal for the young, A-cup who has never had kids, because the the axillary scar can be imperceptible, and the high position on the chest wall of a submuscular implant will not be an issue.

Local vs. Travel

Most patients who travel to visit a surgeon do well, but always consider the small possibility that you may develop complications and need further care and possible surgery. The distance you must travel to see your surgeon may compromise your care, and ultimate outcome.

Surgeon

A surgeon who is good at nose jobs is not necessarily an expert at breast augmentation. Word of mouth from a satisfied breast augmentation patient can be useful. Unfiltered message boards (e.g. ratemds.com) are a very good way to see if breast augmentation is a specialty of a surgeon, and you should be cautious in choosing a surgeon who has lots of negative comments.



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sahand davari
sahand davari
2024-01-15
Amazing experience. The doctor and staff were readily available at a moment's notice and always willing to answer any questions day or night. Everything went smooth from start to finish, and I would proudly recommend Dr Kreidstein to a friend.
K yaldo
K yaldo
2024-01-06
It's been 8 months since I did my gynecomastia surgery here and the results are amazing. Dr. Kreidstein treated post op scar tissue and made sure I was happy with the results, and honestly you can't even tell there has been in incision around the areola.
Christine Jehlickova
Christine Jehlickova
2024-01-05
Dr Kreidstein stepped up and helped my son. He was amazing at giving us confidence we were making the best decisions and the results have been life changing.
Anne Wright
Anne Wright
2023-11-22
I had a very positive experience with Dr Kreidstein and his staff. The results were exactly what I wanted. I am very happy with Dr Kreidstein’s work and would willingly recommend him to others.
Ashley M
Ashley M
2023-11-10
Love , love , love my results- Dr Kreidstein and his staff are terrific . His gifted hands ,eyes of an artist , skill , calm and experience is unmatched. It’s all about u from the moment u see him . He listens and ensures you get what u want . Your happiness makes him happy . I would recommend Dr Kreidstein 💯.
Jane D
Jane D
2023-11-07
Intelligent, compassionate, professional, conscientious and creative are all words I would use to describe Dr. Michael Kreidstein. This surgeon has extensive experience and it is very evident. Recently, I underwent a breast lift/reduction and abdominoplasty with fascial plication. Each team member at this clinic go above and beyond to ensure that every patient has a great experience. I was very nervous the day of my surgery but after meeting with the surgical team I felt more relaxed and knew I was in good hands. After I woke up from surgery, I had the most lovely, young RN looking after me in recovery. I could not have had a better surgical experience. I am now three weeks post op and I can honestly say that the results of my surgery have exceeded my expectations. Plastic Surgery is not just a science, it is an art too. Dr. Kreidstein has a very good sense of what is aesthetically pleasing and is able to work his magic on his canvas, the patient. The team at this clinic are committed to excellence. I would highly recommend this surgeon to anyone.
Tom Murray
Tom Murray
2023-10-24
Dr Kreidstein and his staff were polite, professional and fully attentive to my needs from Day 1. I was tentative about cosmetic surgery (and getting umbilical hernias fixed as well). This doctor's caring and thorough approach made me feel relaxed and confident that he was the best person for the job. Everything gets done in his own 'in-house' clinic, so organization, familiarity and reasonable work is all a given. I completely recommend Michael Kreidstein to anybody in need of surgery.
John Uselton
John Uselton
2023-10-04
Dr. Michael Kreidstein is a plastic surgeon extraordinaire! His expertise and meticulous approach left me in awe of the results. Such an ultimate choice for natural and stunning transformations.
Livia Mattacchione
Livia Mattacchione
2023-09-28
Dr. Kreidstein was able to allay all my concerns of the abdominoplasty procedure I needed. I had thought about it for many years, postponing it because of life and living. I felt I could live with the old scars and some discomfort that evolved over time. It was not an easy decision for me. Once meeting with Dr. Kreidstein, he asked me the questions I needed to answer not only to him but for myself. He answered all my questions, and he thoroughly discussed the procedure. I knew I was in good hands with Dr. Kreidstein and his team, and staff. I will say Thank You to all of you, though the words will never express the relief and satisfaction I feel of having followed through the with procedure. Thank You, Dr. Kreidstein, Team, Staff :)
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