Questions & Answers

“I’m not happy, Doctor??? No Plastic Surgeon wants to hear this from a patient, but it is inevitable that a small percentage of the thousands of patients we see would be unhappy. How a practice responds to complaints may well distinguish a great practice from a good one. Why are patients unhappy? Surprisingly, it most often arises from good outcomes, as bad outcomes are thankfully quite rare. Examples (from our practice): 1. Patient seeks a more youthful appearance and facelift is recommended. Doesn’t want surgery, only injectables, despite warning that injectables like Botox and Juvederm are limited in their effect. Patient returns 3 weeks following injections, unhappy with modest effect…

The Mansierre, The Bro, Moobs- funny on television, but no man with large breasts finds the reality of this problem funny. As ‘deformities’ go, this is particularly difficult for men as it can be an afront to their image of masculinity. Gynecomastia is common among adolescents as hormonal activity and tissue responses play havoc, but generally the breast over-development subsides over a few years. For those troubled by permanent breast enlargement, plastic surgery Toronto is the answer. Surgical planning for each patient requires consideration of three tissues: skin fat and gland. Skin is a problem only if there has been massive weight gain/loss, and the resultant loose skin must be…

At the recent Toronto Aesthetic meeting, the topic of smooth versus textured cohesive gel breast implants came up for discussion. The differences between Mentor and Allergan textured implants was also debated. Studies have not consistently demonstrated the superiority of one implant over another, in part because these implants have properties that allow one implant to be better in some situations, and another implant in others.  Despite the absence of good studies, our experience and that of other top Toronto breast augmentation surgeons has been that texturing does not make a big difference in the development of capsular contracture.  Texturing does allow the use of shaped (anatomic) implants, as a smooth surface…

I performed my first labia reduction in 1994, when just a resident. Training at the University of Toronto included a 6 month cosmetic surgery rotation in which patients could obtain cosmetic surgery from a senior resident at a reduced fee. A young woman came to the clinic requesting labia reduction because she was an actress and was being offered ‘Sharon Stone-type’ roles! Since then, Labia Reduction has grown in popularity, in part driven by the opportunity for women to see images on the internet of labia different from their own. The internet has also allowed women to become aware of the availability of this procedure. Labia reduction has obvious cosmetic…

Cheek and Chin augmentation don’t get enough respect from patients, or sometimes surgeons, but a recent increase in chin augmentation requests reported by the American Society of Plastic Surgeons (and observed anecdotally in our Toronto office) is giving people some cause to reflect. There is speculation that the increased use of Skype and videophones is causing people to take a closer look at themselves, and a closer look at feature enhancement. Chin augmentation is a relatively easy procedure performed with a silicone implant through an incision under the chin. There are variations of the implants intended to mask jowls, or even create a chin dimple. Cheek augmentation with implants carries…

The American Society of Plastic Surgeons has released statistics for sugical and non-surgical procedures in 2011, and 2011’s winner for top surgical procedure is……………Liposuction! Liposuction defeated Breast Augmentation for the first time in three years, regaining its old crown! Toronto cosmetic surgery statistics generally match the American numbers, although Toronto breast implant numbers have been relatively steady as we have had access to cohesive gel breast implants for several years longer than Americans, and so the surge in Toronto breast augmentation surgery was spread over and longer time frame. Other procedures seeing increased popularity are the body contour surgeries (tummy tuck, breast lift, arm lift/brachioplasty), likely a reflection of successful…