With hundreds of different implants to choose from, the breast implant selection process can seem daunting to some patients. The feedback we get from our patients is that they feel very well-supported, from the time they contact the clinic to book an appointment, picking their implants, and through the surgery process. Our consultation differs from many other clinics in that the fellowship-trained plastic surgeon, Dr. Andrade, provides a thorough in-person appointment (averaging 45 minutes in length). We caution against making such an important decision after only having a virtual appointment or speaking with a “consultant” who is not an actual surgeon. Getting the same quality of advice with this type of appointment is impossible.
Patient safety is always the most critical priority in any surgical procedure, so the first step is to fully review the person’s overall health and understand any issues that might adversely affect surgery or healing. It is essential to rule out breast cancer, mastitis or other breast problems.
Patients Goals for Surgery
The next step is to understand the patient’s goals for surgery. Some people wish to have a subtle difference in size, while others want a major difference or even an obviously “augmented” look. It is just as important to discuss the desired shape, be it very high and full, or more natural and “teardrop” appearing. Patients will often bring wish photos to the consult, which can be very helpful when discussing desired outcomes. It is much more helpful to look at actual before-and-after surgical images of patients with a body type similar to yours than simply bringing in photos of models or actors.
Breast Examination
A proper breast examination is then performed which includes skin tone, issue thickness, any asymmetry, sagging (ptosis), lumps, and breast measurements. One of the most important measurements is the base width of the breasts, as this enables the surgeon to recommend implants that properly fill out the breasts without being too wide. Excessively narrow implants will not provide enough cleavage and can look like obvious mounds stuck in the centre of each breast. On the other hand, implants that are too wide can lead to many problems like obvious rippling in the “side boob” area, or an abnormal skin bridge between the breasts (synmastia). This is why Dr. Andrade feels that a video consultation is inadequate for patients seeking breast augmentation surgery.
After the breast examination is done, Dr. Andrade discusses the different breast implants available in Canada. At the end of the discussion each patient will know the following:
- Textured, shaped implants versus smooth round implants
- Pros and cons of saline versus silicone-filled implants
- Different silicone implant gel thicknesses and how they might affect the outcome (some implants are very soft and pliable, but others are much firmer and rounder
- Implant shape / profile and how this affects the final result (low, moderate, high, full profile implants)
Although there are literally hundreds of different implant brands, types, shapes and sizes, Dr. Andrade helps each patient cut through all of this information and narrow down their options efficiently. In Dr. Andrade’s practice the vast majority of patients choose smooth round silicone gel implants in either moderate or full profile. However, every person’s unique body type and goals are considered in the implant selection process.
Certain patients will be offered a 3D photo of their breasts, which enables virtual before-and-after results to be generated. This technology is most useful when done on patients with a smaller, “perkier” shape. Those patients with sagging or a large fold under their breasts will not get a useful image, because the device needs to “see” the entire breast surface in order to model it properly. Although this technology provides additional information how one’s breasts would change with breast implants inserted, it is still just a computer’s estimate. It is never claimed to be an exact prediction of the surgical outcome, or relied upon to make the final surgical decision.
More important than 3D imaging, is the opportunity to actually try on breast implant sizers while wearing an unpadded surgical bra. In Dr. Andrade’s opinion this is probably the best way to get a sense of your final size with breast implants inserted. Of course, the implants will sit differently when they are actually inside the breasts, but the patient will get to experience their actual size and weight on their body. All patients who book surgery are encouraged to come for a second, complementary breast implant sizing appointment before making their final decision.
Breast augmentation surgery is a major focus of Dr. Andrade’s practice and we have one of the top clinics in Ontario by number of procedures performed, as confirmed by our breast implant supplier. Given Dr. Andrade’s reputation as a breast implant expert, it is not surprising that he is one of the top-rated plastic surgeons on websites such as as RateMDs, Realself, and Google.
Disclaimer: This information is meant for Dr. Andrade’s patients and to supplement an in-person consultation. Medical science is constantly changing so it is not guaranteed to be complete or accurate.
