IMPORTANT NOTE: Below you may find untouched before and after photos of patients who have granted permission to their surgeon to show them anonymously. While we protect the identities of our patients, please be advised that by their nature, these photos contain sensitive content.
Dr. Mathew Plant is a plastic surgeon in Toronto, board-certified in Plastic Surgery by the Royal College of Physicians and Surgeons of Canada. In his private practice, Dr. Plant focuses on breast revision surgery, breast augmentation, and other body work. He is one of the exclusive surgeons in the Toronto area to offer the latest breast implant technology, the IDEAL IMPLANT® Structured Breast Implant. We talked to Dr. Plant about his practice, why he recommends the IDEAL IMPLANT, and more.
What should a patient expect during the first consultation?
“If they’ve come in with preconceived notions, for example, ‘my friend got under the muscle, moderate profile, 355cc implants, and she looks amazing, so just give me the exact same thing.’ The first thing I’ll tell them is, ‘Unless your friend is your identical twin, then what worked for her probably won’t work for you. So we’re going to start from scratch and take the appropriate measurements, then we’re going to choose the implants that are right for you.’ Once we get past that general sense of how to pick the right size of implants, we’ll dive a little bit into the different types of implants. I’ll give them the pros and cons of saline implants, silicone gel implants, and IDEAL IMPLANT® Structured Breast Implants. We’ll talk about above or below the muscle placement as well as incision choices – inframammary crease, areola, or transaxillary. Once we’ve covered that I’ll put together a package that works best for that patient and customize everything for that patient. There’s unfortunately no cookie cutter formula that you can use for breast augmentation that just applies across the board.”
What advice do you have for women trying to decide the best size breast implant?
“I think sizing is best done with your plastic surgeon to help you. Try not to come in to an office with preconceived notions about a certain number of cc’s that you want to put into your breast. The right look for you is going to be based on the dimensions of your body. It may end up being the size that you were expecting to come in and get, it may be something different. But when you work together with your plastic surgeon you’ll get implants that fit your body. So forget the number and just go with what works right for your frame.”
Do you see any trends in terms of which implants women are choosing?
“I’ve definitely noticed a shift in what women want. They seem to be coming in much informed about whether they want saline or silicone gel, and I have noticed that the use of traditional saline has almost dropped off. The use of the IDEAL IMPLANT® Structured Breast Implant has significantly increased, because women like the of peace of mind that comes with a saline implant, knowing it’s a natural substance filling the implant. They do prefer the feel of the silicone gel type implant over traditional saline, and now that the IDEAL IMPLANT is on the market they can essentially get the best of both worlds.”
What are your thoughts on the benefits of the IDEAL IMPLANT® Structured Breast Implants?
“I think the overall benefit of the IDEAL IMPLANT is really that you get the best of both worlds when it comes to implants. The peace of mind with saline, knowing that it is a natural substance that’s inside your implant, but the feel that’s pretty close to a silicone gel implant. I’ve done blind tests where we’ve had patients feel IDEAL IMPLANT® Structured Breast Implants and silicone gel implants and I’ve had a lot of them say they prefer the feel of the IDEAL IMPLANT. It really gives you a natural, soft breast feel, and the advantage of having a saline fill so you don’t have to worry about silent ruptures.”
Have your patients been satisfied with the IDEAL IMPLANT® Structured Breast Implant?
“My patients who have gotten the IDEAL IMPLANT® Structured Breast Implant are universally happy with their results. I would say that my IDEAL IMPLANT patients are the ones that want to come into the office for their post-op and give me a hug, saying things like, ‘I’m so happy. The results are so great, it doesn’t feel like the rocks I was expecting with saline filled implants.’ They love the look as well and a big portion of that is because they are saline implants that I can adjust things on the table and customize to their body. We can fix asymmetries in a way that we can’t do with silicone gel implants, but they still get that soft breast feel.”
How long can women expect their breast implants to last?
“When it comes to longevity of implants, I tell every patient that none of them are designed to be a lifetime device, but none of them have a specific expiration date. Patients always come in asking about this ten-year implant exchange, which seems to have made its way around the Internet. There isn’t actually a deadline where people need to come and have their implants exchanged every 10 years, but some women in the US will do that so they get a new warranty, which tend to be 10 years. What we tend to do here in Canada, and what I do in my practice, is if there’s no problem with your implant, there’s no reason to go through an unnecessary surgery to replace them, just to say you’ve replaced them. In particular with the IDEAL IMPLANT® Structured Breast Implant there isn’t really anything that can go wrong that you wouldn’t know about and then be able to address at that time – ruptures and capsular contractures being the most common breast implant complications. There’s no silent rupture so we don’t have to worry about MRIs to check for that. We don’t have to worry about exchanging the implants just to make sure that they are intact. If it ruptures you’ll know, and we will deal with it. Capsular contracture is never subtle in any implant, so if that presents itself we deal with it.
I always tell patients that if you do get breast implants, it is almost guaranteed that you’ll have at least one more operation in your lifetime. It may be a few years down the road because you want to get bigger implants. It might be 35 years down the road because you’ve had no problems with your implants and now you’re 90 years old and you just want them taken out so that you can live out your final years in peace without a foreign body in you.”
How do you advise patients who are worried about their implant rupturing?
“The first thing I do is explain that when we talk about implant rupture, we are usually talking about a small hole in the shell, not the explosive destruction of an implant that is sort of implied by the use of the word ‘rupture’. With silicone gel implants you may never know if you’ve had a rupture because cohesive gel is not going to leak out through a small pinhole, and that’s what we refer to when we are speaking about ‘silent rupture’. If you are someone who is anxious, that may keep you up at night. If you’re coming to me to get a breast augmentation to improve your confidence, the last thing we need to do is give you new anxieties.
“I’ll talk to my patients about saline filled implants at that point, and this is where I think the IDEAL IMPLANT® Structured Breast Implant really wins versus traditional saline. If you have a rupture with traditional saline, yes, you will know it’s ruptured because your breast entirely deflates. That also means that you need to get into surgery quickly to get a new implant in there before that pocket completely collapses. With the IDEAL IMPLANT, there are two chambers. You will know that you’ve had a rupture because the breast will decrease in size. But because it has two chambers the chance of both of those rupturing simultaneously and having a complete deflation making you have emergency surgery is highly unlikely.
“You will know that there’s been a rupture, you will feel confident that it was just saline that leaked into your body. It’s all been reabsorbed and there’s no harm that’s going to come to you. You can talk to your surgeon and make a proper plan to replace the implant and do it without completely upending your life. You can plan it when it works for you.”
What do patients need to know about capsular contracture?
“Capsular contracture is a complication that can come with any type of breast implants. It’s a problem with the capsule that naturally forms around the implant. Anytime we have a foreign object in the body there are two ways that the body deals with it, and we could be talking about something as large as a breast implant or as small as a little splinter in your finger. The body handles these one of two ways, either it gets inflamed and spits it out, which is usually the case with things like splinters and other small things that are superficial. When it can’t do that it tends to form a scar around the object to quarantine it from the body and basically says, ‘You know what, I don’t want to see this. We’re going to hide this from the rest of the body, wall it off and never think about it again.’
“Breast implants can’t easily be extruded by the body because we’ve placed them properly. There is a small incision and a lot of breast tissue between them and the outside world, so the natural response is for the body to form a scar capsule around it. This is a normal process that happens in every single case. We want it to happen because, long term, that capsule is what holds the implants where we want them. In a certain percentage of cases that capsule then starts to contract, and that’s where we have a problem, and we call that capsular contracture. We know that process is led by tiny little microscopic muscle cells in the scar tissue that start to squeeze the implant and compress it. We’re still working out why this happens and the studies are still ongoing. Although we have a whole bunch of prime suspects, we haven’t nailed down the exact cause.
“Because we don’t know exactly what causes in, most of us these days follow a 15-point plan in surgery to address all those potential causes, including going above and beyond levels of sterility for normal surgery. Changing our gloves, washing out pockets with additional antibiotics to ensure that there isn’t any bacteria. Using things like the Keller funnel, or no touch techniques, washing the implants with this antibiotic solution before we even take them out of the package even though they come to us sterile, as well as a few other steps.”
The IDEAL IMPLANT® Structured Breast Implant is a little bit stronger because of the structuring, so it may resist the forces of capsular contracture a little bit better. The studies do seem to show a slightly lower rate in capsular contracture and rupture, and those are certainly advantages as well.”
How will a patient know if they have developed a capsular contracture?
“Patients will notice that their implant has moved higher on the chest and may appear more spherical. That usually prompts them to go in and see their surgeon and find out what’s going on. We’ll examine them and see that the implant is a little bit harder. We’ll diagnose them with a capsular contracture and we will take care of it one way or another. If it progresses, it will become quite painful so women will definitely notice that way. It tends to just sort of follow this progression from sitting nicely in the pocket where you left it, to becoming higher up on the chest and then becoming painful.
What advice can you give women who are searching for a plastic surgeon?
“The basics that you should look for in a plastic surgeon before you even go to a consultation are things like being board-certified, being experienced, being fully licensed in your jurisdiction. Of course, they should have a good track record for results, as shown by their before and afters. The most important thing above and beyond that is your rapport with your surgeon. Once you’ve crossed a certain threshold of quality of surgeon, you’re going to most likely get good results regardless. It’s really important that you choose someone that you can work closely with because to be honest, if everything goes well (as it does in most cases) then it probably didn’t matter who you chose, but if there is a complication, then you want to make sure your surgeon is someone who you are confident will take care of you in that situation and is someone you will be comfortable seeing very frequently until you are completely healed.”
What makes you stand out against other plastic surgeons in Toronto?
“The reason to choose my practice over other practices is the personal attention that you’ll get. I do all of my consultations personally and I meet with each patient for about a half an hour at the time of their first consultation. I do all of my follow ups myself, and, of course, I do all the surgery myself. At no point will you be put off to a patient care coordinator for your consultation or given to a recovery nurse after surgery. I also will see you in follow-up for as long as you want to see me with no limit on the number of follow ups appointments. To be honest, I want to see all of my breast augmentation patients annually for as long as they are willing to come see me.
It’s really important for patients to understand that there is no single best implant, best pocket or best incision. Each of these needs to be carefully chosen for each patient to suit her individual needs, and that is why I am so hands on with every step of the process”
Considering breast implants in Toronto? Contact Dr. Mathew Plant today to discuss your options. Simply call (416) 907-4704 or visit drmathewplant.com. Dr. Plant’s office is located at 1131 A Leslie Street, Unit 300, Toronto, ON M3C 3L8. Call today for more information on IDEAL IMPLANT ® Structured Breast Implants.