Breast Augmentation Surgery

General Overview

The success rate and overall safety of breast augmentation has helped it to become the most popular plastic surgical operation in Toronto as well as North America. My practice at the Cosmetic Surgery Institute has emphasized breast augmentation for many years. I believe that my approach to surgical planning and execution delivers the best results for a wide range of individual needs. All surgery is performed at my private clinic. Having a custom designed surgical facility such as this allows patient care to be extremely comfortable and efficient.

American Society of Plastic Surgeons
Toronto Plastic Surgeon
Wayne Carman,MD FRCSC
  • Canadian Society of plastic Surgeons
  • American Society of Aesthetic Plastic Surgery
  • American Society of Plastic Surgeons
Dr. Wayne Carman is the Director and founder of the Cosmetic Surgery Institute, an exclusive private surgical facility in midtown Toronto. A member of the Royal College of Surgeons of Canada in Plastic Surgery, Dr. Carman has been in private clinical practice for over 25 years. He is the Chief of the Division of Plastic Surgery at The Scarborough Hospital.
Wayne Carman MD FRCSC
American Society of Aesthetic Plastic Surgery
Wayne Carman MD FRCSC

Surgical Technique

There are many variations of technique which allow breast augmentation to be performed in different ways. Choice of incision location, implant style and size, and placement relative to the chest muscle are all factors which help to determine the final outcome. Each individual has different desires and her own unique breast shape. The formula that gives one person an excellent result may be totally wrong for someone else. When I consult with a patient, I suggest the surgical procedure which I feel will work best for her as an individual - my suggestion may be quite different than the plan which worked well for her friend. I explain that everyone is different and needs her own customized surgical plan.

Pain Management

Having surgery usually hurts! Some people are understandably fearful of a painful experience - but fear can be exaggerated. I believe that our duty is to make the surgical experience as comfortable as possible. Pain can be controlled and should not be the most lingering memory of having an operation. With this in mind, I decided long ago to undertake breast augmentation surgery with an overnight stay included as standard practice. Staying overnight with a qualified plastic surgery nurse ensures that my patients are properly cared for during the first night after surgery. It allows me an opportunity to check on my patients in the morning before they leave at which time I can answer any questions and review post operative instructions. I believe that I am the only Plastic Surgeon in the GTA to care for my breast augmentation patients in this way.


In my opinion, hiding the skin incision in the underarm has been the single biggest improvement in breast augmentation surgery in the past 20 years. Incisions can also be successfully placed under the areola or in the crease beneath the breast, but these locations tend to be somewhat more obvious. Unfortunately, not everyone is appropriate for an underarm incision - those with more overhang, or a tight lower curvature may need an areola incision to allow greater control of the breast shape. An incision under the breast is usually reserved for those women who require firmer cohesive breast implants to correct a breast shape that has settled a significant amount.

Breast Implant Style

The two main implant types are those which contain saline solution and those which contain silicone gel. Each implant type has certain benefits and limitations. I tell my breast implant patients that if there was one perfect implant, then all surgeons would use it and there wouldn't be any need for the other 80 or 90 styles. The choice of implant depends upon many factors including preexisting breast shape and size, incision location and the presence of asymmetry. Generally, the implant style is less important than you may think. I commonly advise patients that if I used a different implant style on each side, they probably wouldn't be able to tell them apart. The final decision regarding breast implant size and style is determined during our pre operative consultation.


I advise my patients to take one week off following surgery to stay home and rest. Avoiding physical activity in the early days after surgery makes the recovery process much easier and more efficient. During this time I will prescribe medication to relieve any pain, and an antibiotic to prevent infection. A further two weeks of a more normal activity level, only avoiding heavy lifting or working out, ensures that healing progresses efficiently. Most people can return to their usual activity level three weeks after surgery. More about recovering from a breast augmentation procedure.

Follow Up

Post operative visits are scheduled one week after breast implant surgery and again after 4 to 6 weeks. Most people are fully healed by this time and do not require any further scheduled appointments. Long term follow-up visits are booked according to the wishes of the individual person.

Implant Replacement

I am commonly asked whether implants need to routinely be replaced after 5 or 10 years. The answer is no! A breast implant does not have an expiry date. They do not have a mandatory replacement date. There is a great deal of confusion regarding this idea, however, I advise my patients that the only reason to replace implants that have healed well and are stable years later is to create a change in appearance. As time passes, our bodies change, our goals change, and you may consider a change in breast size. This is a personal decision. If you should wish to explore this possibility, I am available to discuss it at any time.

Dr. Carman welcomes any questions you may have about this procedure. For more information about what it could do for you, call (416) 322-7108 or request a private consultation.