Update on Breast Implant Safety and ALCL

Dr. Mitchell Brown and Dr. Ron Somogyi, Toronto Plastic Surgery

Recently, there has been a surge in media attention regarding implantable medical devices. Coverage has focussed on regulatory agencies, the process for device approval, device safety as well as the importance of collecting accurate post-approval data on adverse events and outcomes. Many devices were discussed including pacemakers, hip and knee implants, cardiac stents, pelvic meshes as well as breast implants. One area of discussion has centered around breast implants and a possible link to a type of lymphoma called ALCL.

A great deal of research has been published regarding breast implants and cancer. We can say quite conclusively that breast implants do not cause breast cancer. For the past several years there have been published cases of women diagnosed with a rare type of lymphoma in the fluid or tissue surrounding a breast implant. This entity has been named BIA-ALCL (Breast Implant Associated Anaplastic Large Cell Lymphoma). ALCL itself is a cancer of the immune system and more commonly occurs in people who have never undergone breast implant surgery. Estimated rates of ALCL is approximately 1 in 10,000 people in the general population.

At present, there are approximately 600 cases of  BIA-ALCL reported worldwide and it is estimated that more than 10 million women have undergone breast implant surgery. To date, all cases of BIA-ALCL have been in association with breast implants that have a textured surface. The current lifetime risk with a textured implant is estimated to be 1:3800 – 1:30000. There is no risk of developing BIA-ALCL with smooth surfaced implants. It is important to know that all implants used at Toronto Plastic Surgery are fully approved by Health Canada as well as the FDA in the United States.

In the majority of reported cases, the initial presenting symptom is a distinct swelling of the affected breast. You would notice this as a substantial size change on the affected side. The breast might feel tense and firm. Usually the swelling comes on fairly rapidly, over several days or weeks, not over months or years. Typically, this occurs on one side only, but in exceptional cases, it can occur in both breasts.

If a person with breast implants notices any of these changes or symptoms, the appropriate action is to contact their surgeon for a follow-up visit. There are some very simple investigations that can be done to determine whether or not a person has BIA- ALCL. When detected early, it is very treatable.

It is important for you to know that both Dr. Somogyi and I have collectively been involved with the use of breast implants for over thirty years. We have followed our patients carefully and have published our experience on the safe use of breast implants and breast implant outcomes. We both attend medical conferences regularly and often participate as educators at these events. We want you to know that we stay up to date on the latest literature surrounding breast implants and breast implant safety.

In addition, it has always been our practice to encourage patients with any breast implant to return for regular follow up at least every 2-3 years. This is important so that we may inform you about new information or changes regarding breast implant technology and safety. Occasional assessment is recommended.

As new information becomes available regarding BIA-ALCL and breast implant safety, we will do our best to keep you informed. If you have any questions regarding breast implant surgery at Toronto Plastic Surgery, please feel free to contact us directly.

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Dr. Brown at Breast and Body Contouring meeting in St. Petersburg, Russia

Dr. Brown attended the Advanced Aesthetics in Breast and Body Contouring meeting in St. Petersburg, Russia, from Oct 11 to 14, 2018. He was part of the international invited faculty and had an active role in the meeting with the following on his agenda:

  • Moderated the live surgery sessions on breast lift and augmentation
  • Presented a video of surgery to correct breast sagging
  • Gave a presentation on correcting the tuberous breast using fat
  • Gave two presentations on how to prevent and manage complications in breast augmentation

During down time, Dr. Brown met with colleagues in plastic surgery and aesthetic medicine from around the world.

Highlights included a visit to the world famous Hermitage Museum as well as the Peter and Paul Cathedral.

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Biologique Recherche Skin Care Products and Facials at TPS

Toronto Plastic Surgery is pleased to announce we have been selected as one of the exclusive distributors of the French skin care brand Biologique Recherche.

Biologique Recherche is most known for the iconic P50 lotion, a cleansing and exfoliating treatment lotion with a unique formula to help the epidermis regain its original regenerative properties.

Home Spa

Purchase Biologique Recherche products at our office or on our website. Prices start at just $37 and shipping is free for orders $125 and above.


Biologique Recherche fits perfectly with several of our medical aesthetic modalities to enhance and improve the skin condition and appearance. Experience our signature Biologique Recherché facials customized for skin tightening and anti-aging.

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Liposuction vs. tummy tuck: which is right for me?

Dr. Ron Somogyi discusses your body contouring options at Toronto Plastic Surgery.

Toronto Plastic Surgery, Liposuction Toronto

If you’re considering surgery to address excess fat or sagging skin on your abdomen, you might be wondering if a tummy tuck or liposuction at Toronto Plastic Surgery is the best option for addressing your concerns.

A tummy tuck—also known as abdominoplasty—is a surgical procedure designed to remove excess skin and fat from the abdomen and to tighten the underlying abdominal muscles, whereas liposuction is a procedure that removes localized deposits of fat from specific areas of the body. Both surgeries are effective in achieving a more contoured mid-section, but the underlying issues they address are actually quite different.

Every patient is unique, and we always spend as much time as necessary to understand your goals and desires before making a recommendation. That said, here are some general guidelines that might provide some insight about which surgery is right for you.

Liposuction is right for you if …

…. you have areas of fat that do not respond to diet and exercise, but skin elasticity is not an issue.

Liposuction uses a vacuum-suction tube inserted under the skin to permanently remove localized deposits of fat to reveal beautiful, sleek body contours. Although there may be some tightening of the skin due to natural skin elasticity, liposuction is not a tightening procedure. For this reason, it is usually recommended for patients with good skin quality and reasonable expectations; older patients who may have less skin elasticity may not achieve the same results as younger patients with tighter skin.

Ideal candidates for liposuction are healthy women and men who are relatively close to their ideal body weight, but have stubborn pockets of fat that are resistant to diet and exercise. Liposuction can also address areas of the body besides the abdomen, including hips, buttocks, thighs, knees, back, upper arms, breasts and neck.

The surgery itself is an outpatient procedure, which means you’ll return home the day of your surgery, though we normally recommend taking a few days off from work to give yourself some time to rest and heal. You’ll likely experience mild to moderate pain, bruising and mild swelling immediately after surgery, so make sure you have someone to help you around the house in your first few days of recovery. After surgery, you will wear a custom-fit compression garment for 3-4 weeks to reduce swelling, optimize tissue recovery, and help retain your new shape. Most patients are back to normal daily activities within a few days and back to full exercise within 2-3 weeks. Results from liposuction are gradual. Initial swelling will hide the true extent of the improvement for the first 3-4 weeks. Over the subsequent months, you will continue to see ongoing improvement in contour as the final swelling resolves and the skin tightens. Liposuction scars are usually minimal, since the fat is suctioned away through several small incisions in hidden areas.

A tummy tuck is right for you if …

… you have excess or sagging skin in addition to excess abdominal fat.

In addition to removing excess skin and fat from the abdomen, a tummy tuck can address a protruding abdomen, abdominal muscles weakened by pregnancy, loose skin from weight loss, and a loss of definition or shape of the belly button. It also allows for the possible elimination of stretch marks, especially if they are located in the lower part of the abdomen.

The best candidates for a tummy tuck are close to their ideal body weight, but have experienced changes to their body following weight fluctuation, pregnancy, surgery, or simply as a result of the natural aging process.

A tummy tuck surgery is usually an outpatient procedure, meaning you’ll return home the day of your surgery. Some patients choose to stay one night in our facility and return home the next morning. It’s normal to experience mild to moderate pain, bruising, and mild swelling immediately after surgery, but we will discuss pain management options with you, and explain how to care for your surgical incisions to ensure optimal recovery and comfort. We recommend taking about 2 weeks off from work to give yourself time to rest and heal. Most patients are back to normal daily activities within 2 weeks, but are asked to avoid heavy physical activity and heavy lifting for 6 weeks.

A tummy tuck does result in a larger scar than that of liposuction, though you can rest assured that every effort is made to ensure incisions are made precisely and that scars heal as fine lines easily covered by bathing suits or undergarments.

A perfect pairing.

In some cases, if you’re concerned about both excess fat and loose skin, liposuction and abdominoplasty can be performed during the same procedure for optimal results.

If you’re interested in learning more about tummy tuck or liposuction at Toronto Plastic Surgery, including which procedure is right for you, schedule a private consultation with Dr. Somogyi today.

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Dr. Brown as Visiting Professor at UCLA

Dr. Brown was a Visiting Professor at UCLA on August 7-8, 2018.

The reception was held at the Ronald Reagan UCLA Medical Centre. While there, Dr. Brown gave an address to the faculty and residents on “Managing the Congenital Breast Deformity” and then spent time with the residents teaching about how to treat complications following breast surgery.

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All about gynecomastia.

How much does gynecomastia surgery cost? What can I expect? Dr. Ron Somogyi answers these common questions and more.

Toronto Plastic Surgery, Gynecomastia Surgery Cost

Men, like women, can experience an over-development of breast tissue. This condition, known as gynecomastia, is very common, and can impact those affected by it both physically and emotionally. In fact, gynecomastia often goes unaddressed in men who are too embarrassed to seek a solution.

For this same reason, there are far too many men with unanswered questions about gynecomastia surgery—also known as male breast reduction—and the results that can be achieved. We want men everywhere to know the impact this surgery can have on their appearance, their self-confidence, and their future. Today, Dr. Ron Somogyi from Toronto Plastic Surgery is answering some common questions and concerns about this life-changing procedure.

What is gynecomastia?

Gynecomastia is an over-development of male breast tissue. Frequently, it begins during puberty but it may occur at any time during adulthood in one or both breasts. The condition isn’t medically serious, but it can cause awkwardness, and many boys and men feel self-conscious about their physical appearances as a result.

There are two types of gynecomastia: primary gynecomastia (the most common) and secondary gynecomastia. Men with primary gynecomastia usually develop excess breast tissue during puberty with no detectable underlying cause. Secondary gynecomastia develops as a result of obesity, underlying health conditions, hormone imbalance, or the use of steroids, marijuana or certain other medications.

What causes gynecomastia?

Many people mistakenly believe that gynecomastia is the result of excess fat, but in reality the problem is an excess of breast tissue, which cannot be addressed with changes in diet and exercise. The condition can, and often does, affect males at a healthy weight. Barring any detectable underlying cause, gynecomastia is usually the result of an imbalance of a male’s hormones. As testosterone levels decrease and estrogen levels increase, these imbalances can cause male breast tissue to over-develop.

In your experience, how does gynecomastia affect your male patients?

Physically, there are usually very few symptoms of gynecomastia. In some cases, patients complain of breast tenderness and discomfort, but most commonly, my male patients are affected emotionally. They often describe feeling self-conscious about their breast size and uneasy about wearing form-fitting clothes or exposing their chest in public. Many patients feel too embarrassed to participate in certain physical activities like swimming or sports because they feel awkward about being shirtless.

What are my options for correcting gynecomastia?

Unless the gynecomastia is caused by an underlying condition that can be treated, surgical male breast reduction is the only consistently effective treatment with long-lasting results.

What is involved in gynecomastia surgery?

When a patient is considering gynecomastia surgery, we begin with a consultation where goals and expectations are discussed. A complete review of medical and surgical history will identify any underlying causes and examination of the area will confirm surgical options and expected outcomes. For the patient, this is also a great opportunity to determine whether your surgeon is the right fit.

The surgery itself is an outpatient procedure, which means you’ll return home the day of your surgery. Most commonly, male breast reduction is performed through a small incision near the nipple where the excess tissue is removed. Liposuction is performed around the edges of the treated area to ensure smooth and natural final result. Occasionally, liposuction alone may be sufficient to adequately treat the problem.

What’s the recovery like?

Pain, bruising, and mild swelling are normal and expected immediately following your procedure. Make sure you arrange to have someone accompany you on the day of surgery to drive you home, and someone to help you around the house in your first few days of recovery.

Patients can often return to most normal activities within a few days, though we often recommend you plan for one week off from work to provide adequate time to rest and heal during this initial period. After surgery, you will have to wear a compression garment, like a tight undershirt, for a few weeks to reduce swelling and optimize tissue recovery. Heavy physical activity is restricted for approximately one month.

Once your surgery is complete, our staff will schedule regular follow-up visits to ensure your recovery is as quick and comfortable as possible. We’ll provide you with post-operative instructions, pain management options, and instructions for caring for your incisions.

Will there be a scar?

As with any surgery, male breast reduction will involve incisions, which inevitably heal as visible scars. The incisions used in this procedure are very small and located near the nipple. You can rest assured that every effort is made to ensure incisions are made precisely and that these small scars heal as fine lines that fade over time.

Do you have before and after photos?

We do! Take a look at my before and after gallery here.

How much does gynecomastia surgery cost?

“How much does gynecomastia surgery cost?” is one the most common questions we receive. At Toronto Plastic Surgery, Gynecomastia surgery, though highly individualized, ranges in cost from $5500 to $7000.

If you have any additional questions about gynecomastia, or you’re interested in scheduling a private surgical consultation, contact us at Toronto Plastic Surgery today.

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