The Consultation

On sizing options, 3D imaging, and the moment I knew.

I took the bus and the LRT. I’m a public transportation kind of gal.

Ottawa Plastic Surgery is on a busy commercial street, which is to say it looks like nothing from the outside and everything on the inside. Spacious, modern, calm. I arrived early. I’m a hate-to-be-late kind of gal.

First Impressions

The first part of the appointment was with one of the assistants. She photographed me from multiple angles: front, side, the full picture. I’ve been in a lot of medical rooms. This one didn’t feel particularly different. I was curious. Not nervous, not especially excited. Just present and paying attention.

Then I met with Dr. Silverman.

We went through my medical history, my medications, the full picture. He was thorough in the way that good surgeons are thorough: not rushing through a checklist, actually listening. Then we talked about what I wanted. My goals, my desires, the shape I had in my head.

I had spent time looking at photos of breasts I admired. I had not, in the end, brought those photos with me. I simply forgot. It turned out not to matter. He asked the right questions and I knew my own answers. But I’ll say this: the reference photos they showed me on the Crisalix screen made everything more real than standing in front of the mirror with implant sizers in my bra. Seeing the projection of your own body with the proposed result is a different kind of information. Bring your photos. It makes the conversation easier.

Finding Reference Images

Finding reference images of women my age had been harder than I expected. Augmentation content on TikTok and Instagram skews heavily toward women in their twenties and thirties. The women closer to my age who documented their journeys had usually gone through pregnancy and breastfeeding and needed lifts alongside augmentation, which wasn’t my situation. I was looking for something specific and the internet didn’t make it easy to find.

The Implant Options

Dr. Silverman walked me through the implant options methodically. Silicone versus saline. The recall history of textured implants and why he works primarily with smooth round ones. Smooth implants carry no known link to BIA-ALCL, the rare cancer associated with textured surfaces, and they move more naturally with the body. Round implants eliminate the risk of rotation that comes with anatomical teardrop shapes. The logic was clear and I trusted it.

We talked about rupture. With saline, a rupture is immediately obvious. Deflation is instant and visible, which for someone who works on camera would be a sudden and very public problem. With silicone, a rupture can be silent, contained within the surrounding tissue, detectable only by MRI. The tradeoff being: saline tells you immediately, silicone lets you schedule. Given my work, silicone made more sense. I could manage a planned revision on my own timeline.

The Sizers

Then he left and came back with two assistants.

I removed my top. He took measurements while one of the assistants noted them down. Then I put on a front-closure bra and stood in front of a mirror and tried different implant sizers. That part is more intuitive than I expected. You hold the weight against your body and something in you either responds or it doesn’t.

My photos were displayed on a television screen across the room. I’ve seen my body from every angle for almost three decades. This was just another angle.

Crisalix

Crisalix is a 3D imaging system that takes your measurements and renders projected outcomes for different implant sizes. Dr. Silverman showed me two options he recommended based on our conversation and my frame: 415cc and 495cc, both smooth round silicone.

Breast implants can be placed in three ways: subglandular (above the muscle, beneath the breast tissue), subfascial (above the muscle but beneath the fascia, the thin fibrous layer that overlays the pectoralis), or submuscular (beneath the muscle itself). Dr. Silverman recommended subfascial placement for me. It would give a good result for my frame, and my skin texture was well suited to it. Twenty years of experience and over 8,000 procedures. I trusted his call.

The Decision

Looking at the Crisalix images side by side, the difference between 415 and 495 is only a few millimetres in real terms. The photos almost don’t capture it. But standing there, looking at the rendered versions of my own body, 495 felt like something and 415 felt like almost something.

He also showed me a moderate profile in the same sizes to demonstrate how that would make the implant wider than my chest and the proportion stops working. That was useful. It confirmed I wasn’t chasing size for its own sake.

I chose 495cc. Smooth round silicone. Full profile. Subfascial placement.

Booked

After the appointment they sent me home with a quote. I told them I’d think it over and be in touch. A day or two later I confirmed my decision, worked out the finances, and booked June 16th.

That was that.

— Seska

If you’d like to support my surgery and recovery, I have a wishlist here in my pinned post on X.