In the last few years, a very rare and specific type of cancer known as BIA-ALCL or Breast Implant Associated Anaplastic Large Cell Lymphoma, has surfaced as a possible complication associated with breast implants. It should be stressed that BIA-ALCL is extremely rare and is only associated with textured implants. Dr. Sweeney does not perform any textured breast implant procedures and has never recommended anything but smooth breast implants. He has occasionally performed augmentation with textured implants in the past when these have been specifically requested by the patient. Early on in his career, Dr. Sweeney noted that textured implants seemed to be associated with a much higher incidence of seroma formation he observed was due to the use of shaped implants required for breast cancer reconstruction. It is likely that the seroma formation he observed was due to the irritation to the surrounding scar tissue by the roughness of the texturing. It also appears that this seroma formation and ultimately in rare cases, BIA-ALCL, may be related. At the Bougainvillea Clinique, we take patient safety very seriously, and pride ourselves in a very low complication rate and a high level of satisfaction in our breast augmentation patients. For this reason, all of our implant procedures are performed using only smooth saline or silicone gel implants. All procedures are performed using meticulous surgical techniques, with barely any bleeding or blood loss, and using the ‘no-touch’ technique with a Keller Funnel. Our preference is for under the muscle augmentation whenever possible, though there may be advantages and disadvantages of this approach which are patient specific and should be discussed in the consultation. This attention to detail and minimizing complications has resulted in an extremely low incidence of complications such as infection, bleeding after surgery, or capsular contracture. Dr. Sweeney has also pioneered the use of fat for breast augmentation, either alone, in combination with breast implants, or to treat breast implant complications.