Breast augmentation is the most popular plastic surgery procedure for women in San Diego and the United States due to loss of breast size and firmness. There are few parts of a woman’s body that can affect self-esteem more than her breasts. Unfortunately, the breasts suffer more from age and motherhood than any other body part.
There are many breast augmentation options in San Diego for women searching for a more feminine physique, and for men to regain confidence with a more masculine presence. At Prime Plastic Surgery, our doctors perform breast reduction, breast lift, and breast augmentation for San Diego and the surrounding areas. They will customize your breast augmentation procedure to fit your needs and desired outcome.
- 1 Before and After Photos
- 2 About
- 3 Consultation
- 4 Candidates
- 5 Choosing Your Plastic Surgeon
- 6 Procedure
- 7 Types of Implants
- 8 Textured vs. Smooth Implants
- 9 Sientra Breast Implants
- 10 Mentor Breast Implants
- 11 Allergan’s Natrelle Breast Implants
- 12 Potential Risks and Complications
- 13 Recovery
- 14 FAQ
Before and After Photos
Breast Augmentation is performed to increase the size and fullness of the breast. Women whose breasts are disproportionately small, or whose breasts have sagged or “deflated” after childbirth, or who have unevenly-shaped or sized breasts, are candidates for the procedure. At times, it is necessary to lower the inframammary fold to achieve the results we are looking for. If the breasts droop too much, a “lifting” procedure may be required in addition to, or instead of the augmentation.
Are you contemplating breast augmentation surgery in San Diego? Schedule a consultation with one of our board-certified plastic surgeons because the relationship with your plastic surgeon is important. It is critical for you to understand the risks, the rewards, and everything about your plastic surgeon and the support team.
At Prime Plastic Surgeon, you will receive professional attention from the instant you contact us. When you call, we will provide needed information and schedule a consultation appointment to serve you further.
Upon arrival at our La Jolla office, you will meet our staff. Our office is far from the stark, clinical medical offices of many. Here you are surrounded by soothing colors, interesting works of art and very comfortable seating. Once you meet with your surgeon for the actual consultation, you will be given a thorough physical exam and asked your reasons for breast augmentation.
Your surgeon will show you before and after photos of patients with similar anatomy who had the same concerns as you.
Your doctor will introduce you to TouchMD. This tool is designed to help you receive more information and become aware of your medical experience. Using TouchMD.com, you can learn more about your doctor, staff and their facilities and explore videos about your breast augmentation. You may view or print images saved by the staff during your office visit and share these experience with your loved ones.
You and your doctor will design a personalized breast augmentation plan which will satisfy your unique body type. He will explain how to prepare for your surgery, what to expect during surgery and the healing process during your recovery.
He will give you plenty of time to voice your concerns and ask any questions. He will not rush you and will answer all your questions.
- Have small or asymmetrical breasts
- Have droopy or sagging breasts
- Have breasts needing reconstruction
- Are in good health
- Do not smoke
- Understand the benefits and risks of breast augmentation
- Have reasonable expectations
“I absolutely LOVE Dr Singer and his entire staff! You can’t go wrong trusting your face or body with them. I called around to numerous surgeons offices before I finally decided as this was huge to me, I hated that thing. My first contact assured me Dr. Singer was the BEST and darned if she wasn’t right! This was not the typical response to my questions as I called around mind you!!! I was sold by her enthusiasm and I couldn’t be happier.”Real Patient
Choosing Your Plastic Surgeon
Although breast augmentation is safer today than previously, your choice of a surgeon is critical. Sadly, any physician with a medical license can perform breast augmentation surgery in San Diego legally, even with having no specific training. It is important for your plastic surgeon to be qualified and have the right credentials. These should include board certification, and in good standing with the various medical boards. It also includes education, experience, and satisfied patients. Don’t forget the staff. Make sure the entire staff is professional, friendly and caring.
These will be the people to call while you heal. Make sure you are happy with the entire surgical center. It is important to investigate and visit with the surgeon one on one. You should visit the surgical center where the procedure will take place. Take your time and get informed.
Breast augmentation is an outpatient procedure done under general anesthesia.
We offer most approaches of breast augmentation and incision placement, as well as several FDA-approved implants with silicone and saline. The modern procedures we use allow us to fashion incisions in inconspicuous locations, either in the crease of the armpit, peri-areolar (an incision under the nipple at the areola where the color changes naturally) or inframammary (under the crease of the breast).
With regards to Breast Augmentation surgery, each patient is unique and the way one patient scars may be much different from the way another person may scar. Our doctors are experts in performing Breast Augmentation procedures in order to minimize visual scars through proper incision practices.
The ideal placement in any particular patient depends on their particular anatomy and understanding of the pros and cons of each approach. Your concerns should be discussed at the consultation.
We also implement three choices for placement of your implants:
A newer technique in which we insert the implant under a thin, but solid layer of connective tissue which shelters the pectoralis major muscle. With this technique, you get a support advantage of the sub-muscular technique without implant movement which causes your implants to shift when your muscles contract.
The implant is inserted under the gland of the breast.
Subglandular implant benefits:
- A shorter recovery time.
- Less discomfort initially.
- No distortion of the breast when the pectoralis muscle flexes.
- Mild preoperative sagging can be improved, especially if no breast lifting procedure is performed.
- Easier surgical procedure.
- Larger implants can be placed.
Subglandular implant disadvantages:
- The implant may be more visible.
- More visible rippling, especially in patients with a small amount of natural breast tissue.
- Generally, saline implants do not produce a good result in front of the muscle.
- Higher incidence of capsular contraction.
- “Bottoming out” in some patients.
- Some radiologists have more problems reading a mammogram with an implant in front of the muscle.
We insert the implant under the muscle
After placement and positioning, your surgeon will close with sutures, and bandage your breasts. Sometimes he will place a surgical garment, helping your breasts to stabilize with the implants.
After surgery, you will be taken to a recovery room and monitored for a short period. Finally, we will release you into the care of an escort, who should drive you home and help you for at least 24 hours.
Submuscular implant benefits:
- Usually results in a better appearance for naturally small breasted women
- Less tendency for seeing ripples of the implant.
- A more natural feel to the breast especially in slender women who don’t have much of their own breast tissue.
- Less interference with mammograms, although most radiologists take additional views no matter where the implants are placed.
- Lower rate of capsular contraction.
- Less of a chance of “bottoming out” where the implant bulges at the lower aspect of the breast and the nipple and areolas tend to appear excessively elevated.
Submuscular implant disadvantages:
- Recovery usually takes a little longer and is more uncomfortable initially.
- There may be an “animation deformity”, which is a temporary distortion of the breasts when the pectoralis muscle is flexed. Body builders and weight lifters generally prefer implants in front of the muscle.
- It is harder to achieve cleavage in women who have widely spaced breasts.
- The implants often ride higher on the chest.
Types of Implants
There are different types of implants. When you decide to get breast implants, you have many specific choices, not only regarding the size and type of material but also regarding shape. We have an extensive selection of implants that will fit your unique body type. We will discuss the advantages and disadvantages of different implants with you so you can make the optimal choice for your needs.
Saline breast Implants
Your surgeon will fill saline breast Implants after insertion, which allows for a smaller incision. The ability to fill the implant after insertion will allow your surgeon to adjust the size during surgery. These implants are FDA-approved for women 18 and older.
Silicone Breast Implants
Silicone breast implants are believed to have a softer, more natural feel than saline. We recommend these implants for women with thin or little breast tissue. Silicone implants require a larger incision because they are intact with no filling required. These implants are FDA-approved for women 22 and older, although younger women may qualify for their use.
While not a frequent occurrence, saline and silicone implants may rupture. The FDA recommends women with silicone implants have an MRI every two years to determine if a rupture has occurred. When a silicone implant ruptures, there is no immediate leakage and no reduction in size making ruptures harder to detect. Because saline implants deflate soon after rupture occurs, it is easily detected.
“Gummy Bear” Breast Implants
Cohesive Gel Implants, also known as “gummy bear” implants, may rupture, but it’s silicone filling will not leak out. The gel of these implants is similar in consistency to gummy bear candies, are less prone to leakage, and a rupture of the outer shell will not alter their shape or size. These implants also have a more natural, teardrop shape.
Textured vs. Smooth Implants
Implant shells can be smooth or treated with a finishing process which texturizes the outer surface. It’s important to know your breasts will feel natural if you have textured implants. The texture assists the implant’s adherence to the adjacent breast tissue to avoid rotation.
Textured Breast Implants
Textured implants are less disposed to capsular contracture – a problem which may occur over time after breast augmentation. In capsular contracture, a constricted scar will form about the implant, triggering the breasts to become too firm and sometimes distorted. Capsular contracture will require breast augmentation revision surgery.
Smooth Breast Implants
Implants with a smooth surface are less likely to ripple than textured implants. If a patient has little breast tissue, we opt for the smooth implant since rippling would be more of an issue.
When the breasts are re-contoured and enlarged with an implant, women often experience a renewed sense of their femininity and a substantial increase in self-confidence. Ideally, breast augmentation surgery, also called augmentation mammoplasty, lasts for a lifetime. No one, however, can guarantee the life cycle of an implant so implant replacement may be necessary.
Sientra Breast Implants
Prime Plastic Surgery is now offering the recently FDA-approved Sientra silicone breast implants to all breast augmentation and breast implant revisionary patients. The new implant is an excellent option to compliment the innovative implant options Prime Plastic Surgery currently provides. The revolutionary implants are crafted using a high-strength cohesive gel that offers the natural look and feel of actual breast tissue. Sientra implants are leak resistant and are available only to board certified plastic surgeons.
Sientra’s Intelligent Design
The revolutionary implants are filled with a form-stable silicone gel which retains form and shape even after being twisted, pulled or cut in half without leaking. Patients can select from a variety of implant options including smooth or textured outer surface, a round or anatomical profile, and a variety of implant configurations that determine a custom degree of outward projection from the chest. Advantages of Sientra’s breast implants for Prime Plastic Surgery patients include:
- More custom shape and profile options for personalized results.
- Leak-resistant gel for greater safety and peace of mind.
- A natural look and appearance, offering a more realistic breast enhancement.
Mentor Breast Implants
After decades of research and development, Mentor breast implants were approved by the FDA in 2006 and are available to board certified surgeons such as our team at Prime Plastic Surgery. The Mentor implant is traditionally used for breast augmentation surgery, breast revision and reconstruction surgery.
Mentor’s silicone implant is developed using MemoryGel, which are available in either textured or smooth surface shells and are available in a wide range of sizes and profiles to fit every patient’s unique body type and individual goals. Advantages of Mentor’s MemoryGel breast implants offered by Prime Plastic Surgery include:
- FDA approval;
- Natural look and feel;
- Crafted using a cohesive gel which holds together uniformly;
- Set fill-volume for predictable results; and
- Offered in a wide variety of profiles and surface options for a custom fit.
Allergan’s Natrelle Breast Implants
Prime Plastic Surgery is proud to offer their patients Natrelle® silicone and saline breast implants by Allergan. For nearly three decades, Allergan’s Natrelle® gel and saline breast implants have been available to women worldwide for breast augmentation, breast revision, and reconstructive surgery. Allergan breast implants offered by Prime Plastic Surgery offers patients a wide range of safe and high-quality saline and silicone breast implant options. The technology behind the implant’s design offers a custom shape and appearance including options for smooth or textured surfaces, varying shapes and projections (including low, moderate and high-profile) and a range of volumes. With these technologies, Prime Plastic Surgery is able to offer the most custom and individualized aesthetic result based on each patient’s unique body type and individual goals.
Potential Risks and Complications
With breast augmentation surgery, the risks involved with surgery and the costs of the procedure should be considered. Costs may depend on the severity and complexity of each case. Risks and complications may include but are not limited to possible bleeding, infection, loss of sensation/hypersensitivity, and/or asymmetry.
Breast augmentation does not guarantee permanent results. Implants may need to be replaced or revisionary surgery may be necessary in the future. Factors such as pregnancy, breastfeeding, weight loss/gain, and aging may affect the results of surgery.
The recovery period is crucial to the healing process and it is important that you follow your doctor’s post-op care instructions to ensure the best result possible.
Breast augmentation surgery may have both positive and negative affects on a person. In order to achieve the results you want, it is important to communicate your personal goals with your surgeon prior to the procedure. Candidates for the procedure are persons who have a detailed understanding of the procedure, as well as, realistic expectations. It is important for the patient to have a good support system, find and research a Board Certified Plastic Surgeon, prepare their financial means and have good reasoning for why she wants breast augmentation surgery. An ideal patient has completed having children, is at or near their ideal weight, and is in good physical health.
After surgery, you will feel sore and fatigued and need plenty of rest for a few days. Breast augmentation patients in San Diego are often able to return to work or school within a week. You should avoid strenuous activities using the upper body for up to one month. Refraining from physical strain is especially important for patients who have had sub-muscular or sub-facial placement. For the first week, you should take prescribed pain medication for your comfort and follow your recovery instructions. You will experience swelling but will see an immediate improvement in your breasts size and shape. Our staff will closely monitor your progress during follow up visits, to make sure your recovery is proceeding well. Communicate with our office with questions or concerns during recovery.
“They took such good care of me so much so that I was never nervous or doubtful. When the time came I closed my eyes and I was out in no time. I woke up and they said feel them!” And I could not believe that it was over it was literally 3 hours and it felt like one second. I was glad I was like that. The work done was extremely detailed and it was exactly what I wanted, it was like if Dr. Singer read my mind.”Real Patient
Post Op Care Instructions
Breast Augmentation Post Op Care Instructions
Sleeping in an upright position for 1 week after surgery.
No heavy lifting for 4-6 weeks.
Keep your hands and elbows to your side for 2 weeks.
No driving for 2 weeks post Breast Augmentation Overfill or until off narcotic pain medication completely and able to react to an emergency.
Please take the medications as directed. Antibiotic medication (if prescribed) is taken for 3 days or until the drains are removed. Pain, nausea, and muscle relaxant medication are taken as needed. Never take medication on an empty stomach and always space out the medications by an hour.
Constipation is very common due to the pain medication and anesthesia. Please use Colace (over the counter) or any stool softener that has worked with you in the past.
If you develop a rash or think you are having an allergic reaction to the medication please call our office immediately. Sometimes Benadryl will help.
No exercises for 4-6 weeks post surgery. We will follow up with each patient at post-surgical visits to give them their workout restraints.
Cant get the breast wet incision line wet for 4-6 weeks post surgery. When you do go in the shower regular soap and water. When you come out of the shower, get your hair dryer put on low and cold setting to dry the incision lines completely
No ocean water, jacuzzi, or pool water for 8 weeks post surgery or until the incision is fully healed.
No tanning or sun exposure to the incision until the your incision has healed completely.
Please do not put scar creams or ointments on the incision immediately after surgery, you may irritate the area or cause an allergic reaction.
After surgery you will have dressings, surgical bra, and stockings provided to you. Please leave everything on until we see you which is usually 3 days post surgery. The surgical bra strap band needs to be placed at the bottom of the breast for support.
You may expect to be swollen for a few weeks. This is why it will also take time for the breast to reach their final shape and size.
For Scar treatment most patients will use scar ointment, which you may get from our office.
Wear the surgical bra for a total of 4 weeks. You may wear a comfortable sports bras or regular non-under wire bras after you get rid of your surgical bra. You wear sports bras for 4 weeks.
Nice under wire bras are okay once you have full sensation at the bottom of the breast and closer to 2 months post surgery. Please note that when you do have Overfill breast sometimes you will need to get custom bras ordered with a lot of support.
You may have some drainage from the incision lines and its normal after suture removal and its usually a light yellow discharge. Please keep the area as dry as possible. If there is significant drainage please contact our office as soon as possible.
If there is redness on the incision line or it feels tender, please call our office and send photos.
Incision lines and final results may take up to about a year.
Please keep in touch via email, and send photos to confirm suture removal, then continue to send photos at your 3rd week, 1 month, 2nd month, 4th month, 6th month…etc. (wearing cute Bras)
If you would like to blog or write a testimonial of your experience in our office please see the following websites
Some women, who never had breast surgery, are naturally unable to breastfeed, and some variations of breast augmentation may make it more likely that you are unable to breastfeed, but most women with breast augmentations are able to successfully breastfeed. Breast implants pose no medical risk to your baby.
Both silicone and saline breast implants can rupture or leak. If this should occur, treatment may require surgical removal of the implant and possible replacement. When a saline (salt water) breast implant leaks, it will usually deflate very quickly similar to what occurs when a balloon loses its air. Your breast will change in size or shape. It is less common for saline to leak slowly, although it can happen. When the saline leaks, the body absorbs it.
A rupture or leak of a silicone breast implants may occur very slowly, produce no symptoms or problems (called a silent rupture), and go unnoticed, because the gel is contained within the normally occurring fibrous tissue that forms around an implant. Sometimes the rupture is discovered only with on mammogram or an MRI or when an implant is replaced. It is possible, however, for the fibrous tissue to become inflamed or form additional internal scar tissue which can lead to:
• Pain, soreness or swelling in the affected breast
• Change in breast size or shape
• Lumps in the affected breast
• Softening or hardening of the affected breast
Implants have been thoroughly evaluated by the FDA and ruptured silicone breast implants aren’t thought to cause breast cancer, reproductive problems or connective tissue disease, such as rheumatoid arthritis.
Breast sensitivity may be increased, decreased or the same after surgery. Sensitivity varies greatly from person to person. After breast augmentation, you may find the nipples have decreased sensation, which generally returns. When it returns, the nipple complex may be hypersensitive before it returns to normal. In most patients, it takes 6-12 months before achieving the final level of sensitivity which may not totally return in some patients, no matter where the incision was made to insert the implant.
You should “take it easy” the day of your operation and the following days. Increase your activity as instructed. Depending on the kind of work you do, you may return to your job as soon as you are comfortable. If your work is fairly sedentary, you may go back to work in three to four days after surgery. Do not lift anything over ten pounds for three weeks. Exercise can typically be resumed three to four weeks following breast enlargement surgery.
You will be asleep during the procedure and feel no pain. After surgery, pain and discomfort can be easily relieved with prescribed medication and usually subsides in a matter of days. The greatest period of discomfort usually lasts about twenty four to forty eight hours. Thereafter, you should have less discomfort and less need for medication. Occasionally, it lasts a little longer. Implants placed in the submuscular position initially produce more discomfort than those placed in front of the muscle.
General anesthesia is commonly used in order to make the intra-operative portion of the procedure pain-free and as comfortable and pleasant experience as possible.
Cases may differ, but on average the surgery lasts one to two hours.
There is a myth that implants will last 10 years. There is no data to support that statement. We have seen patients with implants that are over 30 years old and still intact. You should realize that no one can guarantee the life cycle of an implant, that it may not last forever and it may not be a one time surgery. The implant manufacturers have limited warranties on the implants.
There are a number of new implants referred to as “gummy bear”, “jelly bean”, “form stable”, or “highly cohesive gel” implants that are available, but there are no long term results to show that they are significantly better or will last any longer than the current implants. They do feel firmer.
It depends on multiple factors: Individual anatomy, existing breast volume, breast dimensions of height, width and projection, ribcage width, chest shape, tissue thickness, desired outcome, and realistic expectations. There is no standardization of cup size. A 32 C and a 36 C are very different. Cup sizes vary from bra manufacturer to bra manufacturer. Even different styles from a manufacturer will vary in what they label a cup size. The best way to choose an implant size is to try on try on sizers in the office while wearing a tight t-shirt, bathing suit or leotard.
There are advantages and disadvantages of each type of implant. Both are utilized by surgeons across the country with satisfactory results. They are both approved for usage by the FDA. The best way to determine what the best implant is for you is to discuss the advantages and disadvantages of the various types of implants along with your concerns and personal preferences at a consultation.
The surface of the outer shell of breast implants can be either smooth or textured. There are pros and cons of each. Smooth implants usually have thinner shells and move more freely in their pocket than their textured counterparts. Many plastic surgeons believe that the thinner shell allows smooth implants to feel more natural. Implants with smooth surfaces are also less likely to ripple. Textured implants were designed to lower the risk of capsular contracture, but whether it achieves that is open to debate. The textured implants may have a greater chance of leakage or deflation. One type of implant shape, known as the anatomical or tear-shaped implant, is only available with a textured surface, because this surface helps keep these contoured implants in position and diminishes the risk of rotation and distortion. Some of the differences of the implant surface characteristics depend on whether the fill material is saline or silicone gel.
• Accept your breasts as they are.
• Wear a padded bra or an external prosthesis.
• There are no creams or ‘magic formulas” that are marketed to produce non-surgical breast enlargement that have ever been proven to work.
Breast implants are among the most tested of medical devices. No other medical device has been studied to the extent that breast implants have. Extensive studies of tens of thousands of women with breast implants have shown that both saline and silicone implants are safe. They do not produce a higher rate of cancer or autoimmune disease. After vigorous evaluation by the FDA, both are approved for cosmetic and reconstructive usage.
It is recommended that you take one week off of work after breast augmentation surgery and continue to avoid strenuous activity and heavy lifting for 4 weeks after the surgery. I also ask the patients to not drive for 2 weeks after the surgery.
Breast augmentation can be performed from an age of 18 years old on up. You are NEVER too old to improve the appearance of your breasts.
Every patient’s anatomy is different, therefore, the only way to know which procedure would give you the best cosmetic result is by having a board certified plastic surgeon examine you and discuss your options with you.
No, it is a matter of choice for each woman. More than half of patients perform the surgery before having children and the majority of them have no problems breast feeding afterwards. The incisions used are small and the surgeon attempts to minimize the amount of disruption of the glands to the nipple/areola. The underlying breast implant does not harm the breast fed baby in any way.
The size that a patient decides to achieve is a very personal decision. Often time the patient wishes to achieve a “natural look” to simply improve the proportionality of the upper and lower body. Some patients, however, want a “round” look. For these patients a “natural look” is not a priority and they are not concerned if other people know that they have had a breast augmentation. In making this decision, it helps to discuss your goals with your surgeon. Pictures are often helpful as a form of communication between the patient and the surgeon. Often times, discussing “cup size” is useful but one must be careful since “cup size” depends on the manufacturer of the bra.
Yes. Breast implants, regardless of their location in the sub-muscular or sub-glandular location, can interfere with mammography. Generally, the breast implants placed in the sub-muscular position tend to interfere with mammography less than those placed below breast tissue. Mammography centers are well accustomed to performing mammography on patients who have had breast implants (using displacement techniques).
Yes, a small percentage (<5%) of patients have permanent nipple/areola sensation loss after breast augmentation surgery. Many patients have temporary loss or hyper-sensitivity of the nipple/areola complex. The surgeon takes great care during the operation to avoid injury to the nerve supply to the nipple/areola complex.
Several approaches are available to perform the breast augmentation. These include the following: an incision under the areola, under the breast (just above the infra-mammary fold), and in the axilla (arm pit). The choice of incision is a decision made by the patient and the surgeon. In general, we try to use the incision which is best hidden and therefore less visible. Often times, this decision is made based on the patient’s anatomy. For example, if the patient has some amount of excess skin under the breast, an incision can be well hidden in this area (just above the infra-mammary fold) otherwise an incision around the areola tends to heal very nicely and becomes barely visible with time.
The decision to do a sub-muscular (under the muscle) or sub-glandular (under the breast tissue) breast augmentation is based on several factors. Some of these factors include the patient’s preference and the patient’s anatomy. Each type of augmentation has its pro’s and con’s. In general, however, all things being equal, I prefer to do sub-muscular breast augmentations. This type of augmentation is associated with less chance of seeing or feeling the breast implant. This operation is also associated with a decreased risk of breast implant hardening (encapsulation or scar tissue formation). Sub-muscular breast augmentation interferes with the performance of mammography less so than does sub-glandular breast augmentation.
On the other hand, sub-muscular breast augmentation is generally associated with more patient discomfort and a longer period of time to achieve the final cosmetic results compared to the sub-glandular breast augmentation. Weighing the pro’s and con’s of each type of augmentation, whenever possible, I prefer to perform a sub-muscular augmentation to achieve an end result with fewer complications and a better aesthetic result.
In general, implants feel firmer than your own breast tissue. Also, the appearance and feel of augmented breasts depends on how much breast tissue the patient had pre-operatively. In general, the more tissue the patient the patient has pre-operatively, the more natural the look and feel post-operatively.
Normally, the bra will need to be worn for 2-4 weeks. There are reasons why the bra is important and following your surgeon’s directions will give you the best possible results. Each patient is different and so the recovery will also be different.