Breast Augmentation

Offered at our convenient location in San Francisco

breast augmentation

Considering breast implants? We’re here to help! Learn how you can enhance your profile with fuller, natural-looking breasts, or return to your pre-pregnancy self by restoring lost volume with breast augmentation. Find out about the different types of implants, procedures, recovery, reviews, and costs below.

What is Breast Augmentation?

Breast Augmentation (mammoplasty) is a surgical procedure that enhances the shape, size, and proportions of a woman’s breast using implants. The procedure involves placing implants to increase the size, projection and/or volume of the breasts. Breast Augmentation can do wonders for women who are interested in increasing the size of their breasts in order to balance their figure or have experienced loss of breast volume or asymmetry due to pregnancy or aging. Many patients describe how breast augmentation has helped to enhance their self-confidence and self-image.

The most common concerns corrected with a breast augmentation are:

  • Enhancement of size, shape, and/ or firmness of breast
  • Restore lost breast volume after pregnancy or nursing
  • Reconstruction after Mastectomy, Lumpectomy, or other trauma

Before & After Photos

Who Can Get Breast Augmentation Done?

Augmentation mammaplasty offers an answer for women seeking to restore the fullness of breasts after pregnancy or weight loss. Those with asymmetrical breasts can also benefit from the procedure, with the help of a skilled plastic surgeon to improve the balance and aesthetics of their curves.

While the procedure is available to any adult female whose breasts have fully developed, you must be in generally good health, as this could impact the longevity and results of the procedure. Female patients requesting silicone implants must be age 22 or older.

The most important thing when choosing to have breast augmentation is making sure you have realistic expectations about what the procedure can and cannot achieve. Breast augmentation alone will not correct severely drooping breasts, nipple placement, or breast placement on the chest. To address concerns such as these, an additional procedure such as a breast lift may also be necessary to achieve your desired results.

Types of Implants

Breast Implants on table

There are two main types of implants: Silicone Implants (Cohesive Gel a.k.a. Gummy Bear) or Saline Implants (sterile salt water), each have a silicone shell. Both are a safe, FDA-approved implants each with their own benefits. Other variances include volume, texture, and shape. Sizes range from 50cc up to 1,000cc, they may be smooth-walled or textured, and implants may be round or shaped (teardrop). We offer the entire line of implants from Mentor®, Natrelle®, and Sientra®.

Implant manufacturers introduce new styles and types of implants, so we always have a wide variety of shapes and sizes to choose from. No matter which implant you ultimately choose, it is important to monitor your breast implants and regularly follow-up with your plastic surgeon as needed.

Silicone Breast Implants

Silicone breast implant sample

Silicone Breast Implants have a silicone outer shell filled with a cohesive silicone gel. The silicone gel tends to feel softer and more like real breast tissue when compared to the saline implants. If a silicone breast implant cracks, leaks or ruptures the silicone gel will remain within the implant shell or the tissue pocket surrounding the implant.

Silicone breast implants are FDA-approved for women 22 years or older and come in both anatomic and round shapes. In general, silicone implants have low complication rates, give a more natural look and feel, highest satisfaction rate for breast implant choices.

Saline Breast Implants

Saline breast implant

Saline Breast Implants have a silicone outer shell filled with sterile salt water. Should the implant shell leak, the saline will simply be absorbed and naturally expelled by the body.

Saline implants provide a uniform shape, firmness and feel and are FDA-approved for augmentation in women 18 years or older. Saline breast implants come in both anatomic and round shapes.

Anatomic Shaped Breast Implants

Anatomic Shaped Breast Implants (also known as “gummy bear” implants) are form stable silicone gel implants shaped like a real breast. The consistency of the silicone gel inside these implants tends to be thicker and firmer in order to maintain shape. These are ideal for breast reconstruction after mastectomy or patients who have very little real breast tissue. These shaped implants come in a variety of shapes, profiles and sizes but typically have more projection at the bottom and are tapered toward the top.

Round Shaped Breast Implants

Round saline implant

Round Shaped Breast Implants give the breasts a fuller look when compared to the shaped implants. Round implants are recommended for patients who have a moderate amount of real breast tissue to begin with and are looking for increased fullness and projection.

The existing breast tissue helps conceal and contour the implant once it’s in place so the round shape doesn’t appear too obvious.

Smooth Breast Implants

Smooth Breast Implants have a smooth outer shell & are the softest feeling implants. These implants can move within the breast implant pocket, which may give more natural movement.

These implants may have some palpable or visible rippling. However, Dr. Miranda works very closely with his patients prior to surgery to choose the right size implant. Smooth implants come with either saline and silicone gel filling.

Textured Breast Implants

Textured

Textured Breast Implants have a textured outer shell so the body develops scar tissue to adhere to the implant, making them less likely to move around or reposition.

Most of the anatomic shaped breast implants have this textured shell to prevent any rotation of the implant inside the pocket. It has also been said that textured implants are less likely to develop a tight scar capsule (capsular contracture).

Ideal Breast Implants

The next generation in breast implant technology is here. Pacific Plastic Surgery Group is proud to offer IDEAL IMPLANT for those seeking the best of both worlds – the natural look and feel of silicone and the safety of only saline inside. Ideal Implants are the next generation of breast implant technology. Designed by plastic surgeons to give the best of both worlds – the natural look and feel of silicone and the safety of only saline inside.

With the IDEAL IMPLANT, a women can simply look in the mirror and know her implants are intact.

FDA approved.

How They Work

Ask Dr. Miranda a question about Ideal Implants.

Designed by plastic surgeons to give the best-of-the-best and not having to decide be- tween silicone and saline. The ideal implant has a sequence of shells nestled together and two independent chambers that hold saline. The interior structure controls the natural-look- ing and feeling movement of the saline and supports the implant to reduce folding and wrinkling. In addition, the implant has been designed to contour to the natural curve of the chest wall.

Augmentation Procedure

THE INCISION SITE

Incisions are made in inconspicuous areas to minimize visible scarring. You and your plastic surgeon will discuss which incision options are appropriate for your desired outcome. Incision options vary based on the type of breast implant, degree of enlargement desired, your particular anatomy and patient-surgeon preference. The four primary incision sites are:

Periareolar Incision

is made along the outer edge of the areola, where the skin is darker. This minimizes the visibility of the incision and scars later on.

Inframammary Incision

commonly referred to as the “breast fold” incision, is the most common type of incision for breast implants. The incision is made where the bottom of the breast meets the rib cage. This scar can only be seen when the breast is lifted.

Transaxillary Incision

is made inside the armpit, along the outer edge of the breast and the scare is only seen when the arm is lifted.

Transumbilical Incision

may be used when the patient has chosen unfilled saline implants. The incision is made in the navel, the implants are inserted, placed, then filled.

INSERTING AND PLACEMENT OF IMPLANTS

The method for inserting and positioning breast implants depends on the type of implant, degree of enlargement desired, your body type and your surgeon’s recommendations. After the incision is made, a breast implant is inserted into a pocket either: Under the pectoral muscle (a submuscular placement), or directly behind the breast tissue, over the pectoral muscle (a submammary/ subglandular placement).

Augmentation Size

There are many factors to consider when deciding what size, shape, and type of breast implant to choose. Some things to consider when deciding are your body type, shape, age, activity level, and overall goals.

Do you want see what the difference between 300cc and 400cc looks like on you? Want to be sure you’re choosing a size that looks natural? We offer Crisalix 3D Simulator Imaging at Pacific Plastic Surgery Group. We’re able to create realistic 3D before and after images of your breast augmentation. We offer FREE 3D imaging with our consultations.

What to Expect

Breast Augmentation is most commonly performed on an outpatient basis, meaning you can go home the same day. However, if breast augmentation is combined with other procedures such as a tummy tuck, liposuction and/or facelift you may be given the option to stay over night. This is something you will discuss with your surgeon at your pre-operative appointment. On the day of procedure you will arrive at our private surgery center about 2 hours prior to your surgery to complete your forms, meet the anesthesiologist, and meet with Dr. Miranda or Dr. Dudas again.

During the breast augmentation procedure, which is conducted under general anesthesia, Dr. Miranda or Dr. Dudas will make a small incision in a specific area. The location of this incision will depend on the kind of implant (silicone or saline) and extent of augmentation desired. You will discuss your incision options with Dr. Miranda or Dr. Dudas during your breast augmentation consultation and pre-operative appointments.

Incision options for your breast augmentation include the transaxillary incision, the periareolar incision, and the inframammary incision. The transaxillary incision is made in the armpit and, as it is farthest from the breast, it works best for small saline breast implants. The periareolar incision is made around the areola, and the inframammary incision is made in the breast fold.

Once the incision is made, breast pockets are created in the tissues. The implants are then carefully placed in the pocket, either beneath your pectoral muscle (i.e. under the muscle, submuscular) or over it but behind your breast tissue (i.e. above the muscle, subglandular). The positioning of the implant is another detail you will discuss and decide upon with Dr. Miranda or Dr. Dudas prior to surgery.

The method for inserting and positioning implants varies from patient to patient and depends on the type of implant, degree of enlargement desired, body type, and Dr. Miranda’s or Dr. Dudas’ recommendation. The incisions are closed using either sutures or surgical tape.

Consultation and Preparation

During your consultation, you and your surgeon will discuss why you want breast implants along with your expectations and goals. Together, you will determine the breast size that is best for your body shape and size (in some cases this may require compromise), the site of your incision, whether you want silicone or saline implants and where the implant will be placed.

A general health evaluation will be performed and detailed measurements made to create an optimal course of treatment. You will go over your medical history including last mammogram and family history of breast cancer. You will discuss any current medical conditions, any prescriptions or over-the-counter medications you are currently taking, and share any drug allergies and previous medical treatments.

PREPARATION

After your initial consultation with one of our board-certified plastic surgeons, Dr. Edward Miranda or Dr. Jason Dudas, and choosing the type of implant, procedure, and surgery date, the doctor will advise you on the proper lab tests to have done and go through your prescriptions and over-the-counter medications.

You will meet with your surgeon at least twice prior to surgery to go over all the details of the procedure and answer any questions you might have.

During these consultations you will discuss important aspects of the surgery and what precisely it will entail. Routine procedures include having a baseline mammogram done both before and after your surgery in order to determine whether or not there have been any changes to your breast tissue.

Three Weeks Before Procedure

We are dedicated to assisting you every step of the way.

Stop smoking and drinking. Smoking may even need to stop earlier due to its effect on the healing process. Smoking constricts your blood flow to all areas of your body, which slows down your body’s healing capabilities. As for drinking, it can also affect your healing and your immune system, making you more susceptible to illness and disease.

Alcohol consumption before surgery also makes you more susceptible to bleeding and should be cut out completely before and after your surgery until your counselor gives you the okay. Disclose all prescription and over-the-counter (OTC) medications to your doctor to ensure that nothing will negatively affect you. Lastly, cut back on any foods containing salicylates, since this affects your blood and can cause excessive bruising.

Two Weeks Before Procedure

You should check your medications again. What may have been acceptable three weeks before surgery may not be acceptable now. These medications include ibuprofen, anti-inflammatory drugs, blood-thinners, and Vitamin E supplements.

There are also certain things that you should begin doing two weeks before your procedure. Start taking multivitamin supplements with the approval of your patient counselor, including vitamins A and C. Bromelain (found in health food stores) can also help relieve swelling after surgery. Iron is also recommended before liposuction.

One Week Before Procedure

Reduce your sodium intake. Sodium increases swelling, so reducing it to a minimum one week before your surgery in order to minimize discomfort after the procedure. Be sure to eat healthy and regularly in order to boost your body’s immune system and health. This includes eating fruits, vegetables, and protein with every meal. Get all your prescriptions filled ahead of time, especially those related to your procedure, and contact someone about driving you to and from your procedure.

You should also have somewhere prepared for you to recover after your surgery is complete where you can rest, relax, and easily contact someone for assistance or in case of an emergency.

The Day of Surgery

You will check in at the surgery facility chosen. You will be evaluated by your anesthesiologist and meet with your plastic surgeon. He will measure and mark you for surgery. Surgery takes approximately 2-3 hours. After surgery, you will go to the recovery room, where you will be monitored for another 1-3 hours before being discharged.

Our Plan for your Best Recovery

Pacific Plastic Surgery Group has used our experience in breast augmentation to maximize your outcomes and minimize your downtime and discomfort after having breast implants. We have developed and use a consistent plan before, during and after surgery to make your recovery as easy as possible.

Before Surgery

  • Implants are chosen that fit your measured frame to give you a look consistent with your desires.
  • Pain Medication is prescribed at your pre-op appointment (so you do not have to worry about it after surgery).
  • Topical antibacterial soap is prescribed for use for 5 days prior to surgery to reduce the risk of infection.
  • As most discomfort after breast augmentation surgery is due to inflammation and or stretching of the muscle, simple exercises to prevent the muscles from cramping are taught to you.

During Surgery

  • Long-acting local anesthetics are used before the surgery starts to minimize discomfort after surgery.
  • An optimized combination of medicines are given by the anesthesiologist to minimize inflammation of the muscles, improving comfort during and after surgery.

After Surgery

  • Anti-inflammatory medications are used to reduce pain and increase mobility.
  • Light exercises are performed to maximize mobility and minimize pain.
  • Early mobility is emphasized, and you are encouraged to go out for a walk or out for a light dinner on the evening of surgery.
  • Narcotic pain medicine is prescribed for discomfort that is not fully eliminated with the anti-inflammatory medicine and light exercises.
  • Return to work is generally within a week (although this depends on the type of work).
  • The incisions generally heal within 1-2 weeks. Generally there are no stitches to remove.
  • You can wear the new bras/bikini you purchased after about 2 months!

We have even had a patient go to fashion show the evening after her breast implant surgery–in a gown! (Although, this is atypical). Keep in mind everyone’s recovery is different. We at Pacific Plastic Surgery Group want you to return to your regular life as quickly as possible.

Post Op Instructions

Post-Care, Recovery, and Results

Understanding the importance of post-care is essential. Knowing what the recovery process entails and what to expect is an important aspect of your preparation and will better prepare you for your surgery. After surgery you will be taken into a recovery area and be closely monitored. Your breasts will be wrapped in gauze dressings and an elastic bandage or support bra will minimize swelling to the breasts as they heal. You may be permitted to go home after a few hours.

Before leaving you will be given specific instructions that will include how to care for your breasts following surgery and when to follow up with your plastic surgeon, be sure to follow all instructions carefully.

RECOVERY

You will likely experience 24-48 hours worth of post-surgical recovery time (downtime). During this time, your activity level should be reduced and your pain level may be higher. Some mild pain, swelling, and bruising after surgery is normal; these will be temporary. General soreness and swelling should dissipate in a few weeks’ time. Typically we see you back in the office for a post- operative appointment about 5-7 days after surgery, if any sutures need to be removed that is done at this time.

RESULTS

Your results are immediately visible post-surgery. To ensure optimal results and avoid infection, it is important that you follow post-operative instructions and do not skin any of the education your doctor advises. Return for post-procedure follow-ups, and if you have concerns or feel something is amiss, call our office right away.

Cost & Financing

Each patient is unique and their needs and procedure outlines are curated to compliment those unique needs and optimize their personal results. There are numerous factors that calculate the price of breast augmentation, some variables include the overall goal of the patient, type of technique and implant, type of anesthesia, the facility chosen, post-surgery garments, prescriptions, and most importantly, the experience and skill of the plastic surgeon. Both, Dr. Edward Miranda and Dr. Jason Dudas are highly-skilled and experienced plastic surgeons with excellent breast augmentation results.

The average cost of breast augmentation can vary depending on your unique needs. . By scheduling a consultation with one of our board-certified plastic surgeons, Dr. Edward Miranda or Dr. Jason Dudas, you will be able to have an accurate quote composed for you which will outline all the procedure costs.

We offer financing through CareCredit and Prosper Healthcare Lending.

CareCredit is a healthcare credit card designed for healthcare services like cosmetic surgery and non-invasive procedures with special financing on certain purchases. Provided you have credit available, you can also use your card for follow-up appointments or for different procedures. *Subject to credit approval. Minimum monthly payments required. Visit www.carecredit.com for details.

Prosper Healthcare Lending is the premier financing company in the healthcare industry. Loans are easy (apply, check your rate, choose your terms, get your funds), with low interest rates, fixed terms, and with no hidden fees or prepayment penalties. Learn more on their website.

Ready to apply? Have questions? Please call our office and we would be happy to assist you in learning more. You can also apply online.

Reviews from PPSG Patients

5 Stars 2/21/2015
One word to describe my experience from start to finish with Dr. Miranda and his office: AMAZING. Before I came to Dr. Miranda, I went to a few consultations for breast augmentation and no other doctor made me feel as comfortable or confident with my decision. The results of my augmentation, also amazing. I told Dr. Miranda I wanted the most natural looking job, I even showed pictures and they came out exactly how I wanted. Dr. Miranda is a magic worker, post operatively, I was in hardly any pain. I got the gummy silicone at 330cc, and they look completely natural, hardly any scarring or post-surgical discomfort. I would suggest him to anyone looking to have their breast done.
– Ashley C.

5 Stars 1/4/2015
I am extremely pleased with the outcome of my breast augmentation, Dr. Miranda is an excellent surgeon! Plus my physical & emotional level of confidence has improved tenfold … I highly recommend Pacific Plastic Surgery Group. – Julia E.

5 Stars 5/2/2016
I was referred to Dr. Miranda for my body transformation by 2 friends who went to Pacific Plastic Surgery for breast implants. I had 350cc anatomical implants installed just over 2 weeks ago … Dr. Miranda does a great job of explaining what’s going on & his patient coordinator, Tori, has been lovely. Dr. Miranda is all business & very professional. Tori is fantastic about making sure I’m comfortable & understand everything from billing to recovery time. The staff at the office is great & the surgery center next door is very convenient. Im looking forward to Stage Two! – AV