Breast Augmentation Newport Beach


IDEAL IMPLANTOn November 18, 2014 Valeant Pharmaceuticals and IDEAL IMPLANT Incorporated announced the receipt of approval from the U.S. Food and Drug Administration (FDA) to market the advanced technology Saline Filled IDEAL IMPLANT for use in primary breast augmentation or replacement of existing breast implants.

This is exiting news for Pacific Center for Plastic Surgery. Both Dr. Horowitz and Dr. Nichter are FDA investigators for IDEAL IMPLANT® and Dr. Nichter has been selected as a spokesperson. The doctors are also part of a limited number of breast augmentation surgeons around the country selected to have initial access to the IDEALIMPLANT®. IDEAL IMPLANT® is a saline filled implant with the natural feel of a silicone implant.

Dr. Nicther was quoted in the Valeant press release as saying, “For years, patients have been asking for a breast implant that offers the natural feel of silicone gel with the safety of saline.” He went on to explain, “The IDEAL IMPLANT effectively addresses that need with an internal structure that allows this saline implant to achieve the look and feel of natural breasts. The use of only saline with the IDEAL IMPLANT technology eliminates the potential concern of silent ruptures that require MRI monitoring for detection.”

The IDEAL IMPLANT® saline-filled breast Implant is indicated for women at least 18 years old for primary breast augmentation to increase breast size. Breast implant surgery is contraindicated in women with existing breast cancer or pre-cancer, women with active infections or who are currently pregnant or nursing. The IDEAL IMPLANT® has not been studied for use in breast reconstruction. For more information, you can read some of Dr. Nichter’s articles here.

Pacific Center for Plastic Surgery  is now offering complimentary consultations for prospective IDEAL IMPLANT® patients with anticipated availability in May 2015. For more information, patients are encouraged to contact the practice at (949) 203-3841

Ideal Implant Before/After

Breast augmentation using the saline filled IDEAL IMPLANT









Why breast enhancement?

Many women who would like to restore or enhance the size and shape of their breasts may benefit from breast augmentation, also known as mammoplasty. One of the most common procedures performed annually by members of the American Society for Aesthetic Plastic Surgery, breast augmentation plastic surgery is performed to enhance the breast size and shape due to congenital abnormalities, a lack of development, changes or asymmetries following aging, weight loss, and/or pregnancy. In addition, there may be personal reasons for augmentation mammoplasty. For example, some women may perceive their breasts to be under developed. Women may also decide on breast augmentation, though they may be happy with their breasts, just because they would like them to be fuller. A positive impression of their body image is important to many women, and breast augmentation may aid in offering a more proportional breast size and shape as well as in improving self-confidence.

Who is a candidate?

This operation is performed to enhance or restore the size and shape of a woman’s breasts. Breasts may be small because of a lack of development, or changes following pregnancy, weight loss, or congenital abnormalities. Sometimes a woman’s breasts are very asymmetric. This operation can improve a woman’s body image, self-esteem, self-concept, and quality of life. Women who desire larger, shapelier breasts. Women with a moderate degree of breast sagging and smaller breasts, whose problem can be solved by enlargement. Women who have one breast that is noticeably smaller than the other. Women who have an uneven chest wall or rib cage.

Intended result

To improve the shape, size and contours of the breast. To re-contruct the breast after mastectomy. To improve asymmetries of the breast and chest.

Procedure description

There are four (4) common incision sites: under the arm (axillary), around the nipple (periareolar), the breast fold area (inframammary) or through the umbilicus (belly button). If the incision is made through the umbilicus or under the arm, the surgeon will create a soft tissue tunnel to insert the implant into its “pocket” for the breast implant (endoscopic method). Depending on location, existing scars on the breast or abdomen can be used as an insertion site. TUBA (belly button) Trans Umbilical Breast Augmentation – this incision leave no scars on the breasts; special training, experience, and equipment are required. This is the most common method we currently use for saline implants. The results are excellent and only a tiny incision in the belly button is required. Only saline implants can be inserted by this method. Periareolar – this incision is well concealed, but may be associated with a increased likelihood of inability to successfully breast-feed, as compared to the other incision sites and has an increased risk of capsular contracture (hardening of implant). Inframammary – this small incision is in the fold under the breast. We prefer this for silicone implants when women already have a breast that falls over the fold. A very tiny incision can be used here for saline implants. This is the most common and recommended site for silicone implant placement. Axillary – with this incision, there are no scars on the breasts Special training, experience, and equipment may be required for this procedure. It has an increased risk of capsular contracture (hardening of implant). The breast implant can be placed either partially under the pectoralis major muscle (submuscular) or on top of the muscle and under the breast gland (subglandular). No single incision or placement choice is right for every woman. You should discuss with your surgeon the pros and cons of the implant placement he selects for you. By knowing your options and discussing them, both of you can decide upon an incision/placement combination that is best for you. Submuscular placement may be more uncomfortable the first few days following surgery. The possible benefits of submuscular placement are that it may result in less palpable implants, less capsular contracture, and it will make it easier to image the breast with mammography. The appearance may be more “natural” for patients who are very thin. Subglandular placement may make your surgery and recovery shorter and you may have less discomfort. This placement may provide a slight “lift”. Subglandular placement may result in more palpable implants, more capsular contracture and more difficult imaging of the breast with mammography. This placement is often recommended for those patients with sagging, but do not want a breast lift (mastopexy) and for tubular breast deformity. Dual-Plane placement method is a more current technique most often used when there is a small amount of sagging. The breast tissue and muscle are partially separated to allow the breast tissue to sit in a better position. Saline Implants – a saline breast implant is a sac (implant shell) made of silicone filled with salt water. The implant is inserted empty then filled with saline through a tube during surgery. Very small incisions can be used to insert these implants Silicone Gel-Filled Implants – a silicone gel-filled breast implant is filled with silicone gel, a soft-solid substance like jello. Silicone implants are now made of a cohesive gel which are anti-leak even when cut. It is often called “gummy-bear like”. The procedure is done on an outpatient basis under general anesthesia and usually takes less than one hour. You will spend 30 minutes to 1 hour in the recovery area

Risk, benefits and alternatives

Benefits are noted above. No surgery or treatment is always the first alternative. You should understand the complete treatment plan outlined for your benefit and enhancement. Natural enhancement with your own fat is an option, and the choice of implants have been described. You should be comfortable with your doctor and his staff members. You should be confident that all your questions have been answered in a manner that you understand. You should be aware of all the normal healing, as well as common, less common, and unusual risks to whatever degree you are comfortable with. (Some patients decline to hear about rare complications such as death and other graphic medical problems.) A more comprehensive list of issues and complications during normal healing as well as a problematic post operative course is available online at It can also be provided by your consultant, or at our reception desk. It will be given to you upon scheduling surgery. This will provide additional time to again review all of the material. You must sign the complete consent form by your preoperative visit (2 weeks) before surgery. Again, this allows adequate time to have any and all of your questions answered. Some additional Risks are:

  • Excessive bleeding (hematoma) and bruising
  • Reduced Sensation of Nipple
  • Deflation/Rupture
  • Capsular Contracture
  • Wrinkling/waviness: palpable and/or visible
  • Firmness, and distorted appearance
  • Interference with breast feeding
  • Mammogram Interference
  • Insurance and Cost for Additional Surgeries
  • Calcium Deposits in the Tissue Around the Implant
  • Breast Tissue Atrophy/Chest Wall Deformity
  • Tissue Loss
  • Infection requiring antibiotics or implant removal

In addition to these common complications, there have been concerns with rarer diseases, of which you should be aware:

  • Connective Tissue Disease
  • Galactorrhea (milk production)
  • Second Generation Effects

Additional Advisories

  • Breast and Nipple Piercing Procedures Increased Risk of Infection
  • Interference with Sentinel Lymph Node Mapping Procedures

Recuperation and healing

You can usually drive after all pain and muscle relaxation medications have stopped, and you feel comfortable with this activity, usually within the first week following surgery. Many patients can return to work in a few days, unless their occupation requires particularly strenuous movements and lifting. In such a case, up to 6 weeks may be required depending on the physical demands of your job. The final appearance, shape, and movement are not exactly the same as normal breasts. The surgically enlarged breasts do not move in the same way as normal breasts. They tend to be firmer. The contours are usually somewhat different than normal breasts. In some patients these discrepancies may be rather noticeable. Although every effort is made to place the implants symmetrically, complete symmetry is rarely achieved. Immediately after surgery, the breasts are swollen and firmer. The final shape and size is approximated after 2 to 3 months, but up to one year may be required for the end result. Initial discomfort is controlled with oral medication. Sutures dissolve in 7 to 14 days. Light activities can be resumed as tolerated. Light exercise can be started in about 2-3 weeks, and strenuous exercise after 6 weeks. Your doctor may require you to move or massage the implants within the breast pockets during the postoperative period. Textured implants do not require breast massage.

Other options

An additional procedure that would enhance the result is a Mastopexy (breast lift) if the breasts are sagging in addition to being small. A fat graft from your body can be used to achieve a more modest increase in breast size without implants – Natural Breast Enlargement. Ask your surgeon for details if interested.


You should have a preoperative mammogram if your age or family history dictates this.

Specific post operative instructions

ACTIVITY: Avoid heavy lifting and straining for six weeks. You may, however, do normal activities at any time if they cause no pain or discomfort. Let your body tell you what you can or cannot do. DRESSINGS: These will vary from patient to patient. Some patients may be placed in a sports bra; others will wear a stabilizing elastic support strap. Your doctor will decide after surgery and in subsequent weeks, which dressing will suit your needs. SHOWERING: You may shower three (3) days after surgery. SUTURES: Most sutures dissolve on their own. EXPOSURE TO SUNLIGHT: Scars take at least one year to fade. During this time, you must protect them from the sun. Even through a bathing suit, a good deal of sunlight can reach the skin and cause damage. Wear a sunscreen with a Skin Protection Factor (SPF) of at least 30 at all times when in the sun. Be extremely careful if areas of your breast skin have reduced sensitivity. EXERCISE: You may take gentle walks within a few days, light aerobic exercise in 2-3 weeks, and unrestricted exercise after 6 weeks. DRIVING: You may drive when you no longer have pain, are no longer taking narcotics or muscle relaxants, and feel you can drive safely.

Specific as you heal information

ACTIVITIES: It is important that you not engage in strenuous activities in the first 6 weeks after surgery. Aerobic exercise will raise your bloodpressure, which could cause late bleeding and harm your result. If your job keeps you sedentary, you may return to work when you feel comfortable, several days after surgery. Once you begin exercising again, start gently and let your body tell you what it can tolerate. Don’t rush!! HEALING OF SENSORY NERVES: Tingling, burning or shooting pains, which will disappear with time and should not alarm you, indicate regeneration of the sensory nerves. If these sensations cause pain, repeated, local self-massage helps. ASSYMETRY: The two breasts commonly heal quite differently. One breast may swell more, feel more uncomfortable, or have a different initial shape. After complete healing, they will be more similar and natural. You must have patience, but if this causes concern, ask questions of the doctor or the nursing staff. SHAPE AND CONTOUR: The final shape of your breasts will start to look its best approximately three (3) months after surgery. It takes time for the skin and muscle to stretch and relax around the new implant. The breast will often look higher, firmer, and “less natural” in the first three (3) months. It can take up to a year to see your final result. FOLLOW-UP EXAMS: These are generally done in 1 week, 2 to 3 weeks, 3 to 6 weeks, 3 months, 6 months to 1 year, and 1-2 year intervals. These are included in your initial surgical fee. WARRANTY INFORMATION: Please check manufacturer’s website for current warranty programs Website information listed below. Specific surgical risks Information may be obtained in greater detail from the references listed below: American Society for Aesthetic Plastic Surgery FDA American Society of Plastic Surgeons Breast Implant Safety Mentor 800-235-5731 Allergan / Natrelle 800-362-4426 Ideal Implant (214) 492-2500 Sientra (805) 562-3500

What are some considerations I should take into account when selecting a plastic surgeon?

The most popular way to improve breast size and shape is breast augmentation performed by cosmetic plastic surgeons. Generally speaking, seek out Board Certified Plastic Surgeons with a great deal of experience for best results. Those plastic surgeons that have specialized in breast reconstructive and cosmetic surgery, such as the surgeons at Pacific Center for Plastic Surgery, are a great fit for your breast augmentation needs.

RealSelf Patient Reviews of Jed H. Horowitz, MD, FACS

RealSelf Patient Reviews of Larry S. Nichter, MD, MS, FACS