Breast Augmentation

Breast Augmentation in


Year after year statistical reporting shows breast augmentation as the #1 cosmetic surgical procedure performed in the United States, and this doesn’t look to be changing anytime soon.

For Orange County and Los Angeles women who are unhappy with their breast shape or size, want to improve body image, or want to look better in clothes and/or their bathing suit, breast augmentation can be a wonderful solution. A positive impression of one’s 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.

Newport Beach Breast augmentation plastic surgery is performed to enhance a woman’s breast size and shape due to lack of development, congenital abnormalities, changes or asymmetries following aging, weight loss, and/or pregnancy. In addition, there may be other reasons for wanting breast implants.. For example, some women have a nice breast shape or size, but simply want to be larger. Other women choose to have breast augmentation to increase their earning potential at work. The Pacific Center Plastic Surgery frequently assists women with breast augmentation who work in the entertainment industry. Whether someone is a model, actress, musician, spokesperson, or exotic dancer, having larger breasts can improve their popularity, which in turn makes them more money.

Breast Augmentation Results


Any women desiring breast augmentation surgery in Newport Beach is a candidate as long as there are no health problems present which would preclude her from having surgery. If the desired goal is to enhance or restore size and shape or to improve asymmetry, breast augmentation is a viable option. Breast augmentation can improve a body image, self-esteem, self-concept, and quality of life.


  • Desire larger, shapelier breasts.
  • Moderate degree of breast sag and smaller breasts, whose problem can be solved by enlargement.
  • One breast that is noticeably smaller or is positioned differently than the other (asymmetry).
  • Uneven chest wall or rib cage.
  • Women requiring breast reconstruction following a mastectomy.
  • Restore breast volume or shape following pregnancy, breast feeding and/or weight loss.


There are several choices a woman must make once the decision has been made to move forward with having breast augmentation with breast implants. These choices include: Implant type, implant size, implant profile, incision location, and implant placement.


Saline Implants At-A-Glance

Saline is made with a silicone outer shell that is filled with saline water during the surgery. The implant shell is ordered in a specified size which can be filled to a minimum or maximum fill amount. This allows the plastic surgeon some flexibility with sizing during surgery. Often times a woman has breasts which vary slightly in size. If one breast is slightly smaller than the other, each implant can be filled to a different amount to create better symmetry. Saline tends to be a little less natural feeling than silicone, but it can also create a more dramatic upper breast appearance, which some women prefer.

  • Filled with sterile saline (salt-water). Since saline is like normal body fluid, it is safe and easily absorbed if the implants were to leak
  • Leaks are easily detected due to implant deflation
  • Saline is filled after the breast implant is placed inside the chest
  • Unfilled saline breast implant is able to fit through a smaller incision than silicone
  • Volume of saline can be adjusted at the time of surgery to ensure optimal results, and can allow for a size correction between breasts of different sizes
  • Less expensive than silicone implants
  • Rippling may be felt or seen in thin patients, but rarely occurs due to placement behind the chest muscle

Silicone Implants At-A-Glance

Silicone is made with a silicone outer shell and is filled with a gummy-bear consistency silicone on the inside. More women tend to choose silicone breast implants due to the natural feel and appearance. Silicone implants are now made of a cohesive gel which are anti-leak even when cut. It is often called “gummy-bear like.”

  • Look and feel like natural breasts due to the cohesive silicone gel material
  • New generation silicone gel implants are far superior than those used in the past and have a proven track record of safety. Silicone implants have gone through more testing than any other medical device.
  • Silicone implants are the preferred choice for over the muscle implant placement
  • Silicone breast implants come pre-filled in a larger variety of sizes and profiles.
  • Silicone implants require a larger incision than saline, because they are pre-filled.
  • Cohesive gummy bear like gel material found inside the implant will not migrate into the body if the shell ruptures, which means it is harder to detect a leak.
  • The FDA recommends women have periodic MRI testing to ensure their silicone implants are free from any defects.

Sientra Breast Implants™ At-A-Glance

Sientra Breast Implants are silicone gel implants with full FDA approval only available to board-certified plastic surgeons. Sientra implants are exclusively filled with HSC gel, which aid in upholding shape, reducing risk of rupture, and increasing implant strength. Implants are offered in two shapes:

  • Round: available in multiple projections and designed with strength and softness in mind.
  • Shaped: designed to mimic a natural breast in both look and feel, Sientra shaped implants are both soft while upholding their strength and shape.

Each implant shape is offered in both smooth and textured. Sientra’s texture is a special design method to assist in placement and implant positioning, which helps maintain your implants over time.

Sientra Platinum20 Warranty

Pacific Center Plastic Surgery is proud to support the Sientra Platinum20 Warranty Program to ensure you get the best, long-term use out of your implants. This includes lifetime coverage of implant rupture and replacement, as well as up to twenty years of coverage for replacement in the event of high-grade capsular contracture. This is the most comprehensive and and least-restrictive warranty program in the industry, meaning you get the absolute best coverage for the absolute best results. Ask us about this program during your consultation to learn more.

The Ideal Implant™ At-A-Glance

The Ideal Implant™ is a new saline breast implant option recently FDA approved and is now being offered at the Pacific Center for Plastic Surgery Newport Beach. The Ideal Implant™ was created for women who are not comfortable having silicone implants in their body, but desire a more natural feeling implant than traditional saline implants on the market. The unique structure of the Ideal Implant allows for a similar look and feel as silicone with the safety of saline.

Read more about the Ideal Implant and their implant protection plans here.

Dr. Nichter on The Ideal Implant

With three different implant types offered at Pacific Center for Plastic Surgery, there are also choices when it comes to size, shape, and profile. This will be discussed in full detail at your breast augmentation consultation at our Orange County office.


There are four (4) common incision sites

Areola (peri-areolar) – A full circle incision made along the border of the areola. Heals very well. May be associated with an 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). This incision option is ideal for saline implant placement. Saline implants require a smaller incision because they are not filled until they are inside the body

Breast Fold (inframammary) – A horizontal incision made in the breast crease at the bottom of the breast. Incision is very well hidden. Dr. Horowitz and Dr. Nichter prefer this incision 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 due to the need for a longer incision to accommodate the size of the implant. Silicone implants come pre-filled, so they are full size at the time of placement.

Armpit (axillary) – Not as common. Incision hard to see. Must be performed by a well-qualified breast augmentation surgeon only. Special training, experience, and equipment may be required for this procedure. It has an increased risk of capsular contracture (hardening of implant).

Belly Button (TUBA) – Trans Umbilical Breast Augmentation is a 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. Incision is very well hidden. Must be performed by a breast augmentation surgeon who performs this often. Special training, experience, and equipment are required.

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.


Under the Muscle (sub-muscular)

When you hear the words “under the muscle” this actually means the breast implant is placed partially under the pectorals major muscle. Submuscular placement may be more uncomfortable the first few days following surgery due to the disruption of the muscle. The possible benefits of submuscular placement are that it may result in less palpable implants, decreased risk of capsular contracture, and easier to image the breast with a mammogram. Under the muscle placement is recommend for women are very thin with very little breast tissue. The partial muscle coverage will hide the implant better and help avoid visibility of any implant imperfections such as rippling. The appearance will also look more natural.

Over the Muscle (sub-glandular)

Over the muscle means above the muscle and under the breast tissue. This placement may make your surgery and recovery shorter and you will likely have less discomfort. This placement can provide a slight “lift.” Sub-glandular placement can result in more palpable implants, increased risk of capsular contracture and more difficult imaging of the breast with mammogram. This placement is often recommended for those patients with mild breast sag, but do not want a breast lift (mastopexy) and for tubular breast deformity.


This placement method is a more current technique most often used when there is mild breast sag and the patient does not want a breast lift. The breast tissue and muscle are partially separated to allow the breast tissue to sit in a better position. Dual-plane can be discussed further during the consultation should breast sag be of concern.

Breast augmentation with mastopexy

For women with moderate to severe breast sag, a breast lift (mastopexy) may be recommended to ensure the best result and longest lasting result. Failing to have a breast lift when necessary will only lead to a less than ideal result leaving the patient unhappy and needing a revision surgery. A larger breast implant can help lift the breast, but the low hanging breast tissue will still be present causing a disconnect between the implant and breast tissue located at the bottom of the breast.



Breast augmentation with breast implants is performed under general anesthesia by a board-certified anesthesiologist.


The procedure is performed at one of our preferred outpatient surgery centers located in either Newport Beach or Huntington Beach. Both facilities are accredited and meet the highest standard of patient safety and care.

Surgery Time

Breast augmentation takes anywhere from 45 minutes to 1 hour 15 minutes. An additional 30 minutes to 1 hour will be spent in recovery.


1) No Surgery – While the benefits of breast augmentation have been mentioned above, there is always the option to NOT have surgery. You should understand what breast augmentation with breast implants can and cannot do for you. While breast augmentation can improve self-esteem and self-confidence, surgery is never an option for trying to fulfill deeper emotional issues.

2) Natural Breast Enhancement (fat transfer breast augmentation) – We offer augmentation using your own fat to add volume and improve breast shape. This procedure can also sometimes be done under local anesthesia vs. general anesthesia and requires less recovery time.

3) Breast Augmentation with Breast Implants – The benefits and procedure details have been listed above.

When deciding to have surgery, 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 understand what breast augmentation can do for you and what it cannot do. You should be aware of the potential risks and complications associated with breast augmentation surgery.

Breast Augmentation Surgery Instructions

Prior to Surgery

Once you have scheduled your surgery date, your consultant will schedule your pre-operative visit with one of our registered nurses. This visit will also about one hour. Here is a list of what takes place at this visit:

  • We will take your before photos
  • Ask to see printed breast photos showing what you would like your breasts to look like
  • Go over your health history again
  • Take your blood pressure
  • Give you prescriptions for medications to be filled before surgery (antibiotic, muscle relaxer, pain medication, etc.)
  • We will inform you of any medical testing needed – this is based on age and health history (testing can include: blood tests, EKG, mammogram)
  • Finalize implant type, size, and profile and confirm incision site and implant placement
  • Complete all consents and other required paperwork, pay your final balance
  • If a post-operative sports bra is not provided, we recommend purchasing a couple of basic sports bras to use during recovery.

After Breast Augmentation Surgery

Rest: After surgery you will be groggy from the anesthesia. We recommend going home and resting or sleeping on your back by propping yourself up with several pillows.

Food: Once you feel up to eating, start with bland items such as toast or crackers or even a smoothie. Test your stomach to make sure you do not feel nauseous when you eat. Try to maintain a healthy well-balanced diet to improve your recovery process. Be sure to eat fiber rich foods, because the medications you are taking can cause constipation.

Medication: Be sure to begin taking all mediations as prescribed. Initial discomfort of the breasts is controlled with pain medication and a muscle relaxer.

Showering: You may shower three (3) days after surgery.

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, what is necessary for your needs.

Sutures: Most sutures dissolve on their own within a few weeks.

Walking: Once the anesthesia has worn off, begin walking around the house periodically throughout the day. This will help minimize swelling and bruising and help with the healing process. You do not want to lay in bed for days and days without some mild activity.

Driving: You can usually drive a few days following surgery, if you feel comfortable doing so. Your chest may be sore and your arms may be limited in movement, so take this into consideration before you get behind the wheel of a car. You cannot be under the influence of pain medication or muscle relaxers when you drive.

Work – Most 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 off may be required depending on the physical demands of your job. Some employers will modify a person’s job duties so they can back sooner, but without physical activity. Our office can provide you with a note stating you are not to engage in strenuous activity for a specified period of time. The note will note disclose what procedure you underwent.

Breast Appearance – 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.

Massage – 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. You will be informed about this at your post-operative visit.

Physical Activity/Exercise: Avoid heavy lifting and strenuous activity 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. Aerobic exercise will raise your blood pressure, which could cause late bleeding and harm your result. Once you begin exercising again, start gently and let your body tell you what it can tolerate. Don’t rush!! It may require the full 6 weeks before you can do any upper body work-outs, yoga, etc.

Exposure to Sunlight: Scars can 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.



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.


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.


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.


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.


When you have breast augmentation performed by a plastic surgeon who specializes in cosmetic surgery you greatly improve your chances of getting the result you want without the need for a revision surgery. It is imperative you select a plastic surgeon who is board-certified and has a great deal of experience with breast augmentation and the incision type, implant placement, and implant type. Plastic surgeons who have specialized in breast surgery and cosmetic surgery, such as Dr. Horowitz and Dr. Nichter, are suitable to perform your breast augmentation in Newport Beach. Aside from checking board-certification, it is suggested that you look at before and after photos of the surgeon’s actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.


Virtual Consultations & Destination Services in Newport Beach, CA

Pacific Center for Plastic Surgery is committed to helping you make your trip to beautiful Newport Beach as pleasant and luxurious as possible. Don’t let distance hold you back from meeting our amazing plastic surgeons. Dr. Jed Horowitz and Dr. Larry Nichter see patients from all over the world, and they make patients’ comfort and happiness their top priority. If you want to book a virtual consultation, or you need help finding places to stay in the Orange County area, please call our office today at (949) 565-2121 or request a consultation online.