Ghada Y. Afifi, MD, FACS
Board Certified Newport Beach Plastic Surgeon
You. Just Better.

Breast Augmentation

Breast augmentation, also known as mammoplasty, is a surgical enhancement procedure to accentuate the size and shape of a woman's breasts. While augmentation will make the breasts larger, the surgery will not move the breasts closer together or lift sagging breasts. Breast augmentation is helpful to patients who desire a fuller profile, who have lost breast volume due to pregnancy or nursing, or who have undergone breast reconstruction and want to gain a more natural look.

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Reasons for Considering Breast Augmentation:

  • Enhance body shape if breasts are too small.
  • Increase breast volume after pregnancy and nursing.
  • Equalize a difference in cup size to gain breast symmetry.
  • Reconstruct breasts following a mastectomy or injury.

General Procedure

Breast augmentation involves making a small incision to insert a breast implant into the breast area. The surgery is commonly performed on an outpatient basis at a hospital or state-of-the-art surgical unit while the patient is under a general anesthesia and asleep. There are several possible locations for the small incision that will be used for inserting the breast implant. The most frequent technique utilizes an incision made in the lower portion of the breast. Another technique, though less frequently used, involves making an incision in the armpit. A third technique makes an incision around the areola (the darker skin surrounding the nipple). A newer technique uses an incision in the belly button, thus reducing the chance of scarring in the breast area.  The best technique will be decided together between the patient and the surgeon during the consultation.

During surgery, the breast tissue is raised to create an open pocket under the breast tissue or beneath the chest wall muscle.  Inserting an implant behind each breast can increase a woman's breast size by one or more bra cup sizes. Implants typically contain a saline solution, although in special cases the implants can contain a silicone gel. In some circumstances, particularly those in which there is breast asymmetry (uneven breast size), an inflatable implant may be used to allow the surgeon to adjust the level of inflation to attain breast symmetry and balance. Surgery typically lasts from 1 to 3 hours.



  • Silicone versus saline
    • Silicone
      • with less rippling, feels softer and more natural
      • There are NO health issues such as cancer, arthritis, etc., as shown and proven by FDA!
      • More costly than saline (about $1000 more per pair)
      • More options: cohesive options- Inspira soft touch and highly cohesive (more firm implants with less rippling)
    • Saline
      • less costly, but more rippling and 'water hammer' effect
      • Higher chance of implant failure such as deflation
    • Location: above or below the muscle
      • Submuscular with less rippling and more natural look 
      • Round versus anatomical / shaped implants
      • Shaped implants come as textured only
      • If wish more upper breast fullness, pick round which also has less risk of problems with rotation 
      • Shaped better if wish least risk capsule contracture or if very active and with bigger pectoral muscles 
    • Smooth versus textured implants 
      • If below the muscle, no difference in capsule contracture 
      • Smooth usually less rippling
      • If shaped, they will be textured 
      • Textured - ACLS 
    • Incision location 
      • Inframammary fold
      • Periareolar
      • Transaxillary
      • Transumbilical 
    •  Size: The fun part!

    Recovery Process

    Generally, post-operative instructions call for plenty of rest and limited movement in order to speed up the healing process and recovery time.  Bandages are applied right after surgery to aid the healing process and to minimize movement of the breasts.  Once the bandages are removed, a specialized surgical bra will need to be worn for several weeks.  Patients sometimes report minor pain associated with the surgery.  This pain can be treated effectively with oral medication. While complications are rare, patients can minimize potential problems by carefully following the directions given by the physician after surgery.


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