A Comprehensive Guide to Breast Augmentation

What Is Breast Augmentation? A Clear, Quick Overview

Breast augmentation is a surgical procedure that increases the size, fullness, or symmetry of the breasts using implants or fat transfer.

Here is what you need to know at a glance:

• What it is: Surgery to enhance breast size and shape, also called augmentation mammaplasty
• Who it’s for: Women with small breasts, asymmetry, or volume loss after pregnancy or weight changes
• Main options: Saline implants, silicone gel implants, or fat transfer
• Procedure time: Roughly 1 to 2 hours as an outpatient procedure
• Recovery: Most patients return to light activity within 1 to 2 weeks, with full recovery around 6 to 8 weeks
• Results: Long-lasting, though implants are not lifetime devices and may need replacement after 15 to 20 years

Breast augmentation is one of the most commonly performed plastic surgery procedures in the United States, with around 300,000 procedures done every year. Women choose it for many reasons: to restore volume lost after pregnancy or weight loss, to correct natural asymmetry, or simply to feel more confident in their bodies.

Modern techniques have come a long way. Surgeons today have more implant options, more precise placement strategies, and minimally invasive approaches that mean smaller scars and faster healing than ever before.

This guide walks you through everything you need to know, from implant types and surgical techniques to recovery, risks, and long-term results.

Understanding Breast Augmentation and Implant Options

Choosing the right implant is one of the most important decisions you will make during your journey. At the Waltzman Institute, we believe in educating our patients on the nuances of Implants so they can choose the option that best fits their anatomy and lifestyle.

The two primary types of implants are saline and silicone gel. Both have a silicone outer shell, but what is inside makes a world of difference in terms of feel and management.

Feature	Saline Implants	Silicone Gel Implants
Filler Material	Sterile salt water	Cohesive silicone gel
Feel	Firmer, may feel like a “water balloon”	Softer, mimics natural breast tissue
Incision Size	Smaller (filled after insertion)	Slightly larger (pre-filled)
Rupture Detection	Immediate (the breast deflates)	“Silent” (requires imaging to detect)
Age Requirement	18+ for augmentation	22+ for augmentation

Silicone Gel Implants Often called “gummy bear” implants, these use a highly cohesive gel that holds its shape even if the shell is cut. This shell integrity is a major safety feature. Many of our patients in Long Beach and the South Bay prefer silicone because it offers a more natural-looking and feeling result, especially in women with less existing breast tissue.

Saline-Filled Implants These are filled with sterile saltwater during the surgery. One advantage is that if the shell leaks, the saline is safely absorbed by the body. They are often more affordable and can be inserted through smaller incisions.

Structured Saline Implants A newer middle ground, these have an internal structure that makes them feel more like silicone while still being filled with saline. According to the American Society of Plastic Surgeons, having a variety of options allows for a truly customized aesthetic enhancement.

Who is a Good Candidate for Breast Augmentation?

Most women who are unhappy with the size or shape of their breasts are potential candidates. However, we look for specific markers of physical and mental health to ensure a successful outcome. You might be a good candidate if you experience:

• Hypomastia: Naturally small breast tissue that didn’t fully develop during puberty.
• Breast Asymmetry: One breast is significantly smaller or a different shape than the other.
• Post-Pregnancy Changes: A loss of volume or “deflated” look after breastfeeding or pregnancy.
• Weight Loss: Changes in breast contour following significant weight reduction.

A good candidate should be a non-smoker (or willing to quit for several weeks before and after surgery), at a stable weight, and have realistic expectations about what surgery can achieve.

Contraindications and Safety Considerations

While breast augmentation is generally safe, there are times when surgery should be delayed or avoided. According to the MedlinePlus Medical Encyclopedia, contraindications include:

1. Active Infection: Any infection in the body must be cleared before surgery.
2. Breast Cancer: Untreated cancer or suspicious lumps that haven’t been biopsied.
3. Pregnancy or Nursing: It is best to wait at least 3 to 6 months after you stop breastfeeding to allow breast tissue to stabilize.
4. Autoimmune Disease: Certain conditions may affect healing or increase the risk of complications.

Psychological readiness is just as important as physical health. We want our patients to undergo this procedure for themselves, not to fulfill someone else’s ideal image.

Surgical Techniques and Placement Strategies

Precision is the hallmark of a great result. The way a surgeon creates the “pocket” for the implant and the location of the incision can determine how natural the breasts look and how well they heal.

There are four primary incision locations:

• Inframammary Fold (IMF): The most common approach, where the incision is hidden in the natural crease under the breast.
• Periareolar Incision: Made along the edge of the nipple (areola). This offers great access but may have a slightly higher risk of affecting breastfeeding.
• Transaxillary: The incision is made in the armpit, leaving no scars on the breast itself.
• Transumbilical (TUBA): A less common technique where the implant is inserted through the belly button.

Implant Positioning and Anatomy

Where the implant sits in relation to your chest muscle (the pectoralis major) is a key technical decision.

• Subglandular Placement: The implant is placed directly behind the glandular tissue but in front of the muscle. This allows for a faster recovery but may be more visible in very thin women.
• Submuscular Position: The implant is placed behind the pectoral muscle. This provides more coverage, which often results in a more natural transition at the top of the breast and a lower risk of capsular contracture.
• Subfascial: A specialized technique where the implant is placed under the thin lining of the muscle (the fascia). This offers a blend of the benefits of both subglandular and submuscular positions.

Advanced Minimally Invasive Approaches

Dr. Waltzman focuses on staying at the forefront of advanced plastic surgery techniques like Preserve Minimally Invasive Implants. Using Motiva implants and the ELIXIR MD™ protocol, we can often perform the surgery through much smaller incisions.

These advanced methods focus on tissue preservation and endoscopic assistance. For the patient, this typically translates to:

• Significantly smaller scars.
• A rapid recovery with less downtime.
• Fewer traumas to the surrounding tissue, leading to more natural-looking results.
• Lower risk of nerve damage or numbness.

Recovery, Safety, and Long-term Outcomes

As of April 2026, the safety standards for breast implants are higher than ever. However, it is vital to understand that implants are medical devices, not lifetime parts.

Safety monitoring is a lifelong commitment. The FDA currently recommends that patients with silicone implants receive regular imaging, such as Breast Implant Surveillance Ultrasounds, to check for “silent” ruptures. While rare, we also monitor for BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma), a rare immune system cancer that has been linked primarily to textured implants. Because of this, many surgeons, including Dr. Waltzman, predominantly use smooth surface implants.

The Recovery Timeline and Aftercare

Recovery isn’t just about waiting; it’s about active care.

• Days 1-3: You will feel some tightness and soreness. You’ll wear a surgical bra to manage swelling.
• Week 1: Most stitches are removed (if they aren’t dissolvable). Many patients return to desk work during this time.
• Weeks 2-4: Swelling begins to subside. You may start Aspen Therapy or specialized massages to keep the tissue soft and prevent capsular contracture (where the scar tissue around the implant hardens).
• Weeks 6+: You can usually return to strenuous exercise and heavy lifting.

Longevity and Revision Surgery

Most surgeons estimate a 15 to 20 year lifespan for breast implants. Over time, the silicone shell can degrade, or your aesthetic preferences might change.

Some patients may eventually require an Implant Revision or Implant Removal. Common reasons for revision include:

• Capsular Contracture: Hardening of the breast tissue.
• Implant Malposition: The implant shifting over time.
• Changes in the Body: Weight loss or aging. For example, some patients notice Sagging Breasts After Ozempic or other significant weight loss. In these cases, a Breast Lift may be needed along with the implants to restore a youthful shape.

Frequently Asked Questions about Breast Augmentation

How does the procedure impact breastfeeding and sensation?

This is a top concern for many of our Southern California patients. In most cases, women with implants can successfully breastfeed. The risk to the lactiferous ducts and nerve supply is minimized when the surgeon uses a submuscular placement and an inframammary (under the breast) incision.

Nipple sensitivity may change temporarily after surgery. While most patients regain full sensation within a few months, a small percentage may experience permanent increases or decreases in sensitivity.

How do fat transfer and implants compare?

If you want a more modest increase in size and want to avoid “foreign objects,” Fat Transfer is an excellent alternative.

This process involves:

1. Liposuction: Removing fat from donor sites like the abdomen or thighs.
2. Purification: Processing the fat to keep the healthiest cells.
3. Injection: Carefully grafting the fat into the breasts.

Benefits of Fat Transfer:

• Two-for-one: You get body contouring at the liposuction site.
• No Implants: No risk of rupture or capsular contracture.
• Natural Feel: It is your own living tissue.

However, fat transfer usually only provides a 0.5 to 1 cup size increase, whereas implants can provide more dramatic volume.

How Much Does Breast Augmentation Cost?

The cost of breast augmentation varies based on several factors:

• Surgeon’s Fee: Reflects their experience and board certification.
• Implant Type: Silicone is generally more expensive than saline.
• Facility and Anesthesia: Fees for the surgical center and the anesthesiologist.
• Geography: Costs in Los Angeles and Orange County tend to be higher than in other regions.

Generally, insurance does not cover cosmetic augmentation. However, exceptions exist for reconstructive surgery following a mastectomy. Many practices, including ours, offer financing options to help make the procedure more accessible.

Conclusion

At the Waltzman Institute in Long Beach, CA, we believe that breast augmentation should result in a look that is as natural as it is beautiful. Led by Board-Certified Plastic Surgeon Dr. Josh Waltzman, our team is dedicated to providing a safe, supportive, and high-tech experience for every patient.

By utilizing advanced techniques like Preserve Minimally Invasive Implants and ELIXIR MD™, we are able to offer our patients fewer scars and a faster recovery. Whether you are looking to restore volume lost to time or simply want to enhance your natural silhouette, we are here to help you achieve your goals with confidence.

If you are ready to take the next step in your journey, we invite you to schedule a consultation with us today.