Breast Augmentation

Breast Augmentation

How Your Breast Augmentation in Long Beach Is Planned

Dr. Waltzman builds each treatment plan around one important component—you, the patient. Your procedure is highly customizable; patients and surgeons work together to determine where the breast implant is placed, what incision is used to place the implant, the size and shape of implant, and the type of implant. That’s why so it’s crucial that you find a surgeon that can help you make the right choices for your procedure. During your consultation, Dr. Waltzman will perform a thorough examination to analyze your skin, your frame, and take detailed measurements. He’ll listen intently to what your personal goals are and walk you through what can be achieved.

Dr. Waltzman knows that patients are sometimes unhappy with their results because their treatment wasn’t tailored to their needs or the surgeon didn’t quite listen to their aesthetic goals. Before moving forward, Dr. Waltzman always takes the time to discuss important steps to the procedure so you can be an active collaborator in your own procedure.

Before each breast augmentation, Dr. Waltzman will take into consideration your measurements, your skin’s elasticity, your lifestyle, whether you’ve had children, whether you’ve breastfed, and other factors to help plan the surgery. When we talk about results that look “natural,” what we really mean is that the results look perfectly tailored to your unique body. By respecting your anatomy, Dr. Waltzman can create results that look impeccable and last for years.

Our breasts are such a crucial part of our feminine identity; it stands to reason that breast augmentation is the most popular plastic surgery procedure of all time. Cosmetic breast surgery has helped millions of women all over the world achieve fuller breasts and restore lost volume. But there’s more to breast enhancement than enhancing the size of the breasts and improving their projection; those seeking breast implants in Long Beach are also looking to boost their confidence and pride in their body.

Breast enhancement techniques and the surgeons that perform them have evolved considerably in the last 50 years.  Results look more natural than ever because surgeons are better able to customize treatment towards a patient’s unique body and aesthetic goals. With that degree of personalization, implants can give women a new figure that looks proportional and balanced.

Of course, even with the incredible advancements in cosmetic surgery, your surgeon is still the most crucial aspect of your treatment plan. That’s why so many women choose Dr. Waltzman, a Board-Certified Plastic Surgeon that’s renowned for his work with breast augmentation. Dr. Waltzman was specialty trained at an Aesthetic Surgery fellowship at the world-renowned Cleveland Clinic, where he learned advanced techniques for this procedure.

Dr. Waltzman is known for his dedication to helping women achieve self-confidence, and he takes great care to support every patient throughout their entire journey. From the consultation to the recovery period, Dr. Waltzman will be there to personally guide you. Dr. Waltzman understands that breast augmentation is a transformative process, and his ultimate goal is to make sure every patient feels a peace of mind.

In addition to providing outstanding patient care, Dr. Waltzman personalizes your treatment so your results won’t just look stunning—they’ll look right and natural for your body.

How Your Breast Enhancement is Performed

Your procedure will be performed using general anesthesia, and the procedure will be held in a Long Beach hospital, or surgery center, where Dr. Waltzman has hospital privileges.

The first step is the creation of an incision; Dr. Waltzman will create an incision either around the areola or under the breast crease. He’ll then create a pocket inside the breast (either under or over the chest muscle), and slip the implant inside and center it behind the nipple.

Dr. Waltzman uses an innovative device called the Keller Funnell to insert all implants; with the Keller Funnell, Dr. Waltzman can perform a type of no-touch breast augmentation where the implants never touch the patient’s skin. By limiting contact with the skin, the Keller Funnell keeps the implants sterile and drastically reduces the risk of certain complications.

Your Choice of Implants

This is one of the most important decisions: what kind of implants you get. You’ll get to choose between an incredible variety of implants, but the end goal is to find the implant that fits best with your unique needs. 

Dr. Waltzman will explain all the factors that go into choosing your implant:

  • The quality of your skin
  • The texture of your skin
  • The elasticity of your skin
  • Whether you’ve had children
  •  Whether you used to breastfeed
  • The amount breast tissue you have available
  • The width of your breast

Of course, these implants all have different variations in size, projection, shape, and texture, but in general, there are three types a patient can choose from:

The Different Ways to Place an Implant

Dr. Waltzman performs three placement options for his breast augmentation patients. The pectoralis muscle plays a significant role in breast implant placement technique. For example, the implant may go under the muscle (submuscular placement), over the muscle (subglandular placement), or in front of the muscle but under the connective tissue (subfascial placement).

Submuscular “dual plane” placement

In submuscular breast implant placement, Dr. Waltzman positions the breast implants partially under the pectoralis muscles. With this approach, there is significantly less rippling on the upper portion of the breast, and capsular contracture rates are lower.

Added benefits include:

  • Patients experience more accurate mammograms
  • A more natural appearance
  • Reduced rate of capsular contracture
  • Lower risk of rippling
  • A concurrent breast lift is easier to perform

Subglandular Placement

Also referred to as over-the-muscle placement, the subglandular placement positions the implant between the chest muscle and existing breast tissue. Dr. Waltzman performs subglandular positioning so that the implant lies below the breast glands. Subglandular placement tends to be chosen by a subset of women who are athletes, bodybuilders, or desire this particular look.

Added benefits include:

  • No interference with pectoralis muscle function
  • No need for stretching muscle so the implant will settle into position
  • Less movement of implants during physical activities
  • Less discomfort after surgery

Subfascial Breast Augmentation

Subfascial breast augmentation provides patients with the natural-looking result they desire while avoiding a lengthy recovery. This unique approach involves placing the implant beneath the fascia. This slender yet durable tissue can be found on nearly every muscle inside your body.

Benefits of subfascial breast augmentation include:

  • Shorter recovery: After placement, implants are permanently secured into their final position to eliminate the “settling” process, significantly reducing recovery time.
  • Minimized risk of distortion: This approach involves the implant being anchored in place above the muscle, leaving it untouched by muscle movements. Subfascial augmentation is ideal for women who want to enhance their physique and maintain an active lifestyle.
  • Discreet, long-lasting results: This technique provides support for the implant that’s similar to a bra. As a result, this creates a more natural, slope-like appearance, ensuring the breasts preserve their appearance and position for years to come.

Breast Implant Shape

Another selection you will make with Dr. Waltzman is what shape of implants you want. He offers two basic shapes: round and teardrop. While a round shape has traditionally been used and tends to create more cleavage and a fuller look, a teardrop shape tends to create a more natural appearance. Teardrop shapes also tend to be a bit firmer than round shapes. Some women appreciate this while others prefer the softer feel of the round implant.

Dr. Waltzman finds that teardrop shapes tend to work best for women who want a more natural, firmer feel and those who do not have a lot of skin or fat tissue to cover their implants. However, which shape looks best on you is based on both your preference as well as your body shape. During your consultation, Dr. Waltzman will fully explain both shapes and show you before and after pictures of patients who have chosen both the round and teardrop shape. This will help you better understand the two choices and select the one that is right for you.

Breast Implant Sizing

Dr. Waltzman helps patients choose the size of their implants based on their unique characteristics; during the consultation process, Dr. Waltzman will perform a thorough analysis of your breasts. One of the most important measurements that can define the size of your implants is the width of your breasts, and your implant will need to be smaller than the width of your breasts to fit naturally.

Breast Augmentation Incisions

Dr. Waltzman uses two types of incisions, but the inframammary is Dr. Waltzman’s preferred incision for breast implant placement.

Benefits of the inframammary incision:

  • Greater visibility when placing the implant
  • It removes the incision from the breast and places it neatly within the breast fold
  • It has lower capsular contracture rates
  • Less risk of damaging the milk ducts

The peri-areolar incision allows Dr. Waltzman to hide the incisions around the borders of the nipple, but there is a risk that the ability to breastfeed will be impeded in the future.

Recovering from Breast Augmentation

Patients tend to recover after 1-2 weeks, but it really depends on what the patient’s work is like. If their job is much more physical than an office job, then the recovery process might be longer.

In general, Dr. Waltzman’s patients tend to feel some soreness, swelling, and tightness after the procedure. Dr. Waltzman’s more active patients tend to experience more soreness in their chest muscles. However, many of his patients also report that the recovery is very tolerable and that they can switch from prescription pain medication to over-the-counter pain pills in just after a few days.

Dr. Waltzman recommends that patients are gentle with their body during the first few months of recovery as the muscles and the body heals. During the first couple of weeks, patients should avoid upper body workouts, and after a month, they could slowly ease into a gentler workout regimen.

Dr. Waltzman can explain the implant procedure in better detail during a one-on-one consultation. To speak with the renowned Board-Certified plastic surgeon himself, contact Waltzman Plastic & Reconstructive Surgery for a consultation.

" Great Office, staff very friendly. I went in to speak about breast augmentation and body contouring treatments. Dr. Waltzman was very helpful from the beginning to the end result. I have recommended several friends so far. He has several before and after pictures of his work, he listened to my concerns. I look so natural and full. I am so much more confident (and happy!)​"
-M.M.

Schedule a Consultation

Ready to book a procedure with Dr. Waltzman? Contact us today to schedule a consultation and begin your new aesthetic journey today!

Schedule a Consultation

Ready to book a procedure with Dr. Waltzman? Contact us today to schedule a consultation and begin your new aesthetic journey today!

Frequently Asked Questions About Breast Augmentation

One is not better, they are just different. It depends on a variety of factors which are unique for each patient. There are pros and cons to each option, but beautiful results are possible with each approach.

Patients are asked to stop taking blood-thinning medications such as Aspirin, along with Vitamin E, fish oil, and more. Patients are also asked to stop smoking for at least 6 weeks before and after your surgery.

Dr. Waltzman will give you specific instructions on how to prepare for your journey.

At first, your breasts will appear swollen and sit in a higher, more unnatural position. The swelling will decrease in a month, and in 3-6 months the implants should drop and settle into the breast pocket.

Dr. Waltzman offers his Long Beach patients a chance to visualize their possible results with Crisalix 3D, a simulation program that allows patients to “try on” their post-surgical results. The Crisalix 3D offers a 3D view of your new breasts before the big surgery day.

Finding the lowest cost does not always ensure the best results. There are 4 basic components which make up the cost of breast augmentation surgery: the surgeon fee, the OR fee, the anesthesia fee, and the cost of the implants. Other factors which influence the cost of your procedure include:

  • The geographic location of where you have the surgery performed.
  • The surgeon’s training and experience.
  • The type of implant: Silicone is often more expensive than saline. And shaped implants are typically more expensive than round implants.

Put your trust in Dr. Waltzman. His honesty, integrity, and devotion to his patients will serve you well. Contact us today to schedule a consultation.

Any surgical procedure which carries potential risks.  Dr. Waltzman will spend time in the office with you discussing the risks and benefits of breast surgery in detail.  Some of these risks include:

  • Bleeding: If there is significant bleeding around in the implant (called a hematoma), this will require going back to the operating room to remove the implant, wash out the collection of blood, and then replacing the implant. It is not a good idea to leave collections of blood around the implant because it is uncomfortable for the patient and can increase their risk of infection and capsular contracture.
  • Excessive scar tissue can form around the implant and distort the shape of the breast implant. This is called capsular contracture. Whenever a foreign substance is put in the body, the body recognizes it as foreign and attempts to isolate the material. However, if this capsule becomes too thick it may cause the breasts that feel firm and hard. Between 5-10% of patients will develop capsular contractures. If this happens, it may require an additional surgical procedure to correct it. Capsular contractures pose no health threat, but they can compromise the aesthetic results and be uncomfortable.
  • At the first sign of any infection, the patient is immediately placed on antibiotics. Unfortunately, if the actual implant is infected then if often times requires removing the implant to treat the infection.  The implant can be replaced at a future date once the infection is appropriately treated.
  • Changes in sensation in the nipples and breast. This can result in increased or decreased sensation.  This is usually only temporary.
  • Implant rupture or leakage. When a saline implant ruptures patients notice almost an immediate change in breast shape or size.  This is similar to breaking a balloon filled with water.  In contrast, if a silicone implant is damaged or ruptured, the patient may not notice any difference.  Often times the rupture is detected incidentally during an imaging study. This is referred to as a “silent rupture”.  Many implant companies will cover the replacement of a ruptured implant under the product warranty.

Every woman has a natural “footprint” of where their breasts are positioned on their chest.  Some women have breasts that sit higher on their chest, and some have breasts that are positioned relatively low on their chest.  Some women have breasts that are widely spaced (wide cleavage) and some have breasts positioned very close to each other (narrow cleavage).  The best way to think of a breast augmentation is that it makes you a bigger version of what you are.  If you have cleavage before you will have cleavage after.  If you have wide cleavage before, you will likely have wide cleavage after.  A good quality bra is the best solution for shaping cleavage post operatively. 

The feeling after a breast augmentation is like you did a whole bunch of push-ups.  Your chest will feel tight and sore.  Most patients take prescription pain medication for 2-3 days, and then only Tylenol or Advil.  I recommend no upper body exercise for 4 weeks.  Lifting less than 10 pounds per hand is ok from the first day.  This works out to about the weight of a gallon of milk per hand.  Isolated lower body workouts are ok as soon as you can tolerate, but running or other bouncing exercises are not allowed for the first 4 weeks.  After 4 weeks you can begin upper body exercises, starting with low resistance and working up slowly. 

The no touch technique is a way of inserting breast implants without ever actually touching the implant with your hands.  I use a special implant funnel that is coated with a very smooth surface to gentle squeeze the implant into the breast pocket.  The results in minimal to no contamination of the implant with bacteria from the patient’s own skin, reduces the risk of capsular contracture, and puts less stress on the implant gel as it is placed into the breast.  Additionally, it allows me to minimize the length of the incision when placing larger implants. 

The true answer here is that almost any implant can be made to feel and look very unnatural, or very natural.  Most of the art of creating a natural look and feel comes from selecting the right shape and size of implant, and then choosing the most appropriate pocket for placement of that implant (above or below the muscle).  Typically, the most natural feeling implant will be a cohesive silicone gel implant.  If a woman with very little natural breast tissue is trying to minimize upper pole fullness and create a very natural contour, then sometimes an anatomic (or teardrop) implant is the most appropriate option. 

Any time someone is having surgery on their breast there is always the risk of changes in sensation.  This could happen on any part of the breast, including the nipple or areola.  Occasionally, a patient will experience temporary decreased sensation over parts of the breast or nipple.  This typically returns to normal over the first several weeks as the swelling resolves.  It is extremely unusual for a woman to completely lose sensation to the nipples after primary breast augmentation. 

No, I do not use drains with primary (1st time) breast augmentations.  If there are other procedures be performed at the same time, then a drain might become necessary. 

No, all of your sutures are dissolvable and will be hidden under your skin. 

It really depends what kind of job you have.  If you have a desk job, then you can probably return to work in as little as 3-4 days.  If your job is more physical or requires you to drive from location to location, then you will probably want to consider taking 1-2 weeks off.  If you have a very labor-intensive job that requires heavy lifting, then you will need to consider 4 weeks off of work.  However, many of our patients can return much sooner on “modified” or “light-duty”. 

You should be sitting at the dinner table the evening of your surgery.  You should not be laying in bed for days.  However, you do need to give your body a chance to heal.  Walking is ok from Day 1.  I recommend no upper body exercise for 4 weeks.  Lifting less than 10 pounds per hand is ok from the first day.  This works out to about the weight of a gallon of milk per hand.  Isolated lower body workouts are ok as soon as you can tolerate, but running or other bouncing exercises are not allowed for the first 4 weeks.  After 4 weeks you can begin upper body exercises, starting with low resistance and working up slowly. 

Although rare, the common complications after breast augmentation include: excessive bleeding, infection, capsular contracture, implant malposition (asymmetry), and implant rupture. 

My philosophy on breast augmentation is that an appropriately sized and placed implant will give you the best result for the longest amount of time.  I personally like a more natural appearing breast with nice curves, and not an overly augmented breast that looks round and tight.  It is important to realize that natural appearing does not mean the same as “small implants”.  Natural appearing means using the “right implant”. 

We have several ways that we help you get the correct size.  First, I start with a detailed exam of your breast tissue and take multiple measurements of the breasts.  Next, I create a 3D simulation of your breasts and we can virtually try on different breast implants.  The simulation allows you to see yourself from all angles, and even allows you to virtually try on different outfits.  I am able to create multiple simulations with varying sizes of implants.  You will receive an email link to view your 3D simulations at home.  At this point I have a very good idea of your ideal size range.  We then have you try on special implant sizers that are shaped like an actual breast.  These sizers are worn under a sizing bra in our office, but we encourage you to wear your own clothing and look at yourself in the mirror during your consultation.  Between these 3 steps I am able to understand what you are looking to achieve and come up with the best plan to meet your goals. 

We have several ways that we help you get the correct size.  First, I start with a detailed exam of your breast tissue and take multiple measurements of the breasts.  Next, I create a 3D simulation of your breasts and we can virtually try on different breast implants.  The simulation allows you to see yourself from all angles, and even allows you to virtually try on different outfits.  I am able to create multiple simulations with varying sizes of implants.  You will receive an email link to view your 3D simulations at home.  At this point I have a very good idea of your ideal size range.  We then have you try on special implant sizers that are shaped like an actual breast.  These sizers are worn under a sizing bra in our office, but we encourage you to wear your own clothing and look at yourself in the mirror during your consultation.  Between these 3 steps I am able to understand what you are looking to achieve and come up with the best plan to meet your goals. 

All scars fade with time, but there will always be a scar.  I know this is a concern to many patients, so I include scar therapy in every single breast surgery I perform.  Silicone scar therapy has been shown to decrease redness and help flatten scars.  There is no way to perform breast augmentation without a scar somewhere.  All patients have to make the trade of larger, fuller breasts for a small scar.  My preference for first time breast augmentation patients is the inframammary incision hidden in the breast fold.  For most patients this is only a 3-4cm scar. This keeps the incision completely off the front of the breast and in a natural skin crease.  If a patient already has a scar from a previous surgery, then I am often times able to use that incision if the patient desires.

Yes, you should definitely try breastfeeding.  I generally tell patients that any type of breast surgery (augmentation, lift, reduction) can increase the likelihood that you will need to supplement your breastfeeding with formula.  Many women who never had breast augmentation are not able to completely breastfeed, and there is no way to tell how your body will respond.

All implants are man made and have a risk of rupture.  For saline implants you would notice the implant deflate in a matter of 24 hours.  Your body will absorb the saline and your breast will be significantly smaller.  Silicone implants can be a little less obvious.  If your silicone implant has ruptured you might notice that the breast appears different or possibly flattened on a particular part.  Capsular contracture can also be a sign of implant rupture.  The best thing to do is have an exam by your Plastic Surgeon who can examine the breast and order an ultrasound or MRI. 

Absolutely!  Just let the person performing your mammogram know that you have implants. 

Breast implants have not been shown to cause breast cancer.  However, there are some implants (no longer on the market) that have been associated with an extremely rare type of lymphoma called ALCL.  If identified early, this lymphoma is very curable and treatable. 

Normal movement like getting dressed, showering, or making food will not hurt anything.  Raising your arms above your head will not hurt anything. 

I do not require patients to wear a specific bra immediately after breast augmentation.  For the first several weeks patients can wear nothing, a tank top, a padded top, or a loose-fitting sports bra.  After about 1 month I advise patients to have a professional bra fitting.  At that point they can wear any type of bra except for underwire.  After about the 3-month mark, or once the implants have fully dropped, I am ok with patients wearing any type of bra. 

 Yes, I perform all breast augmentations under general anesthesia with the care of a Board Certified Anesthesiologist. 

I recommend that you have someone with you for the first 24 hours after general anesthesia. 

Probably at some point.  On AVERAGE, women with breast implants have some type of surgery every 10-15 years.  Reasons you might have surgery include: change size, change to a newer material, correct capsular contracture, replace a ruptured implant, or to take your implants out completely.  I do not believe that implants need to be replaced just because it has been 10 years. 

 The price is competitive with most of Los Angeles.  The cost might be slightly less due to less expensive OR facility fees in Long Beach compared to other parts of Los Angeles.  Fees can vary based on complexity of procedure, experience of the surgeon, and type of implants selected. 

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