The Jacobs Center for Cosmetic Surgery

Breast Augmentation

Getting Implants in the San Francisco Bay Area

A breast augmentation is, quite simply, exactly what it sounds like. Women who desire better proportions, a better fit in their clothing, or restoration after changes in their body from age or breast-feeding may choose to get implants that physically augment—in other words, enlarge—their breasts. Our goal with breast augmentation at the San Francisco Bay Area's Jacobs Center is to achieve natural results that have our patients looking and feeling great, whether they are seeking a subtle enhancement or a head-turning boost.

The breast augmentation procedure can be performed alone, but it's important to note that a breast augmentation will make the breasts larger, firmer, and stand out more, but won't raise them higher. If you're looking for more than what breast augmentation alone can offer, know that it can be done in concert with a breast lift, or combined with other procedures as part of a "mommy makeover" to get the look you're going for. We are also excited to offer the latest fat grafting techniques for augmentation and shaping, removing fat with liposuction from unwanted areas and putting it to work for you. The important thing is to be clear with your surgeon about your hopes and expectations from the start.

Talk to someone in the office about breast augmentation in the Bay Area by calling The Jacobs Center's San Francisco branch (415.433.0303) or Healdsburg branch (707.473.0220).

Is Breast Augmentation Right for Me?

Some women may think that making the choice to get breast augmentation is the only decision involved in the procedure. Either you want to have breast implants or you don't, right?

Actually, there are several choices to be made when deciding to proceed with breast augmentation. When you get into it, choices such as specific size, shape, saline versus silicone, approach, and the position of the breast implants can seem daunting. Even many well-trained surgeons under-appreciate the importance of fine details in implant choice and technique, which may leave patients disappointed or coming back for more surgery to correct problems down the road.

For example, there are a variety of ways your surgeon may choose to insert the breast implants. The choice of where to make the incision depends on the specific type of implant used, a patient's unique body type, the size of the breast augmentation, and individual preference on the part of the patient and the surgeon. The incision may be made at the base of the areola, under the breast, or even under your arm. Recent advances in texture, shape, and variety of implants have created many options for customizing implant selection to each patient's unique body, and it is important for your breast augmentation surgeon to have the experience to go beyond simply choosing the desired volume.

Dr. Eric Culbertson
Dr. Eric Culbertson Associations

Fellowship-trained plastic surgeon for breast & body-focused procedures, Dr. Culbertson personally strives to achieve natural yet undeniable results that bolster one's self esteem and reinforce, rather than change, one's identity.

To that end, the most important decision is actually in selecting your surgeon. Having put in hundreds of implants, a qualified doctor knows that communication is the key to great breast augmentation surgery, urging each patient to find a doctor she feels understands what she's looking for and to put her trust in that surgeon. Sometimes this requires multiple visits or bringing in pictures, but spending the time to establish clear lines of communication is paramount.

The doctor goes through the pluses and minuses of each option with his patients and strives to find the perfect fit for your body and personal goals. Even after that, the doctor selects a range of implants to bring to the operating room for the best look on the day of the breast augmentation surgery. Every member of the team wants every breast augmentation surgery to be right the first time and knows that spending more time before surgery putting together the perfect plan is the best strategy to achieve this.

Breast Implant Options

Size

Of course, the question of how big an implant should be is typically the first thing women ask. While the choice is up to the breast augmentation patient, Dr. Culbertson works with each individual to understand her aesthetic goals and determine which size would be most likely to help her achieve them. Note that implant sizes do not correspond to bra sizes, but have a classification system all their own.

Though some women desire large, obviously enhanced breasts, many breast augmentation patients opt for a size that results in a more natural look. They key to this is taking overall body proportions and other factors into account.

Dr. Culbertson can provide images that show how implants of different sizes ultimately appear once in place.

Dr. Eric Culbertson will choose one of several incision options as part of breast augmentation surgery in the San Francisco Bay Area. Dr. Eric Culbertson will choose one of several incision options as part of breast augmentation surgery in the San Francisco Bay Area.
*There are several possible incision locations—periareolar around the nipple and areola, inframammary in the breast crease, and transaxillary under the arm—used for breast augmentation at the San Francisco Bay Area’s Jacobs Center for Cosmetic Surgery. The exact incision chosen depends on a range of factors, including implant type, degree of augmentation, and more.*

Filler

Generally, there are two broad options when it comes to implants for breast augmentation: saline and silicone. While both are comprised of a silicone shell filled with a material designed to add volume and mimic natural tissue, they differ in that material's makeup and consistency. Saline is a sterile fluid—essentially salt water. Silicone is a thicker gel that can be from one of two sub-categories: the standard thick filler or a "form-stable" silicone that holds its shape like a gummy candy.

In the case of a leak, a saline-filled implant will deflate, leading to an obvious visual change in the breast. This is a sure sign that implant revision is needed. Leaks are less apparent with silicone-filled implants, which is why regular imaging checkups are recommended for women choosing silicone for their breast augmentation. Form-stable silicone is even less likely to flow out of a leak, though checkups are still recommended.

Shape

Implants may be round or "anatomical," which is a teardrop shape. Round implants provide more fill for the upper pole of the breast, creating a fuller and more voluminous look overall. Anatomical implants mimic the organic slope, being thicker at the bottom and tapering up to a thinner top. This creates a visually fuller lower pole.

Round implants may rotate within their pocket, which would not visibly impact the shape of the breast. If an anatomical implant rotates after breast augmentation surgery, the shift might be noticeable.

Surface

The surface of an implant may be smooth or textured. Smooth implants may be more likely to rotate or shift in their pocket, while textured implants can form a more secure bond with the surrounding tissue. Studies have shown that textured implants are more likely to harbor bacteria that can cause capsular contracture, a condition that causes scar tissue to form around the implant, but this can be mitigated with the surgeon following a precise 14-point plan to combat bacteria throughout the breast augmentation process.

Dr. Culbertson can further discuss the relative merits of each type of implant with a prospective breast augmentation patient during the initial consultation.

What to Expect After Breast Augmentation

Breast augmentation surgery typically takes about an hour to perform. Meticulous attention to detail during the operation allows patients to experience a rapid recovery—many patients go out the same night as surgery!* Narcotic pain medication can be minimized or even avoided altogether, though every patient is different. Patients usually need a week of recovery time off work and three to four weeks of restricted light activity. You'll wear a surgical garment after surgery that helps keep the implants in place while not putting too much stress on the incision. Patients may shower after 24 hours.

Pain is usually well controlled with pain medication and muscle relaxants. A short course of antibiotics is also prescribed to help avoid infection after your breast augmentation surgery.

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Other Breast Surgery Options

While breast augmentation is ideal for adding volume, it does not address sagging or drooping breasts. Women who want their breasts to sit higher on their chest, to have more projection, and to address the direction their nipples point can choose a breast lift. For women primarily seeking a lift, the addition of a small implant can add upper pole fullness that my not be achieved with a lift alone, while minimizing the added volume.

Breast augmentation may also be part of a Mommy Makeover, a combination of procedures and treatments designed to address changes to the body caused by pregnancy, childbirth, and nursing. The makeover may include liposuction, a tummy tuck, and more.

Women whose breasts are oversized can opt for breast reduction, which can help clothes to fit better, make an overall silhouette appear more proportional, and relieve the strain of significant weight pulling down from the chest.

Moving forward

If you're considering breast augmentation, or you've already decided and now want to narrow your options down with help from a trusted professional, call to set up a consultation at The Jacobs Center. Patients in San Francisco and the surrounding Bay Area and beyond are welcome. Call the Healdsburg office at 707.473.0220 or the San Francisco office at 415.433.0303.

* Patient Results May Vary

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