Breast Augmentation

Breast Augmentation / Breast Implant Surgery in San Francisco Bay Area

Breast augmentation / breast implants, technically known as augmentation mammaplasty, is a surgical procedure to enhance the size and shape of a woman’s breast for a number of reasons:

  • To enhance the body contour of a woman who, for personal reasons, feels her breast size is too small
  • To correct a reduction in breast volume after pregnancy
  • To balance a difference in breast sizes
  • As a reconstructive technique following breast surgery
  • By inserting an implant behind each breast, surgeons are able to increase a woman’s bust line by one or more bra-cup sizes.

Recent Breast Augmentation Patient Comments


Read the rest of this real patient’s Breast Augmentation journey on Realself

Dr. Rajagopal discusses commonly asked questions about Breast Augmentation on KRON4’s Body Beautiful:

The Best Candidates For Breast Implants

A women looking for improvement, not perfection, in the way she looks is the best candidate. If you’re physically healthy and realistic in your expectations, you may be a good candidate.

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Types of Implants For Breast Augmentation

Doctor Rajagopal uses both saline and silicone implants. Most saline-filled breast implants share some standard features, like a silicone rubber shell and a valve for filling with saline solution. However, to better meet each individual woman’s needs, breast implants come in different shapes and sizes. Some implants are round, and some are anatomical. The shape of the implants you choose may affect the shape of your augmented breasts. The newest implant is the inflatable one, which may be used in selected patients. Doctor Rajagopal will recommend an implant depending on your breast and body shape.


Used consistently in more than 60 countries outside of the US for 25 years, Natrelleā„¢ breast implants use a cohesive silicone gel that is more a soft-solid than a liquid, so it maintains its shape. Many believe this makes an implant look and feel more natural.

Every silicone gel-filled breast implant in the Natrelleā„¢ Collection is FDA-approved, and protected by our patented patch design with 360-degree barrier layer coverage. What’s more, they are available in a wide variety of options, so you and your surgeon can find your best fit.

For more information about Natrelle silicone implants see the official Natrelle website (


San Francisco Plastic Surgery also offers Sientra silicone breast implants. Sientra products come in various shapes and sizes for a tailored solution for each individual. These products are only sold to board certified plastic surgeons to ensure top quality.

The Breast Augmentation Procedure

The method of inserting and positioning your implant will depend on your anatomy and Doctor Rajagopal’s recommendation. The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surround the nipple), or in the armpit. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous and minimal as possible.

Working through the incision, Doctor Rajagopal will lift your breast tissue and skin to create a pocket, either directly behind the breast tissue or underneath your chest wall muscle (the pectoral muscle). The implants are then centered beneath your nipples.

Some surgeons believe that putting the implants behind your chest muscle may reduce the potential for capsular contracture. This placement may also interfere less with breast examination by mammogram than if the implant is placed directly behind the breast tissue. Placement behind the muscle however, may be more painful for a few days after surgery than placement directly under the breast tissue.

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After Your Breast Enhancement Surgery

You’re likely to feel tired and sore for a few days following your surgery, but you’ll be up and around in 24 to 48 hours. Most of your discomfort can be controlled by prescribed medication.

You may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades.

Your stitches will come out in a week to 10 days, but the swelling in your breasts may take three to five weeks to disappear.

Read more about wearing a bra after breast augmenation surgery.

Getting Back to Normal After Breast Augmentation

You should be able to return to work within a week, depending on the level of activity required for your job.

Your breasts will probably be sensitive to direct stimulation for two to three weeks, so you should avoid much physical contact. After that, breast contact is fine once your breasts are no longer sore, usually five to six weeks after surgery.

Your scars will be firm and pink for at least six weeks. Then they remain the same size for several months or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely.

What Are The Risks Associated With Breast Implants?

Capsular Contraction- is the most common side effect of breast implants. During surgery, a pocket is created for the implant that is somewhat larger than the implant. A fibrous membrane, called a capsule, then forms around the device. Under ideal circumstances, the pocket maintains its original dimensions and the implant “rests” inside, remaining soft and natural. For reasons that appear to relate to the individual characteristics of the patient, however, the scar capsule shrinks in some women and squeezes the implant, resulting in various degrees of firmness. This contraction can occur soon after surgery or many years later and can appear in one or both breasts. Capsular contraction is not a health risk, but it can detract from the quality of the result and cause discomfort, pain, or distortion of the breast contour. When contraction of the capsule occurs, correction may be possible.

Rippling and Wrinkling- are always present in some form and is due to the implant fill volume as well as traction rippling which is caused by the implant pulling on the capsule. The larger the implant, and the thinner the tissues, the greater the rippling.

Loss of Nipple Sensation- Although this does not happen routinely, it can happen no matter how carefully the surgery is done. If sensory loss occurs, the nerves slowly recover within 1-2 years in about 85% of cases.

Implant Leak or Deflation- This causes no medical harm, but requires replacement of the implant in a secondary procedure. The rate of saline-implant leakage is quoted at about 1-2% per year.

How Often Do These Risks Occur With Breast Implant Surgery?

In results released from a recent study of 2528 saline breast implants placed:

  • 2% of implants deflated
  • 7% developed capsular contracture
  • 20% had visible rippling that required reoperation

Also, see our video on the breast lift page: How to know when you need a breast augmentation, breast lift or both?

If you have any questions regarding Breast Enhancement Surgery, or wish to schedule a consultation with Doctor Rajagopal in the San Francisco Bay Area, California, please call the San Francisco Plastic Surgery Laser Center at 415-392-3333.

See our affordable pricing, financing & fees: Cost of Breast Augmentation

Usha Rajagopal, MD
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