Breast Augmentation

Breast augmentation, or augmentation mammoplasty, sometimes also called a "boob job" or an "aug", is a cosmetic surgical enhancement procedure to increase the size and improve the shape of a woman's breasts.
Breast augmentation can be done with implants (most common) or, for patients wanting a smaller change, with fat transfer. Breast augmentation can also be coupled with a breast lift as well as an areola reduction if that is desired.
Board-certified San Francisco plastic surgeon Dr. Steven Williams provides individualized breast augmentation consultations and can help you decide if it's the right breast surgery for you.

Is Breast Augmentation Right for You?
Breast augmentation, or augmentation mammoplasty, is a cosmetic surgical enhancement procedure to increase the size and improve the shape of a woman's breasts.
Breast augmentation can be done with implants (most common) or, for patients wanting a smaller change, with fat transfer.
Breast augmentation can also be coupled with a breast lift and areola reduction if that is desired.
During the procedure, your physician will place a saline or a silicone implant behind the natural breast tissue and usually under the muscle to enhance breast size and shape.

What to Expect
Breast Augmentation Procedure
- also called "boob job" or "aug"
Goal: Increase breast fullness and projection and shape
2-3 hours
Outpatient
Usually General
Long lasting. Weight loss/gain, pregnancy, and age may reduce surgical results over time
Choosing an Implant Size
Doctors Speak in Volume
The first thing you should know when choosing an implant size is that doctors don't speak in cup size, they speak in volume. You may imagine that you are interested in a "full C" size cup, but depending on the measurements of your chest and the skin available, you and your doctor will need to decide how many cc's of implant volume you see need to accomplish.
Keep Your Lifestyle in Mind
If you are an athlete, having larger breasts might make exercising more difficult for you. Make sure you keep your lifestyle in mind when conversing with your physician regarding size.
Bring in a Image
The best way to show your doctor what you want is by bringing in a photo. An even better way is to bring in a picture of one of your physicians past patients.
To see Tri Valley Plastic Surgery previous patients, visit our Before & After gallery.
Types of Implants
Silicone or Saline?
Silicone implants are filled with silicone gel while saline implants are filled with sterile salt water. They feel slightly different and typically, patients have a preference for which one they prefer.
Smooth or Textured?
Smooth implants are designed to be slightly mobile in the breast pocket allowing for more natural movement while textured implants are designed to develop scar tissue which keeps the implant in place.
Teardrop or Round?
Teardrop implants are designed to look more like a natural breast while round implants can be made to look natural or less-natural depending on profile. It should be noted that teardrop implants aren't used as frequently due to their tendency to rotate in the breast pocket.
Which profile?
By profile, we mean the projection of the implant. You might hear your physician talk about high profile, moderate profile and low profile implants. We have examples of all types in the office and are happy to help you make your decision.
Fat Grafting

Fat Grafting is a Modern Technique
Breast augmentation using fat grafting is a modern technique in which a plastic surgeon harvests unwanted fat from a part of your body and then uses it to replenish fullness in the breasts.
This method can be used in cases where the patient is striving for a less dramatic change in the shape and size of the breasts. If a more dramatic change is preferred, breast augmentation with implants may be a more effective option.
Frequently Asked Questions
Q:
Am I a candidate for breast augmentation?
In general, a good candidate for breast augmentation is:
- 18 years of age or older
- Not currently pregnant or nursing, and with no immediate plans to become pregnant
- In good physical health
- Psychologically stable
- Wanting to improve their appearance
- Realistic in their expectations
At Tri Valley Plastic Surgery, Dr. Williams spends time to make sure that each patient receives all of the information needed when considering a breast augmentation. In our offices in the San Francisco Bay Area, often we perform silicone or saline breast augmentations. Breast augmentation (mammaplasty), also known as breast enlargement or breast enhancement surgery, is used to enhance the breast contour and breast size for a female who views her current breast size as small for her frame. Breast augmentation can also be used to correct the natural loss in breast fullness which occurs following pregnancy and breast feeding, weight loss, or to balance an asymmetry in breast size.
Some of our patients seeking breast augmentation are young women who have been unhappy with their figures all of their lives, women who feel that their breasts are no longer attractive following changes in weight, changes associated with aging, or changes due to childbearing. This means a relatively wide age range of women seek this procedure for a variety of reasons.
The best candidates for breast augmentation are women with little or no sagging, and who have a reasonable amount of breast tissue with which to cover the lower part of the implant. Women who are less than ideal candidates can still get excellent results as Dr. Williams has many techniques to help you improve your appearance.
Q:
What is a breast augmentation procedure?
A breast augmentation (mammoplasty), commonly known as a “boob job”, also known as breast enlargement, breast implant surgery, and breast enhancement, is a surgical procedure to reshape the breast in order to make it larger. Breast augmentation is typically performed to enlarge small breasts, underdeveloped breasts or breasts that have decreased in size after childbirth by surgically inserting an implant behind each breast.
Breast augmentation in the San Francisco Bay Area at Tri Valley Plastic Surgery involves inserting a saline (salt-water) filled or silicone gel-filled breast implant underneath the breast and pectoralis muscle via a hidden short scar underneath each breast. The smooth round saline or silicone gel-filled breast implant permanently resides under your pectoralis major muscle.
This operation does not weaken your chest muscles, future breast feeding is still possible and nipple sensation is preserved. The incisions can be hidden in the fold between your breasts and chest, around the areola or in the armpit. Once faded, the scars are well concealed.
The procedure is performed as outpatient surgery, meaning you will go home the same day of your operation. No drains are required and only absorbable sutures are used, making recovery easier. Most patients are able to return to work within a week or less.
Q:
How do I prepare for breast augmentation surgery?
Dr. Steven Williams and the Tri Valley Plastic Surgery team will carefully explain your breast augmentation operation with you at your initial consultation. Prior to surgery, you will be given specific instructions and information to prepare you for your procedure. This may include:
- Pre-surgical considerations, diagnostic testing and medications
- Day of surgery instructions and medications
- Specific information related to the use of anesthesia
- Post-operative care and follow-up
In addition, you will be asked to sign consent forms stating that you fully understand the procedure you are undergoing, as well as any potential risks, complications and side effects associated with breast augmentation surgery.
Your breast augmentation will be performed in an accredited ambulatory surgical hospital. We only use board certified anesthesiologists, nursing and OR staff trained in cosmetic plastic surgery.
Q:
What steps are involved in a breast augmentation surgery?
STEP 1 – PRE-OP
The nursing staff will start an IV. Dr. Williams will answer all last minute questions and perform pre-operative markings on your breasts and chest wall. These markings help us in the operating room.
STEP 2 – ANESTHESIA
Medications are administered for your comfort during the surgical procedures. Most of our patients don't remember going to sleep or most of their time in the post-op recovery area. Our anesthesiologists use special tools to make sure you are asleep and safe throughout the whole procedure.
STEP 3 – THE INCISION
The most common incisions include:
- An inframammary incision near the crease just under the breast
- An auxiliary incision in the underarm area
- A periareolar incision placed at the edge of the areola, the pigmented skin surrounding the nipple
- Incision patterns vary based on the type of implant chosen, the degree of enlargement desired, and the individual patient's anatomy.
STEP 4 – IMPLANT PLACEMENT
Once the incisions are made, a pocket is created beneath the pectoral muscle and on top of the chest wall (submuscular placement). Occasionally the pocket may be modified as needed to achieve an optimal result. Dr. Williams uses special tissue sizers to find the perfect size implant at this stage in the operation.The implant is then positioned within this pocket and the incisions are closed with layered, removable sutures, surgical tape and a post-operative dressing.
STEP 5 - RESULTS
The results of breast augmentation are immediately visible. Over time, post-surgical swelling will subside and incision lines will gradually refine in appearance. Implants are typically positioned some what high and settle over the first few weeks. Patients see an immediate satisfaction at their results, and experience fulfillment in self-confidence and personal body image.
Q:
What are the side effects and surgery risks when getting a breast augmentation?
By making the decision to consult with Dr. Williams and following all the instructions given, you are taking an important step in helping to assure your safety. Dr. Williams is certified by The American Board of Plastic Surgery, a certification ensuring that your surgeon is a designated expert who is trained in the field of plastic surgery of the face and body.
BREAST AUGMENTATION SIDE EFFECTS:
- You may feel sick as a result of the general anesthetic.
- For a few weeks after surgery your breasts will feel sore, swollen and firm, and you may feel a burning sensation in your nipples or along the incisions. Using extra pillows when sleeping can help reduce the swelling around your breasts.
- You will have scars which will be pink and noticeable at first but should fade gradually.
BREAST AUGMENTATION COMPLICATIONS:
Possible complications of any operation include an unexpected reaction to the anesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).
BREAST AUGMENTATION RISKS AND COMPLICATIONS ARE RARE, BUT CAN INCLUDE:
- An unevenness in size and shape, possibly caused by natural differences highlighted by the surgery.
- Creasing, crinkling and ripples on the skin over the breast implant (less likely with silicone implants).
- Infection which may need antibiotic treatment, sometimes requiring the implant to be temporarily removed .
- Abnormal scar tissue forming around the implant which may cause a firm, sometimes painful swelling called capsular contracture requiring further surgery.
- Change in skin and nipple sensation which is a rare but potentially permanent condition.
- Build up of fluid around the implant (seroma) which may require further surgery.
- Unusual red or raised scars (keloids) which can take years to improve.
It's possible that you still won't be satisfied with your appearance after the operation.
The exact risks are specific to you and will differ for every person. Dr. Williams will explain how these risks apply to you.