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Breast Augmentation

Breast Augmentation in San Francisco

Breast augmentation has become one of the most popular cosmetic procedures globally, boosting patients’ self-confidence and enhancing breast shape, volume, and fullness. Because of its high demand, many providers offer this surgery. Few, however, possess the knowledge, skill, and experience to deliver the most outstanding results.

woman posing to show upper body

Dr. Leonard Gray, our Bay Area board-certified plastic surgeon, has extensive breast augmentation experience. Frequently conducting breast augmentations from his state-of-the-art facility overlooking the beautiful San Francisco Bay, he’s performed over 10,000 in his 20 plus years of practice. Dr. Gray has given countless patients gorgeous and lasting breast enhancement results.

Deciding to have breast augmentation is a big decision to make and requires proper consideration of various factors. Dr. Gray genuinely values patient education and wants his patients to have all the information they need to make an informed decision on their own.

To learn more about the best breast augmentation in San Francisco, we invite you to read on or contact Dr. Gray at 415-434-8858 or schedule your consultation online today.

Implant Types

One of the most common questions surrounding breast augmentation is “silicone or saline?” Dr. Gray offers both of these options, although there are some key differences to be aware of:

Silicone

Silicone implants consist of a silicone-based gel and are widely considered to feel the most like natural breast tissue. There are three silicone implant manufacturers: Sientra ®, Mentor ®, and Allergan ®.

Mentor

Mentor uses the same gel and shell forever. Dr. Gray has seen about a 1% deflation rate with his patients. Many patients like how soft and natural these implants look and feel. Mentor has recently come out with a new line called “Xtra” that overfills the implant. This creates a look that gives a bit more fullness to the upper part of the breast.

Sientra

“Gummy bear” implants are more highly cross-linked and maintain more of a jello-like consistency. They don’t squish down as much and are considered to be perkier than their counterparts. To date, Dr. Gray has experienced a 0% deflation rate with Sientra’s gummy bear implants.

Allergan

Allergan’s silicone implants had a redesign several years ago. These implants are flat on the back and curved on the front. They have not been as popular among Dr. Gray's patients.

All implant companies use silicone gel, but Sientra and Allergan have a more highly cross-linked option.

Saline

Saline implants are filled with a sterile saline solution. These implants are said to have a firmer feel, and the volume can be slightly adjusted during surgery for precise results. Some key factors to think about when contemplating saline implants:

  • Gray can insert saline implants through smaller incisions in the nipple.
  • Since saline implants consist of a solution similar to existing liquids found within the body, it can be easily absorbed by the body if damaged.
  • Saline implants tend to ripple. They also look and feel less natural than silicone.
  • Although saline implants were popular in the past, Dr. Gray does not receive many requests for these currently.

Implant Shape

Implant shape refers to the two distinct shapes that implant manufacturers offer: round or teardrop. Implant shells can be smooth or textured. Hover over each box to learn more.

Round Implants

These round, smooth implants generally look and feel the most natural. When they are placed beneath the muscle using the correct technique, they appear as a teardrop shape. Round implants are by far the most popular choice among Dr. Gray’s patients.

Teardrop Implants

These implants are not preferred because they have a high risk of spinning around in the breast pocket, causing revision surgery. We have found that most patients are unaware they can still achieve a natural teardrop-shaped breast using a round implant.

Textured vs. Smooth Implants

Because risks of ALCL (anaplastic large cell lymphoma), fluid collection, and other concerns have been attributed to textured implants, they have been essentially removed from the market. Dr. Gray does not currently offer these options.

Dr. Leonard Gray

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Instilling Beauty
Inspiring Confidence

Dr. Gray is a board-certified plastic surgeon with over 20 years of experience conducting surgical procedures of the breast, body, and face. His emphasis on patient education and attention to detail have made him the top choice for plastic surgery in the Bay Area. Dr. Gray invites you to meet with him for a friendly and informative consultation.

Implant Profile

One of the most important decisions you will make will involve the breast implant profile. This measurement refers to the distance that your implant will project from your chest. Patients looking for the best size (volume in CCs) will take into account implant projection and width, which can be determined during a consultation with Dr. Gray.

The main types of implant profiles we offer are:

Low profile implants are a suitable choice for the most conservative patient, as they provide the least amount of projection. That said, Dr. Gray has found them to be generally the least chosen option among patients.

The moderate plus projection is the most popular implant profile choice globally. These implants are a relatively conservative choice compared to the larger profiles but still provide desirable fullness and shape.

This option has about a centimeter more projection and between 1-3 shot glasses (depending on the company) worth of volume than the moderate plus. This option projects further, provides a more dynamic change, and looks different than the moderate plus.

These implants provide the highest-profile boost. Women desiring the most dramatic change will likely choose Extra-high profile implants, as they create the fullest and roundest look.

Incision Types

There are three types of incisions that you can choose from, depending on your implant type, preference, and aesthetic goals:

Inframammary Fold (Breast Fold)

Currently, the most popular incision type is the inframammary incision, which Dr. Gray places beneath the breast fold. This incision is the easiest to hide and has quickly become the most sought-after incision technique. This method is inconspicuous, allows for more precise implant placement, and has low risk of damaging nipple sensitivity. It also has lower rates of capsular contracture and has a very low chance of affecting breastfeeding.

Periareolar (Nipple)

Although they are the same size, Periareolar incisions are slightly more visible than inframammary incisions. This incision can affect nipple sensitivity and breastfeeding, though these issues are rare.

Tiny Nipple Incision

Dr. Gray invented a nearly undetectable incision method dubbed the “tiny nipple incision,” and has performed this method on thousands of patients. The tiny nipple incision can only be performed when the patient selects a Saline breast implant. Silicone gel patients must choose between Inframmary or Periareolar incision placement.

Stunning natural results

Dr. Gray’s training, precision, and personalized treatment plans provide genuinely outstanding results. Want to see for yourself? Follow the link below to view before and after pictures of Dr. Gray’s actual patients.

Implant Placement

Implant placement refers to the plane in which the implant will be placed after creating the incision. Placement will affect several things, including cleavage, drooping, rippling, capsular contracture risk, and more.

Submuscular

Submuscular placement means that the implant will be placed beneath the pectoralis major muscle. Dr. Gray will relax the lower portion of this muscle, which allows the implant to move into position for better cleavage. Dr. Gray creates cleavage by relaxing this muscle and choosing the correct implant width. With submuscular placement, there is significantly less rippling on the upper portion of the breast, and capsular contracture rates are lower.

Subglandular

This option refers to when the implant is placed above the pectoralis major and beneath the breast tissue and mammary glands. Recovery tends to be less painful but takes the same amount of time as submuscular placement. Subglandular placement is known to have higher capsular contracture rates, along with rounder and more artificial-looking implants. Subglandular placement tends to be chosen by a subset of women who are athletes, bodybuilders, or desire this particular look.

How is a Breast Augmentation Performed?

Dr. Gray conducts breast enhancement surgery as an outpatient procedure under general anesthesia in Bay Area Plastic Surgery’s AAAASF accredited surgical center. Before the operation, Dr. Gray will apply a nerve block. Patients can choose from a nerve block that lasts six to eight hours, or Exparel®, a numbing solution that will last for up to four days. Exparel is ideal for patients who do not wish to be sore, want to avoid narcotic medications, have responsibilities like looking after small children, wish to work from home during recovery, or have other similar concerns.

woman in swimsuit torso

Once he makes the incision, Dr. Gray will skillfully create a pocket within the breast. Creating the pocket just right takes a considerable amount of work, but once the pocket is right, he will pick the correct implant width to make sure it fits perfectly. Dr. Gray will adjust the implant while you are lying down and then again when you are in the upright position to make sure they look good in each position.

Lastly, Dr. Gray will close your incisions with absorbable sutures and Dermaflex™ glue. You will then be taken into a recovery room when you will be monitored until you wake up.

What Should I Expect in Recovery?

After awakening from your operation, you will be able to return home the same day. Because Dr. Gray uses Dermaflex glue, you will have no dressings, drains, wrappings, or bandages. You can also shower the same day as your surgery. This glue lasts about three weeks before falling off, and any sutures will dissolve naturally. You will stay in the same underwire support bra for the first two weeks, and then  you’ll be asked to switch to a better, more supportive underwire bra for the remaining postoperative period. You will be educated and given advice on the best bras to buy to keep your results looking beautiful over time.

You will be maximally swollen three to four days after surgery. After this time, the swelling will begin to dissipate, and your breasts will begin to feel normal as they fall into their new position. It usually takes around four months for swelling to heal. You will have regular follow-ups with Dr. Gray at one week, two weeks, one month, two months, three months, and four months.

Dr. Gray advises that you limit your activity, including no heavy lifting or exercise, and stick to flat walking until the five-week mark. From here, you can begin to increase your physical exertion level gradually. Many patients work up to the five-week mark by flat walking for increasingly longer durations as they start to feel more comfortable. Dr. Gray will be there to answer any questions you may have and help you along every step of the process.

Your Breast Augmentation Consultation with Dr. Gray

Your next step is to schedule a one-on-one consultation with Dr. Gray. Here, he will take plenty of time to educate you on each of these issues, answer any questions that you may have, and let you make an informed choice on your own. You will also be able to try on actual implants to see how each option would look with your unique body type and shape. Dr. Gray genuinely wants to make sure his patients are confident, prepared, and can realistically benefit from breast augmentation.

Bay Area Plastic Surgery is excited to offer this incredible operation to give you the outcome you’ve always wanted. If you are interested in learning more about why patients continue to choose Dr. Gray as their breast augmentation specialist in San Francisco, we invite you to contact us today!

San Francisco Breast Augmentation FAQ

If your breasts have been affected by age, pregnancy, or weight loss, this surgery can revive them with increased volume. It is also a welcomed answer if you work out with weights or have limited original breast mass. Dr. Gray would be happy to discuss your particular breast augmentation goals in consultation.

In general, a breast lift addresses a droopy breast, and breast augmentation adds volume. There are different breast lift options that address varying levels of droopiness. Dr. Gray can help determine which option best suits your goals during your consultation.

Yes, most women breastfeed after a breast augmentation with no trouble. Some methods, such as an areolar incision and some types of breast lifts, can potentially interfere. However, this is highly unlikely. Virtually all of Dr. Gray’s patients have had no problems breastfeeding as a result of implants. If you have any specific concerns about breastfeeding, Dr. Gray can address these in consultation.

Yes, we do provide a breast augmentation flash recovery. Dr. Gray is highly precise and will meticulously follow each procedural step to avoid bruising and ensure your recovery is as rapid and comfortable as possible. Dr. Gray also uses nerve blocks to prevent pain during and after the procedure. Exparel, a powerful numbing agent, can prevent pain for up to four days. For more details on a flash recovery, be sure to ask Dr. Gray about this in your consultation. 

Yes, you can always have your implants removed. Sometimes, patients choose to have a removal and replacement of their implants. This is known as breast revision surgery. These concerns can be reviewed in consultation with Dr. Gray. 

The FDA (Food and Drug Administration) has found no increase in breast cancer from breast implants. However, textured implants have been linked ALCL (anaplastic large cell lymphoma), a cancer of the immune system. For this reason, Dr. Gray does not offer textured implants.

Capsular contracture is a risk, although it’s not particularly common. Everyone has a capsule, but capsular contracture is when the capsule begins to harden and sometimes squeeze the implant. Most contractures can be treated conservatively, and treatments for bad contracture are now better than they were in the past.

There is a risk for any implant to deflate, but this is very low. Silicone implants generally have a lower rate than saline. All manufacturers have warranties for deflation and contracture. 

For silicone implants, there are two detection options: physical exam and MRI. When saline implants deflate, they physically shrink, making them much easy to detect visually. Saline implants will deflate much quicker and are absorbed by your body naturally and safely. Silicone implants can be detected with an MRI. Both types of implants are covered under warranty.