A smooth breast augmentation starts long before the day of surgery. Good results come from the combination of surgical skill, thoughtful planning, and patient preparation. In my experience, the most satisfied patients do three things well. They set clear goals and communicate them plainly. They prepare their bodies and homes for both surgery and recovery. They keep perspective during the early healing window, when swelling and nerves can trick the eye.
The following guide walks through the specifics I give patients in consults and pre-op visits. It covers planning, implant choices, sizing strategies, medical clearance, recovery logistics, and the small details that prevent big headaches. It also points out when a breast lift or other procedures like liposuction and a tummy tuck may factor into the plan. Use it as a reference, then bring your questions to your visit so we can personalize each step.
Clarify your goals before talking about implants
Every successful plan starts with language we both understand. Cup sizes are a moving target, since bra sizing varies by brand. Photos help calibrate expectations better. Bring two sets. First, “ideal” examples that feel achievable on a body like yours. Second, “too much” examples to define your upper limit. The comparison is useful. It sharpens the aim and reduces the odds of sizing regret.
Think beyond size. Shape matters as much. Do you want more upper-pole fullness, a natural slope, or a perky round look? Are you mostly correcting postpartum deflation or seeking a major change? If you exercise regularly, how your chest looks in a sports bra may matter more than how it looks without one. Tell me which scenarios are most important in your daily life. Clothes, gym, work, and special occasions all drive different design choices.
Expect a discussion about your tissue. The skin envelope, nipple position, and the thickness of your existing breast tissue set the boundaries. If your nipple sits below the fold or points downward, a breast lift may be necessary to center the breast on the implant. If your skin is very tight or very thin, we may recommend smaller volumes or staged enlargement to protect long-term shape. Patients with strong pectoral muscles often do well with dual-plane placement, which softens movement during flexing.
Pick the right implant for your body and goals
There is no one “best” implant. The right choice depends on anatomy, lifestyle, and aesthetic preferences. We will talk about three main variables: fill material, shape, and surface.
Saline and silicone both have advantages. Saline implants are filled after placement, which allows tiny adjustments in the operating room. They tend to feel less natural in very thin patients, especially at the upper pole. Silicone gel offers a softer, more natural feel and less rippling. Modern cohesive gel implants come in different firmness levels. Firmer gels hold shape and upper-pole fullness better. Softer gels feel very natural but can settle more over time. For most patients seeking a believable, soft result, silicone is a strong choice.
Shape can be round or anatomically shaped. Round implants can still look natural, especially when placed thoughtfully and sized modestly. They are popular because they do not have a “top” and “bottom,” so rotation does not change the look. Anatomical, or teardrop, implants were designed to mimic a natural slope. They can be useful in reconstructive work or in select cosmetic cases, but they require careful handling and are not necessary for most augmentations.
Surface options include smooth and textured. In the United States, most cosmetic augmentations use smooth implants. They move more naturally in the pocket and have a lower association with rare conditions like BIA-ALCL, which has been observed primarily with certain textured implants. When we discuss surface choice, the conversation stays anchored to safety data, pocket stability, and your specific tissue.
Volume selection should match your chest width and skin elasticity. Two people with the same height and weight can require different implant sizes because chest diameter, breast base width, and rib shape vary. The goal is to fill the footprint, not overflow it. Overly wide implants push tissue sideways into the armpit and can cause discomfort and cleavage that looks forced. Narrow implants on a wide chest can leave a gap and a ball-on-the-chest appearance.
How I guide sizing to avoid regrets
Sizers and 3D imaging both help, but they are tools, not oracles. I use chest wall measurements, base width, soft tissue pinch thickness, and the degree of upper-pole fullness you want. In many cases, a range of around 25 to 50 cc separates two sizes that look similar on the table but read differently in clothing. We will address the common fear of going “too big.” The bell curve of patient feedback skews toward “I could have gone slightly larger,” but that does not mean you should. It means we need to anchor sizing in your daily priorities, not a single selfie.
When you try sizers in a non-padded sports bra, focus on movement and silhouette rather than a single mirror angle. Sit, stand, raise your arms, and bend forward. If you plan to jog or lift weights, try on a compression top. Think about work attire, not just swimsuits. Comfort and proportion in your routine are the true test.
When a lift adds more than volume can
Volume does not fix droop. If the nipple falls below the fold, simply placing a larger implant will add weight, not lift. A breast lift repositions the nipple and tightens the skin envelope. You may need a lift alone, a lift with an implant, or an implant alone based on the anatomy. The trade-off is scars. Modern lift techniques use meticulous closure to minimize widening, and scars typically fade over 9 to 18 months, but they are present. Patients who prioritize perkiness and centered nipples usually accept this trade-off.
In some women, pairing a modest implant with a lift keeps the breast round and full at the top while restoring position. In others, a lift alone provides the shape they want. If you are uncertain, plan for a conservative implant size that matches your base width and use the lift to address position.
Medical preparation that actually matters
Safety is not mysterious. It is the sum of good judgment and clean execution. A few habits move the needle most.
Stop nicotine in all forms for at least four weeks before and four weeks after surgery. That includes vaping, patches, gum, and secondhand exposure in your home. Nicotine constricts blood vessels and increases the risk of delayed healing and infection. If you need help stopping, say so early, we can coordinate support.
Disclose all medications and supplements, even the natural ones. Many affordable plastic surgeon Newport Beach “natural” products thin the blood or affect anesthesia. Common culprits include fish oil, turmeric, ginkgo, garlic, and high-dose vitamin E. Most patients stop these 10 to 14 days before surgery. Avoid NSAIDs like ibuprofen unless your surgeon says otherwise. Acetaminophen is usually allowed for pain before surgery, but ask to be sure.
Plan for lab work and clearance. Healthy adults often need basic labs and, depending on age and history, an EKG. If you have a history of anemia, thyroid disease, diabetes, or an autoimmune condition, expect additional labs. If you have had breastfeeding or a recent change in a breast exam, you may be asked to get imaging, typically a mammogram or ultrasound, based on your age and risk profile.
Aim for stable weight. Small fluctuations are fine, but large swings change your skin envelope and the way implants sit. If you are planning significant weight loss or a major training cycle, discuss timing. In massive weight loss cases, skin redundancy may warrant a lift rather than a large implant.
Sleep hygiene matters more than most people think. Recovery goes easier if you already sleep on your back with your upper body elevated. Practice this setup for a week before surgery. It reduces the shock of the first nights at home.
Logistics for the week before surgery
The best surgical day is quiet and predictable. That happens when you control what you can control, which is a lot.
- Confirm transportation and a responsible adult to stay the first night. This is not optional. You will be groggy from anesthesia and need help with meals, meds, and position changes. Prepare a recovery nook at home: firm pillows or a wedge for elevation, a side table for water and meds, and a phone charger within reach. Stock the kitchen with easy, low-sodium meals. Think lean proteins, cooked vegetables, and fruit. Salty takeout adds to swelling. Set out the clothing you will wear for the first week: front-closure bras if provided, zip-up hoodies, soft joggers, slip-on shoes. Avoid tight sleeves and anything you need to pull overhead. Fill prescriptions in advance. Organize them in labeled containers with a simple schedule.
Keep your skin clean and avoid heavy moisturizers or oils near the incision sites for several days before surgery. If instructed, use an antiseptic wash the night before and Best Plastic Surgeon morning of surgery. Stay well hydrated in the days leading up to surgery and follow fasting instructions exactly, usually nothing by mouth after midnight unless you are told to take specific pills with a sip of water.
What to expect on the day of surgery
Most patients feel a mix of excitement and nerves. We review the plan, mark the chest, confirm implant choices, and run through last questions. Anesthesia is typically general, administered by a board-certified anesthesiologist. The surgery itself often takes 60 to 90 minutes for straightforward augmentation, longer if a lift or fat grafting is included.
Pocket placement can be subglandular, submuscular, or dual-plane. Most primary augmentations use a dual-plane approach because it blends soft tissue coverage at the top with natural movement at the bottom. I irrigate the pocket with antibiotic solution, use a no-touch technique for implant insertion, and minimize handling to reduce bacterial exposure. These details lower the risk of capsular contracture and infection.
You will wake up in recovery with a supportive bra or dressings, and your nurse will monitor your comfort, vitals, and nausea. Most patients go home the same day. If your case is complex or you have specific medical concerns, we may recommend an overnight stay in a monitored setting.
Pain, swelling, and the first 72 hours
Discomfort after breast augmentation varies, but the pattern is predictable. Tightness across the chest, pressure, and a feeling like you did too many push-ups is common, especially with submuscular work. Many patients describe the peak within the first 48 hours, then steady improvement.
I favor multimodal pain control. That means a combination of non-opioid medications taken on a schedule and a small supply of opioids for breakthrough pain if needed. Staying ahead of pain is better than chasing it, so set a timer and follow the schedule we give you. Ice is usually avoided directly on the breasts in the first few days unless advised, because it can numb the skin and mask pressure signals.
Nausea prevention starts in the operating room. If you are prone to motion sickness or have had issues with anesthesia before, tell us early so we can tailor the plan. Eat light, bland meals the first day and hydrate in small, frequent sips. A stool softener from day one helps avoid straining.
Swelling and bruising are normal. The breasts often sit high at first. This is not the final shape. Implants settle over 6 to 12 weeks, sometimes longer, as the upper pole relaxes and the lower pole fills out. Asymmetry in the first month is common and usually resolves as swelling evens out.
Activity timeline that protects your result
I prefer clear rules that are easy to remember. Gentle walking starts the day of surgery to encourage circulation. Keep elbows near your sides and avoid reaching overhead for the first week unless cleared. You can usually shower after 24 to 48 hours, depending on dressings. Pat the incisions dry. Do not soak in baths, pools, or the ocean until we give the green light.
Light desk work is often possible within a few days if you feel well and avoid lifting. Childcare and pet care require planning, since lifting a toddler or a squirming dog can strain incisions. By two weeks, most patients can increase arm range within comfort, still avoiding heavy lifting. By four to six weeks, many return to lower-body workouts and gentle upper-body movements. High-impact exercise, chest-focused weight training, and push-ups usually wait six to eight weeks or longer. We tailor this timeline to your healing and the specifics of your implant placement.
Sleeping positions matter. Back sleeping with a slight incline for the first week reduces swelling and protects incisions. Side sleeping is often allowed after the first week if it is comfortable and supported with pillows. Avoid stomach sleeping until at least six to eight weeks.
Scar care that works
Scar quality depends on genetics, technique, and aftercare. Incisions fade best when protected from sun and friction. Keep sunscreen on healing skin once it is closed and cleared, usually SPF 30 or higher, and avoid direct sun exposure when possible for the first six months. Silicone gel or sheets can improve scar maturation when used consistently for several weeks. Massage may be recommended once incisions are fully healed. If you are prone to keloids or hypertrophic scars, tell me upfront so we can monitor closely and intervene early if needed with steroid injections or other treatments.
Incision location is usually in the inframammary fold, around the areola, or in the axilla. The most common choice is the fold, which offers precise control of pocket creation and often the most discreet, well-hidden scar when the breast is in a natural position. Areolar incisions can blend color well, but not everyone is a candidate, and bacterial exposure can be higher. Axillary incisions avoid direct scars on the breast but limit access for certain maneuvers. We choose the location that balances visibility, control, and your anatomy.
The mental side of recovery
The first two weeks can play tricks on you. Swelling, tape marks, bruising, and the unfamiliar shape can spark second thoughts. This reaction is common and temporary. I encourage patients to postpone any snap judgments until at least week six. Photos taken at regular intervals help normalize the changes. If a concern arises, share it early so we can evaluate together. Most early asymmetries are swelling or muscle tightness, not surgical errors. If something needs correction, we do not guess. We measure, image if needed, and give healing time before making a plan.
When to consider combining procedures
Many mothers choose to coordinate breast surgery with other contouring like liposuction or a tummy tuck. Combined procedures can reduce total downtime by consolidating anesthesia and recovery into one period. The trade-off is a longer day in the operating room and a more involved first two weeks. Patient selection is key. Healthy nonsmokers with good support at home typically do well. We design the order of operations to maintain safety, manage fluid shifts, and keep post-op care manageable. If you are weighing a staged approach versus a single session, we will walk through the pros and cons based on your goals and baseline health.
Risks you should understand and how we reduce them
All surgeries carry risk. The aim is not to eliminate risk, which is impossible, but to minimize it and plan for it.
Infection rates in clean cosmetic breast surgery are low, often quoted around 1 to 2 percent, and vary with technique and patient factors. I reduce risk with a no-touch insertion technique, pocket irrigation, antibiotic prophylaxis, and meticulous hemostasis. You can help by following wound care instructions and avoiding nicotine.
Capsular contracture represents the body’s reaction to the implant shell. All implants form a capsule, but in some cases it tightens abnormally, distorting shape and causing firmness. Reported rates range widely by cohort and technique. Under-the-muscle placement, no-touch technique, and antibiotic protocols appear to lower risk. If contracture occurs, options include capsulotomy, capsulectomy, pocket change, or implant exchange. The right move depends on severity and history.
Changes in nipple sensation are common in the early weeks. Most patients recover baseline feeling over months, though a small percentage can have lasting increased or decreased sensitivity. The risk rises with larger implants and more tissue dissection. Reassuringly, permanent loss is uncommon in primary augmentation with careful technique.
Implant rupture is rare in the early years and increases slowly over time. Modern silicone ruptures are often silent, meaning you may not notice. The FDA recommends periodic imaging to monitor. Saline ruptures deflate visibly and are easier to detect. If a silicone implant ruptures, we usually remove the gel and the implant shell, clean the pocket, and place a new implant if appropriate.
Breast implant illness is a patient-reported constellation of systemic symptoms attributed by some to implants. The scientific community continues to study this. My approach is to listen carefully, rule out other causes, and support each patient’s decision. If a patient believes implants are impacting her health and wants removal, we plan an explant procedure and discuss expected changes, with or without a lift.
BIA-ALCL is a rare lymphoma associated primarily with textured implants. Its signs include persistent swelling or fluid around the implant, often years later. The absolute risk is low, and the prognosis with early treatment is favorable. Smooth implants used in most cosmetic cases have not shown the same association. We discuss this history openly so you can make an informed choice.
A pragmatic pre-op and post-op mini checklist
Use this as a quick reference, then rely on your personalized instructions.
- Two to four weeks before: stop nicotine, pause blood-thinning supplements and NSAIDs as directed, complete labs and imaging, confirm a responsible adult for the first night, practice back-sleeping with elevation. One week before: set up your recovery nook, stock low-sodium meals, fill prescriptions, arrange childcare and pet help, set out front-closure clothing. Day before and day of: follow fasting instructions, use antiseptic wash if instructed, remove jewelry and piercings, bring your ID and paperwork, wear loose layers and slip-on shoes. First week after: walk several times daily, keep arms close to your sides, manage pain on schedule, keep incisions clean and dry, avoid lifting and overhead reach unless cleared. Weeks two to six: gradually expand motion, avoid high-impact exercise and chest workouts until cleared, start scar care when allowed, send or bring progress photos to follow-ups.
How to get the most out of your consultation
Arrive with priorities and honest questions. If you are torn between two sizes or two approaches, say so. I prefer to discuss trade-offs openly. If you have a history of motion sickness, anesthesia nausea, or difficult pain control after other surgeries, share that early. If feeling natural matters more than looking round, I will lean toward softer gels and conservative volumes. If upper-pole fullness is your top goal, I will shape the pocket and implant selection accordingly.
Bring details about your routine. If you travel for work, we adjust timing and plan for compression and movement on flights. If you are a swimmer, we will discuss how long to stay out of the pool. If you are mid-marathon training, we will design a return-to-running schedule that respects healing.
Speak up about future plans. If you want children or plan to breastfeed, tell me. Many women breastfeed successfully after augmentation, but we do not guarantee it. Incision choice and implant position can influence glandular disruption, and we factor that into the plan.
Real-world expectations by the numbers
Timelines vary, but there are patterns. Most patients feel well enough to run errands within three to five days if they have help lifting. Desk work often resumes in a similar window. Driving returns when you are off narcotics and can move comfortably, often within a week. Swelling decreases significantly by week three. Implants settle over 6 to 12 weeks, and subtle refinements continue through month six. Final scars can take a year or longer to mature. If you combine augmentation with a breast lift, expect a slightly longer initial recovery and more follow-up to monitor scar behavior.
Keeping results over the long term
Longevity comes from match-making. If implant size fits your base width and tissue quality, and if you maintain a stable weight, results can remain attractive for a decade or more. Life changes breasts. Pregnancy, breastfeeding, weight shifts, and gravity do not stop. Some patients choose a revision after several years, either to refresh shape, adjust size, or address a capsule. Plan to check in periodically, even if everything feels fine. Routine follow-up keeps small issues from becoming large ones.
Quality bras help. Wearing supportive sports bras during high-impact exercise reduces stretch on the lower pole. At night, many patients feel more comfortable with a light, non-underwire bra during the early months. After healing, underwire is typically fine if it sits comfortably below the fold.
Final thoughts
Preparation is the quiet engine behind great outcomes. When patients arrive with clear goals, a practical recovery plan, and realistic expectations, the surgical day feels uneventful in the best way. Your part is to be candid about your lifestyle and preferences, follow the playbook, and ask questions when something is unclear. My part is to guide the details, operate with precision, and help you navigate choices with evidence and experience. Together, we can create results that look and feel like you, just more aligned with how you want to show up in your life.
Michael Bain MD is a board-certified plastic surgeon in Newport Beach offering plastic surgery procedures including breast augmentation, liposuction, tummy tucks, breast lift surgery and more. Top Plastic Surgeon - Best Plastic Surgeon - Newport Beach Plastic Surgeon - Michael Bain MD
is breast augmentation worth it?
Tangential Facelift
Breast Augmentation in Newport Beach
Orange County Plastic Surgeon
Breast Augmentation Surgery
Breast Reconstruction in Newport Beach CA
Breast Reconstruction
Board Certified Plastic Surgeon
Michael A. Bain MD
2366 San Miguel Suite 307
Newport Beach, CA 92660
949-720-0270
https://www.drbain.com
Newport Beach Plastic Surgeon
Plastic Surgery Newport Beach
Board-Certified Plastic Surgeon
Michael Bain MD - Plastic Surgeon
is breast augmentation worth it?
Tangential Facelift
Breast Augmentation in Newport Beach
Orange County Plastic Surgeon
Breast Augmentation Surgery
Breast Reconstruction in Newport Beach CA
Breast Reconstruction
Board Certified Plastic Surgeon