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Breast Augmentation

Breast augmentation is a surgical procedure that increases the volume of the breasts with implants. With today’s innovations, patients can enjoy a treatment that gives them many options in implant shapes, sizes, materials, and incision techniques.

The medical team at Esthetica Center for Cosmetic Surgery of San Diego makes sure each patient enjoys excellent outcomes. Dr. Wael Kouli has extensive knowledge and a commitment to quality care. Whatever your reason for seeking treatment, you can expect a team that supports you every step of the way. Schedule a consultation at one of our offices throughout San Diego or Orange County and see how you can enhance your feminine contours.

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Before and After Photos

About Breast Augmentation

The very first recorded cosmetic breast enhancement occurred in 1895, when the surgery was performed to reconstruct the breast following a mastectomy.[1]
However, it wasn’t until silicone implants were created in the 1960s that breast augmentation began to experience the popularity it enjoys today. Breast augmentation with implants is an effective way to add more volume to the breasts, and modern implants are safer than ever. Our medical staff works closely with each patient during every step of the process to ensure that they have the best experience possible. From selecting implants to enjoying their final results, Dr. Kouli and the team at Esthetica make sure that each patient receives the guidance and outcome that fulfills their aesthetic goals.

Breast Implant Considerations

Breast augmentation is a surgery that can be customized to meet a patient’s unique desires and anatomy, and as such, there are many decisions that a patient will discuss with Dr. Kouli before finalizing the details of their treatment plan. This includes the size and shape of the implants, the material of the implants, and how the implants are placed in the breast.

  • Saline, silicone, and gummy bear implants

Saline implants are silicone shells that are filled with saltwater during surgery and can be inflated precisely to the patients specifications. This allows the implants to be placed with small, barely noticeable incisions. Meanwhile, silicone implants are designed with a poly (dimethylsiloxane) elastomer shell.[1] These pre-filled implants feature multiple exterior layers to reduce the chance of rupture or leakage.[2] Finally, patients can choose to have their augmentation with the help of the most realistic alternative on the market: gummy bear implants! Cohesive-gel implants, or gummy bear implants, are prefilled with a thick silicone gel that keeps its shape and offers a firm, natural feel.

  • Round and anatomical implants

Round implants are dome-shaped prostheses that create even fullness across the breast. These implants are soft to the touch and give a full appearance that is most frequently chosen by women undergoing breast augmentations.

On the other hand, anatomical implants were designed to mimic the natural curvature of the breast. These implants are teardrop-shaped, with a downward slope and “bottom-heavy” appearance.

  • Smooth and textured implants

Breast implants have either smooth or textured surfaces. When implants are placed below the pectoral muscle, the rate of capsular contracture tends to be the same for smooth and textured implants. However, both types of implant surfaces have their own advantages.

Smooth implants are long-lasting breast enhancement devices that have a softer feel. They are less likely to rupture and pose a lower risk of developing breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) or cancer of the lymphatic system.[2] Textured implants feel slightly firmer. Because of the textured exterior, the body is able to “grab” onto the surface as it heals, so they have a lower chance of moving within the breast pocket.

Placement options for incisions include:

  • Inframammary: The commonly performed technique makes a discreet incision that is concealed under the natural creases of your breasts.
  • Periareolar: A well-hidden incision is made on the lower half of the areola. This technique is sometimes reserved for patients who combine a breast lift with their augmentation procedure.
  • Transaxillary: Surgical staff will make a concealable incision under the armpit. Patients opting for saline implants are good candidates for this method.
  • Transumbilical (TUBA): This innovative approach makes small incisions in the belly button. Surgical instruments create passageways under the skin so a saline implant can be guided under the skin and into the breast pocket, where it is then inflated. This avoids any incision or risk of scarring on the breasts.


Breast augmentation gives patients the privilege to obtain the breast profile they desire. Whether you’re looking to make modest changes or extensive revisions to your breast size, this treatment can help you achieve the results you deserve. Interested patients can also expect:

  • A procedure that offers many choices of implant shape, size, and contours
  • Replenishes volume loss caused by weight loss or pregnancy
  • Can be paired with a breast lift to increase the size and elevate the breast profile
  • Ability to “fill out” more exciting clothing options


An initial consultation helps identify whether you are a good candidate for this popular surgery. During your meeting, we will explain who a breast augmentation surgery is suitable for:

  • Healthy adult women without underlying health conditions
  • Patients who are committed to following aftercare instructions diligently
  • Non-smoking women or those willing to quit until they are fully healed
  • Women who are not currently pregnant or nursing
  • Those with realistic expectations

Personal Consultation with Esthetica Center

  • Why choose us?

Esthetica Center of San Diego is a modern surgical center with offices in San Diego and in Orange County. We are a team of renowned cosmetic surgeons dedicated to providing only the best customer care and outcomes.

  • Your consultation

Your consultation will be an open and honest discussion to discover more about how breast augmentation will enhance your unique anatomy. After evaluating your medical records and the results you’re hoping to achieve, we’ll discuss your augmentation experience in better detail. You’ll be guided through the many implant textures, sizes, and shapes. If you’re a good candidate for this procedure, after your consultation, we will schedule your surgery.

  • Contact us

To learn more about surgery and to find out if you are a good candidate, contact our office today to schedule a personal consultation. Patients in San Diego and the surrounding areas can call (858) 367-7514 in Del Mar(619) 836-1682 in Coronado, or (949) 989-6075 in Newport.


In the weeks before surgery, patients are asked to complete a few items. Breast augmentation patients can prepare themselves by:

  • Having a mammogram and or blood tests if necessary.
  • Avoid smoking until the aftercare process is over. Cigarettes and other nicotine products impede blood flow and inhibit your ability to heal.
  • Stop using aspirin, anti-inflammatories, and other blood-thinning supplements.
  • Arrange to take a few weeks off from work to rest.
  • Arrange to have a friend, significant other, or family member drive you home after surgery.
  • Follow fasting instructions from our medical team.
  • Plan to arrive 1 hour before your appointment to check in and fill out paperwork.


Your augmentation will occur at our surgical offices in San Diego or Orange County. Once anesthesia is administered, the appropriate incision will be made near the breast profile or inside the navel for TUBA patients.[3] Once the breast cavity is accessed, the implant will be secured subglandularly (above the pectoral muscle) or subpectorally (under the pectoral muscle).[4] Once Dr. Kouli closes your incisions and places a compression garment over the treatment area, you will be allowed to go home.


You will encounter moderate swelling, bruising, tenderness, and fatigue after treatment. These symptoms will be most pronounced in the first few days after your surgery, so be sure to get plenty of rest and take the pain medication we’ve prescribed. You can switch to OTC pain medications once your symptoms improve. For the next few weeks, patients should rest on their backs and continue wearing supportive garments. Within 1-2 weeks, you can start returning to light movement and return to sedentary work. However, wait another 4-6 weeks before beginning more strenuous activities, including exercise.

After your surgery, we’ll invite you back for regular follow-up visits to monitor your progress. After you’ve fully healed, you’ll have yearly visits.


You will enjoy the full benefits of a more prominent breast profile once the implants have settled into place. Your new breast curves will boost your self-confidence and allow you to explore new clothing options. Implants are durable and are expected to last 10-20 years. Regular breast exams and yearly MRIs are recommended to detect any abnormalities and to ensure that the implants are functioning normally.

Corresponding & Complementary Procedures

Many patients choose to include a breast lift with their augmentation treatment to address volume and projection concerns. Both can be performed simultaneously to reduce costs, recovery time, and multiple trips to the office. A breast lift reshapes the breasts by removing excess tissue and moving the breasts to a higher position on the chest for a perkier, lifted appearance.

Patients who prefer a natural enhancement to their profile without implants can choose to have their breast augmentation done with a fat transfer. This procedure allows patients to slim down pre-selected areas while adding natural volume to the breasts. After incisions are made, a cannula is placed under the skin to collect fat. It will be purified, prepared, and injected into the breast tissue. The result is a subtle yet noticeable increase in breast size.

Cost of Breast Augmentation in San Diego

Final costs for your unique treatment are based on the recommendations from our medical team. On average, this treatment can range from $3,350 to $9,550. Esthetica of San Diego offers several ways to pay for treatment, including CareCredit, Alphaeon Credit, and Lending USA. Look through our financial page to learn more about the availability of these payment programs.


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The office and procedure room were immaculate. Dr.Kouli and staff checked up on me often post.


I had an incredible experience at esthetica. Dr. Kouli is both personable and professional. Everyone in the office is friendly and aim to make you feel as comfortable as possible. I’d highly recommend their services.


I would recommend this office to anyone seeking a procedure. They answered any and all of my questions immediately. No matter how big or small.


Dr. Kouli is the best!, best surgeon, best bedside manner, best follow up… just the best


I can’t say enough about dr. Kouli. He looked a my problem which was pretty bad and immediately knew that he could fix it.