Breast Augmentation

Consultations offered at our four convenient locations in Del Mar, Coronado, Newport and San Diego, CA

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Breast Augmentation San Diego

Our breast augmentation procedure is designed to produce more aesthetically-pleasing breasts. There are several types of breast augmentation, including enhancement with breast implants, natural fat transfer, and breast reconstruction after a mastectomy.

The breasts are an appealing feminine feature that adds to your physical allure. If you were not born with the breasts that you want, it can be a blow to your confidence and self-esteem. For patients in San Diego, breast augmentation can enhance your bust, creating the feminine curves you want, and increase your confidence and quality of life.


The reasons women seek breast augmentation are as unique as the woman herself. Some women were born with small breasts and have always wanted more curves. Others feel their breasts are less attractive as they appear deflated following pregnancy, breastfeeding, or significant weight loss.

Whatever your reason for seeking breast augmentation in San Diego, our team of professionals will support and empower you. Whether you’re seeking a subtle enhancement or a dramatic change, we can help you realize your aesthetic vision for your breasts.


Most women requesting a consultation for breast augmentation are looking to:

  • Enhance their breast size
  • Restore diminished breast volume from weight loss or pregnancy
  • Improve their contour
  • Elevate sagging breasts with a breast lift

Alternatively, some women in San Diego may need a reconstruction procedure after a mastectomy following breast cancer.



Some women want subtle changes, while others desire a more significant outcome. In both cases, breast augmentation is a very popular procedure to improve your self-image and confidence. A thorough understanding and explanation of what you are looking for is critical to your results. You should decide to have surgery only after you have a solid understanding of your expectations.

Breast augmentation candidates are women who are looking for improvement, not necessarily perfection. Every woman has different expectations regarding their outcome. During your consultation, you should communicate your desires. Our mission is to surpass your expectations and provide you with the best breast augmentation results possible.


Costs for breast augmentation can vary depending on the type of implants you choose, and the procedure needed. At Esthetica of San Diego, we will discuss your vision for your breasts and provide you with a custom quote.

I came to Dr. Kouli for breast augmentation and I couldn’t be happier! Of course, I had my fears and hesitations with a surgery this big, but Dr. Kouli and his staff immediately put them to rest. He definitely took into consideration my personal needs and my lifestyle to determine how the surgery was to be done. I am 100% satisfied with how everything turned out. And I’m so glad I chose to come here! I would highly highly recommend to anyone!



Types of Implants

Breast augmentation with implants is the most popular cosmetic plastic surgery in the nation. As reported by the American Society of Plastic Surgeons (ASPS), more than 300,000 breast augmentation surgeries were performed in the U.S. last year. After an in-depth consultation and careful evaluation of your anatomy, our skilled cosmetic surgeons at Esthetica of San Diego can recommend the best type of implants for you.

There are different types of breast implants, as well as various sizes, textures, shapes and profiles. The implant size is based on projection and width. Textures are either smooth or rough. The shape can be round or anatomic (teardrop). And finally, profiles are low, medium or high.

During your consultation at one of the San Diego offices in Coronado or Del Mar, you will have the opportunity to examine the implants, see how they feel and look with your body. Our plastic surgeons will guide you in selecting the best breast implants for your body type.

Breast Implant Options

Breast implant technology has advanced significantly in recent years. Women who want breast augmentation today have a variety of options to choose from. Patients have choices as to:

  • Implant materials (saline, silicone, or gummy bear)
  • Implant shape (round or anatomical)
  • Implant size (one of the most important factors contributing to the result)
  • Implant placement (under or over the pectoral muscles)
  • Surgical incision placement (in the breast crease, around the areola, in the armpit, or through the navel)
  • Implant surface: Textured or smooth


Surgical Incision Options

Incision placement options for breast implants include:

  • Inframammary – in the fold beneath the breast: This is the most common technique for breast implants. It allows the surgeon maximum access for placing implants. The inframammary incision better exposes the interface of the breast tissue and pectoral muscles, which makes it ideal for silicone implants.
  • Peri-areolar – around the areola: The surgeon makes an incision near the lower half of the areola for a well-concealed scar. This technique is often used when breast lift is performed in combination with breast augmentation surgery.
  • Transaxillary – in the armpit: This approach is far less common and can only be used with saline implants. The surgeon creates a small incision in the armpit, dissecting a tunnel in which to place the implant. Transaxillary incisions leave no scarring on the breasts but may pose a higher risk of asymmetrical implant placement.
  • Transumbilical (TUBA) – around the belly button: Like the transaxillary incision, the transumbilical approach can only be used with saline implants that are filled after they are placed. The surgeon makes an incision in the area of the navel and creates a tunnel upwards towards the breasts. The saline implant is rolled up like a cigar and fed through the dissected tunnel for placement in the breast.

Saline Vs. Silicone Vs. Gummy Bear Breast Implants

The type of implant you choose is an important decision in a breast augmentation procedure:

  • Saline implants consist of a silicone shell filled with sterile saline solution. A chief advantage of saline implants is that they are filled by our surgeon after placement. This allows for smaller incisions and more precise placement to achieve the desired outcome.
  • Silicone implants consist of a silicone shell filled with silicone gel to mimic the feel of human fat. Many people believe that silicone implants have a more natural look and feel than saline implants. However, silicone implants are costlier, and they are placed in the body fully filled, requiring larger incisions and limiting incision placement options.
  • Gummy bear implants, also known as cohesive-gel implants, are a newer option that has become available in recent years. They are filled with thicker silicone (hence, the name) and designed to mimic the shape and slope of a natural breast. A disadvantage of gummy bear implants is that they require substantially larger incisions than saline or silicone implants.

Round Vs. Anatomical Breast Implants

Round implants tend to cost less than anatomical implants. They have a round, symmetrical shape that does not become malformed if the implant moves within the pocket that contains it. Once implanted, round implants do not look unnatural, but rather take on the shape of an anatomical implant in the vertical position.

Anatomical implants were originally designed for breast reconstruction patients but are now being used for cosmetic breast augmentation. When viewed from the front, they appear oval, and when viewed from the side, they have a “bottom heavy” appearance, with more volume at the bottom than at the top, like a natural breast. Anatomical implants are made with a textured surface to minimize displacement in the breast pocket, which can cause asymmetry.


Smooth Vs. Textured Breast Implants

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:

  • Textured implants have less chance of displacement (moving in the breast pocket) than smooth implants.
  • Smooth implants are longer lasting with a slightly lower rupture rate.
  • Textured implants have a thicker shell that makes them feel firmer.
  • Smooth implants present a lower risk of developing breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a cancer of the lymphatic system located in the breast.

Are Breast Implants Safe?

The outer shell of the implant is a solid silicone, rubber shell that may have a smooth or textured covering. After extensive research and investigation, the FDA (U.S. Food and Drug Administration) has approved both saline and silicone as filling substances for breast implants.

Before placing implants, a woman’s breasts should be fully developed. Saline implants are approved by the FDA for woman at least 18 years of age, while silicone implants are approved for women at least 22 years of age.


This is the time for you to get to know and become comfortable with our plastic surgeons and the staff at Esthetica. You should express your needs, desires and expectations for your procedure. We will review your medical history and explain the surgical technique. All of your questions will be answered as thoroughly as possible.

A breast examination will be performed to evaluate the quality of your skin, breast size and tissue. A breast lift may be recommended for saggy breasts. We will thoroughly review the various implant types and you will have an opportunity to try them on. Measurements will also be taken to ensure that the implant you choose will deliver the expectations you desire.

Possible Complications

When you work with an experienced cosmetic surgeon, complications are very rare. During your consultation, we will review the potential complications and explain the pre-operative and post-operative process.

During this time, it is important to inform our surgeons about the following:

  • Allergies
  • Medications you take, including herbs, eye drops, over-the-counter medicines and creams
  • Blood thinners (anticoagulants), aspirin, or other drugs that could affect blood clotting
  • Use of steroids (by mouth or creams)
  • Possibility of pregnancy, if this applies
  • History of blood clots (thrombophlebitis)
  • History of bleeding or blood problems
  • Smoking history
  • Previous surgery
  • Previous problems with anesthetics, including local anesthetics
  • Any other health problems



You will experience mild to moderate swelling, bruising, and tenderness in the breasts following your breast augmentation, which can be well-managed with pain medication prescribed by our surgeon. You will need to wear a compression garment for several weeks following your surgery.

This will help to encourage your body’s own healing processes while stabilizing your new breasts, assisting in blood flow, and reducing swelling. The first three days following your procedure are typically the most uncomfortable. Many patients find they are able to switch to over-the-counter pain medication after the first few days following surgery.

Follow-Up Appointment

You should maintain a close relationship with your surgeon in the months following your breast augmentation. Your initial follow-up appointment will be scheduled approximately one week after your surgery so our surgeon can check your incisions, remove any drains that were put in place, and inspect your breasts and implants to ensure they are healing properly.

Following your initial appointment, our surgeon will want to see you at regular intervals over the course of the next six months and then yearly after that point. These regular appointments will allow us to ensure your implants are settling correctly and the incisions healing as they should.

Choosing Your Surgeon

The most important decision you make when it comes to your breast augmentation is choosing a highly-talented, experienced plastic surgeon to perform the procedure. Selecting a plastic surgeon with a history of successful breast augmentations is a crucial point in our satisfaction and pleasure with your newly-shaped breasts.

Breast augmentation is a very delicate procedure requiring both surgical skill and a keen eye for symmetry and beauty. Our surgeons are at the top of their fields and can be trusted to perform breast augmentation with meticulous care.

Review Your Expectations

For example, what do you want from your procedure? How do you want your breasts to look and feel? What size do you want them to be?

Select a Breast Implant Type

When choosing between silicone and saline implants, it’s important to consider the following:

  • The type of implant affects how the breast feels.
  • Gel implants should be checked every so often. That is because a leak often produces no symptoms.
  • Age makes a difference. In the United States, saline implants can be used for augmentation in women 18 and older. Gel implants can be used for augmentation in women 22 and older.

Have Blood Tests and a Mammogram

In some cases, the surgeon may order for you to have a mammogram (breast X-ray) and/or blood tests before the surgery.


  • Do not eat or drink for about eight hours before your surgery.
  • Arrive at least one hour before surgery. This will give you time to check-in and fill out your paperwork.
  • Make arrangements for someone to drive you home after your surgery.
  • Two weeks before your surgery, stop using aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief. This includes prescription drugs and over-the-counter drugs. Also, stop taking vitamin E. If you take blood thinners, ask your caregiver when you should stop taking them.




You will be given an anesthetic to ensure your comfort. Breast augmentation is usually done under general anesthesia for our Coronado clients, which means you will be asleep throughout the procedure. Occasionally, the surgery can be done under local anesthesia. In these cases, the breast area will be numbed, and you will be awake during the procedure.


A small cut (incision) will be made in your breast. The cut can be made near the nipple, in the crease beneath the breast, or in the armpit.


For most breast augmentation patients, we will pull the breast tissue away from the muscles to create an open area for the implants. Alternatively, we may form a pocket for the implant under the muscles.


The implant is placed and positioned.


The incision is closed with stitches and covered with surgical tape.

After Your Procedure

  • Your breasts will be wrapped in gauze.
  • You will be taken to a recovery area and monitored until the anesthesia wears off.
  • You will go home to begin the healing process.


Why Choose Esthetica of San Diego?

Our renowned cosmetic plastic surgeons have significant training and experience in breast enhancement procedures. We are committed to excellence and quality patient care. We can custom-tailor a surgical plan including the right implant options for your unique anatomy and aesthetic goals.

Breast implants can transform your body. If you wish to learn more, contact us today and schedule a consultation with our staff.