Breast Augmentation

Breast augmentation is one of the most commonly performed cosmetic operations in America. This advanced procedure can beautifully enhance volume and fullness in the breasts with results that look natural. Our board-certified plastic surgeon, Dr. Eric Okamoto, is highly skilled and experienced with breast enlargement surgery and will customize the procedure to meet your unique needs and goals.

Breast augmentation can be an ideal option for women who would like to increase the size of the breasts, address asymmetry, improve overall shape, and/or make the breasts more proportionate to their body frame.

What Are the Benefits of Breast Augmentation?

Breast augmentation offers a number of significant advantages for women who would like to enhance and rejuvenate the appearance of their breasts. This procedure can:

  • Add volume to the breasts for a fuller breast aesthetic
  • Improve breast shape and symmetry
  • Improve balance between the contours of the breasts and the body for a more proportionate silhouette

Dr. Okamoto is extensively experienced with this procedure and can achieve your goals with the most natural-looking results possible. He will meet with you for an initial breast augmentation consultation to discuss your goals and address any concerns you may have.

Featured Cases
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Where Are the Breast Augmentation Incisions Made?

The potential incision location for inserting the breast implants will be discussed. There are four choices: through the navel, through the armpit, underneath the breast, or the edge of the areola (the dark-pigmented region surrounding the nipple). Dr. Okamoto prefers the areolar or under-the-breast incision techniques; however, he will explain all of your options and ultimately make the determination based on your individual needs.

Where Are the Breast Implants Placed?

A decision must be made whether to place the implant above or below the main chest muscle (pectoralis major). In almost all cases, under-the-muscle placement will be emphasized, but there are some occasions where above-the-muscle placement would be more appropriate.

What Are the Types of Breast Implants Available?

The advantages/disadvantages between breast implant types will be thoroughly evaluated. This is the time to discuss virtues and drawbacks as they pertain to silicone vs. saline implants, textured vs. smooth, and shaped vs. round implants. Any implant manufactured in the U.S.A. and approved by the U.S. Food and Drug Administration is generally available for your use; however, if you don’t have a preconceived idea as to the type of implant you desire, Dr. Okamoto will explain the multiple advantages for smooth-walled, round saline implants, his usual preference.

One of the most important decisions you’ll make while you are considering breast augmentation is the type of breast implant that will be best for your needs. The two major types of breast implants available are:

Saline Breast Implants

Saline breast implants are composed of silicone outer shells that are filled with sterile saline at the time of surgery. Because they are inserted in a deflated state and filled afterward, short scars on the breast skin are used. Saline implants have been effectively utilized for decades to augment breasts.

Silicone Breast Implants

Like saline implants, silicone implants also have silicone outer shells. The main difference is that silicone implants are pre-filled with silicone gel. Silicone gel implants often have a more natural feel when an augmented breast is palpated – this can be particularly advantageous for women with very little breast tissue.

Dr. Okamoto will explain the types of breast implants that may be best for your unique needs during your initial consultation, and he will be happy to answer any questions you may have. If you have concerns about rare conditions such as BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma) or BII (Breast Implant Illness), Dr. Okamoto will not hesitate to discuss these with you. Please see the BIA-ALCL and BII sections below for more information on these conditions.

Breast Implant Sizes, Shapes, and Textures

Breast implants of all types typically come in a variety of sizes, shapes, and textures. There are those that are round or teardrop shaped, as well smooth-walled and textured. In general Dr. Okamoto almost always recommends smooth-walled round implants which can be further discussed during consultation. When it comes to size, the potential for the best results are often based on your individual body type and the size that can achieve your goals with the most natural-looking results. Breast augmentation is as much about renewing the proportions of your breasts as it is about giving them a fuller appearance, and Dr. Okamoto will talk with you in detail about the size that is most appropriate for your needs. You can find more information on breast implant sizes in the section below.

Breast implants are also available in an array of profile ranges. These measure from low to moderate to high profile implants, and your decision in this area will be based on how much forward projection you would ultimately like to attain.

What Size Should I Be After Breast Augmentation?

The fourth decision during the breast augmentation consultation is to determine the most appropriate size for your breasts. Plastic surgeons recognize that many different methods exist to help make this determination, each with its specific advantages and disadvantages. Sometimes, more than one method is utilized to make the final choice.

One of the most important things to remember when choosing the size of breast implants is that the decision is ultimately the patient’s. Although a spouse, a friend, or even the plastic surgeon may influence one’s selection of the breast implants’ size, the patient must take personal responsibility for making the final decision. This is a very personal choice and each patient should feel completely confident and comfortable that they are making the right choice for their own needs and goals.

With that in mind, there are a number of ways in which Dr. Okamoto can help individuals gain a better understanding of how certain breast implant sizes may look. Time will be afforded to each potential patient to “try on” different-sized implants in the office with an office bra. A similar size test can be done in the privacy of the individual’s home with rice, a nylon stocking, and a metric measuring cup, which will be explained during the consultation. Once the patient’s preference for implant size is chosen—this is typically measured by milliliters (mls) or cubic centimeters (ccs)—a chart basing implant size vs. breast base diameter is utilized to determine the appropriate profile for the implant that will be used. 

View breast augmentation before-and-after photos here.

As you can see, women considering breast augmentation have a number of options when it comes to choosing the size, shape, and type of breast implants that will help them achieve their goals. At Fremont Plastic Surgery, Dr. Eric Okamoto offers a comprehensive array of breast implants that you will be able to see and feel during your initial consultation. Our plastic surgeon will talk with you about all of your options, and help you decide which type of implant can provide you with the best possible results.

What Does the Breast Augmentation Procedure Involve?

The next step in the consultation process is to discuss the risks and complications of the operation, particularly those special considerations that are related to the implants. Once you have made your decisions, had your concerns addressed, and are determined to be a good candidate for this procedure, your breast augmentation treatment plan will be created. During the operation, Dr. Okamoto will utilize the incision location agreed upon in your consultation to place the implants. Once they are placed, the incisions will be closed and the recovery stage of the process will begin.

Breast augmentation surgery typically takes about 1 – 1½ hours to complete and is usually performed on an outpatient basis.

What Can I Expect During Breast Augmentation Recovery?

In general, most women with relatively sedentary jobs can return to work about one week after breast augmentation surgery; however, since most breast augmentations utilize under-the-muscle placement for the implants, it will take six to eight weeks for this muscle to fully heal. There will be some swelling, bruising, and numbness in the breasts for a few weeks following surgery. Post-surgical pain and discomfort can be managed with medication.

Please note that you should still have mammograms after breast augmentation surgery. Dr. Okamoto can talk more with you about the kinds of mammograms you may require in order to properly see around breast implants for accurate results.

Will I Have Noticeable Breast Augmentation Scars?

The visibility of residual scarring from breast augmentation will ultimately depend on the technique utilized in the procedure. Some of the more frequently performed breast augmentation techniques here at our practice involve incisions around the areola (which can yield barely noticeable scarring) or under the breast (which also tends to produce scars that are easily concealed). As with all surgical procedures, scars from breast augmentation are inevitable; however, Dr. Okamoto takes great care to minimize signs of scarring and place incisions in inconspicuous places whenever possible. In addition, post-operative instructions will be provided to you that detail the proper way to care for the incisions and produce optimal healing. Scars also typically fade to some degree over time.

How Long Do Breast Implants Last?

Many of today’s breast implants are designed to last for many years. In fact, some breast implant developers provide warranties of several years following the breast augmentation procedure. Since every patient’s needs and goals are different and a variety of different factors play a role in the longevity of breast implants, the exact amount of time the implants will last varies among patients. With that in mind, it is very important that breast augmentation patients undergo routine breast exams and remain watchful of their breast implants to identify any changes over time. A rupture or leak in a saline breast implant will likely be very noticeable; however, these complications in silicone breast implants are not as easily identifiable. Regular self-exams plus the recommended amount of physician exams, x-rays, and MRIs can help detect problems with the implants and let patients know when it might be time to exchange or remove them.

Breast Implant Illness (BII) and BIA-ALCL


Breast implant illness is a condition that refers to a collection of symptoms reported by a relatively small number of individuals who have had breast implants placed. Some in the medical community believe the symptoms may indicate an inflammatory response to the breast implants. The symptoms experienced include fatigue, pain in the muscles and joints, discomfort in the breasts, hair loss, skin rashes, memory loss, “brain fog” (lack of mental clarity), light sensitivity, chest discomfort, persistent headaches, and others. Some individuals have reported that the symptoms stopped once their breast implants were removed. As of 2020, there have not been many extensive, long-term studies of BII, and there has not been diagnostic testing that specifically identifies the condition. According to the American Society for Aesthetic Plastic Surgery, up to the time of this writing, some women who have symptoms that they attribute to BII have tested positive in tests for autoimmune diseases, while others’ results showed no abnormalities.

It is very important to understand that the large majority of women who have breast implants do not experience negative lingering effects. It is also important to note that women sometimes acquire some or many of the symptoms attributable to BII without ever having a breast augmentation—that is, these are symptoms that can commonly occur in daily life. While there is debate in the medical and scientific community about whether the constellation of symptoms associated with BII experienced by some individuals are linked to the breast implants themselves, Dr. Okamoto encourages all breast augmentation patients to be forthcoming about any unexplained symptoms they may be experiencing. He can perform an evaluation and talk with patients about their concerns, as well as explore options for breast implant removal, if desired.

Breast Implant-Associated Anaplastic Large Cell Lymphoma

Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a very rare implant cancer that, according to the American Society of Plastic Surgeons, has been found in approximately 871 cases (both suspected and confirmed) in the world as of December 6th, 2019. BIA-ALCL is not breast cancer—in fact, it is an extremely uncommon type of immune system cancer that, in the cases that have been confirmed, has been mostly associated with certain types of textured breast implants. Many women naturally think that this is a rare sort of breast cancer because these implants are implanted under the breast tissue, but if the same implants were implanted elsewhere on the body, the cancer frequency would likely be the same; however, it would likely be the exact same cancer named something else, without the use of the word “breast.”

The risk of developing BIA-ALCL is very low. When diagnosed early and treated immediately with breast explantation and removal of the scar tissue capsule that surrounds the implant, the likelihood of curing the condition is very high.

In July of 2019, the U.S. Food & Drug Administration requested a voluntary recall of Allergan BioCell® textured-surface breast implants and tissue expanders, and the Allergan corporation complied with this recommendation. Symptoms of BIA-ALCL can include pain, skin rashes, a hardened feeling and/or fluid accumulation in the breasts long after they were initially placed, pain, breast asymmetry or enlargement, lumps in the breast and/or the armpit, and swelling. The FDA did not suggest that women who are not showing symptoms should have these particular types of implants removed. However, patients should always conduct regular self-exams and attend the recommended schedule of check-ups and mammograms to identify any potential irregularities as soon as possible. Patients who are experiencing symptoms and those who are simply concerned about their breast implants should never hesitate to contact their plastic surgeon for an evaluation.

Will I Need a Breast Lift with My Augmentation?

Breast augmentation is often an ideal procedure for patients who simply want to add volume to the breasts; however, it cannot address breast ptosis (sagging) in any significant way. For women who would like to enhance breast volume as well as improve a sagging appearance, a breast lift with implants procedure may be the best option. Medically known as a breast augmentation mastopexy, this combined treatment involves the placement of breast implants along with a breast lift to eliminate excess skin and lift the breasts to a higher, more youthful position on the chest. In many cases, the same incision made for the breast lift can be utilized for the breast implants as well. Breast lift with augmentation can provide a comprehensive breast rejuvenation for patients who would like to give the breasts a firmer appearance while simultaneously enhancing breast shape and volume.

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Will I be Able to Breastfeed After Breast Augmentation?

Many women are not naturally able to breastfeed, regardless of whether they have had any kind of breast surgery. However, women who have the ability to breastfeed prior to having breast augmentation surgery should still have that ability after the procedure is performed, as long as the proper techniques are utilized. It is important to talk with Dr. Okamoto about your wishes regarding future breastfeeding during the initial consultation so that he can develop a treatment plan designed to place the implants without interfering with the anatomical structures that enable milk production.

How to Choose the Best Breast Augmentation Surgeon for You

Selecting the best breast augmentation surgeon for your needs is one of the most important steps of the treatment process – potentially the most important step. In addition to ensuring that you have chosen a surgeon who is highly-qualified and experienced with breast augmentation procedures, you should also feel comfortable with the doctor’s overall approach to care and have confidence that they are being honest, thorough, and attentive to your needs and concerns. Safety should be the surgeon’s top priority, along with the utilization of advanced techniques and a commitment to achieving your goals with results that look both beautiful and natural.

Researching the breast augmentation surgeon’s background and professional biography is a good place to start. Surgeons who are certified by the American Board of Plastic Surgery, such as Dr. Okamoto, are often ideal choices as they have proven to have completed extensive training in plastic surgery. Taking a look at a surgeon’s breast augmentation before-and-after photo gallery can also help give you an idea of the results they are able to achieve. You can learn more about choosing a plastic surgeon here.

When you have narrowed down your selection, scheduling a consultation with the surgeon can help you decide on whether the doctor is right for your needs. At this meeting, you can evaluate your rapport with the surgeon and determine whether you feel comfortable and confident in their care. A few good questions to ask the surgeon during the initial consultation include:

  • How many times have you performed breast augmentation surgery?
  • How long have you been in practice?
  • What breast augmentation techniques do you offer?
  • What are the risks associated with this procedure, and what precautions do you take to minimize them?
  • What should I expect during the recovery process?
  • May I view some before-and-after photos of your previous breast augmentation patients?

You should feel free, at all times, to ask any questions you may have and to have your concerns addressed. Dr. Okamoto firmly believes that breast augmentation surgery is a true collaboration between the doctor and the patient. He is committed to providing you with effective treatment, honest communication, and compassionate care to ensure you experience this process in a supportive environment.

Additional Frequently Asked Questions About Breast Augmentation

Are breast implants safe?

When the augmentation is performed by an experienced plastic surgeon like Dr. Okamoto, and when the breast implants are FDA-approved, high-quality models, the safety potential for this treatment is very high. As explained above, medical concerns such as BII and BIA-ALCL are rare, and Dr. Okamoto takes maximum precautions when performing this procedure to minimize risks. He will thoroughly examine your health and medical history before determining whether you are a candidate for this procedure, and he will explain all associated risks so that you understand both the risks and benefits of this procedure before the treatment plan is in place. Please also note that Dr. Okamoto only uses FDA-approved breast implants for the safety of his patients. If you have concerns about the safety of breast implants, please contact our practice and we can answer any questions you may have.

How much do breast implants weigh?

Regardless of size, shape, or type, breast implants typically do not weigh enough to have a significant effect on a patient’s overall weight. While the weight of breast implants will depend on the materials that the implants are made of and the weight of the solution that fills them, these components are often extremely light. In fact, the total weight of breast implants typically falls in the one-to-two pound range, and often even less than that.

What do breast implants feel like?

Dr. Okamoto utilizes advanced types of breast implants and surgical techniques designed to yield results that feel as natural as possible. Silicone breast implants often produce results that feel the most natural; however, saline implants can also create outcomes that feel very much like natural breast tissue. The size of the breast implants, the location they are placed, and the current amount of fat in the breasts are all factors that will affect the overall sensation of how they feel after breast augmentation. One of Dr. Okamoto’s top priorities is to create results that both look and feel like natural breasts, so he will design the treatment plan in such a way that this important goal can be accomplished.

How should I sleep after breast augmentation?

You may need to make some slight modifications to your regular sleeping habits for a few weeks after breast augmentation surgery. The breasts will need to be free from any pressure as they heal, so it is often recommended that patients sleep exclusively on their backs until the breasts have sufficiently healed and swelling has dissipated. Dr. Okamoto may also recommend utilizing some extra pillows to keep your back propped up. He will be happy to discuss any concerns you may have about the ideal sleeping positions following breast augmentation and provide specific recommendations based on your needs.

How painful is breast augmentation?

While the actual breast augmentation procedure is performed under general anesthesia, a major surgery such as this will result in some degree of discomfort during the healing process. With that in mind, Dr. Okamoto can prescribe pain medication to manage these effects. For many patients, the discomfort is most pronounced over the first two or three days post-operatively, and then gradually fades. Since each individual has distinct anatomical responses to treatment, one person’s experience may be different from another patient’s experience based on the particular breast augmentation techniques that were utilized for the procedure. Dr. Okamoto will give you a precise post-operative guideline with tips on how you can effectively control discomfort and care for your incisions so that your recovery is as smooth as possible.

How long until I can swim after breast augmentation?

How soon you can go swimming after breast augmentation will ultimately depend on your rate of healing. Dr. Okamoto will provide you with specific recommendations upon evaluation. For many patients, it is often okay to go swimming after three weeks, as long as they thoroughly dry off their swim tops or towels immediately after leaving the water. The incisions are still in a stage of healing at this point and should not be subjected to prolonged periods of wetness or dampness. That said, please be sure to ask Dr. Okamoto before you decide to go swimming so that he can determine whether it is an appropriate time during the healing period.

What type of bra should I wear after breast augmentation?

The answer to this question will depend on each patient’s unique needs. Some individuals may be given a special kind of support bra to be worn for a short time following surgery. If Dr. Okamoto advises that it is okay for you to wear a bra during the healing period, he will likely recommend that it be one that fits loosely and does not contain an underwire.

What is capsular contracture?

Capsular contracture is a physiological reaction to a breast implant which generally manifests as a hardened capsule of scar tissue. Additional symptoms may include an abnormally firm sensation in the breast; lopsidedness or asymmetry; and, in some cases, pain or tenderness. The severity of the condition can be identified in four stages (or “grades”), with Grade IV most often presenting discomfort.

Dr. Okamoto utilizes advanced surgical techniques and takes every precaution to minimize the risk of severe capsular contracture development when performing breast augmentation.

How do I know if I have a breast implant rupture?

Outward signs of rupture can vary depending on the type of implant. For instance, a ruptured saline implant is often readily noticeable, as saline implants tend to deflate and leak their contents, which are then harmlessly absorbed by the body. As to silicone implants, detection of rupturing might depend upon the type of silicone involved. Present-day silicone is often called “gummy bear” because the silicone is a flexible solid and rupturing in this case usually goes undetected. However, the older silicone implants were characterized as sticky liquids and, when these implants rupture, they frequently cause abnormal signs and symptoms. If a silicone implant rupture is suspected, a breast MRI might be a useful tool to utilize. In the event you notice any signs of irregularities, please contact Dr. Okamoto immediately so he can conduct an examination.

Can breast implants affect mammograms?

It is very important to ensure you are receiving regular mammograms following breast augmentation. Breast implants interfere with the usual routine for mammograms. Therefore, it is important that you inform the radiologist that you have implants before undergoing the mammogram so they can make any necessary modifications to the testing process and maximize the potential for accurate results.

What if I change my mind about breast implants later in life?

While the majority of women enjoy the results of this procedure for many years, Dr. Okamoto understands that some women may choose to have their implants removed. This decision may arise for a variety of reasons, including a rare complication that may necessitate implant removal, but in many cases, women who opt for removal simply do not wish to have implants any longer. Alternatively, they may wish to exchange and upgrade their implants to a newer model or another type, size, or shape. A surgery known as breast explantation can be performed to remove the implants, or a revision breast augmentation procedure can remove and replace the implants with a different implant model.

Please contact Dr. Okamoto today with any questions you may have, or to schedule an appointment.

*Individual results may vary