Breast augmentation, or augmentation mammoplasty, is a procedure designed to increase the volume of the breasts through placement of saline or silicone implants. While this cosmetic surgery primarily aims to increase the breast size, utilizing implants can also improve the shape and symmetry of the breasts. As the most popular aesthetic procedure currently performed by plastic surgeons worldwide, breast augmentation has helped countless women achieve their desired breast appearance for improved confidence and breast contours.

Whether pursued for cosmetic enhancement or reconstruction after mastectomy, board-certified plastic surgeon John Ayala, MD, FACS can achieve natural-looking breast augmentation results for patients in and around the San Antonio and San Marcos regions. After a discussion of your goals, he will develop a personalized treatment plan tailored to attain your ideal outcome.

Why Breast Augmentation?

Breast augmentation is often considered one of the best techniques to enhance the breast shape and size. Every patient has their own personal reasons for undergoing breast augmentation, but the procedure is typically popular with women who have lost breast volume due to pregnancy, experience asymmetry between the breasts, or simply wish to attain the breast size they have always desired.


Increase Size


Post-Pregnancy Correction


Correct Imbalance



Who is a Candidate for Breast Augmentation?

Breast augmentation can be a very rewarding procedure for individuals who wish to:

  • Increase or restore their breast volume
  • Enhance the shape of their breasts
  • Resolve asymmetry
  • Achieve an improved breast contour

In addition to enhancing the silhouette, some patients also find that breast augmentation helps them fit in a wider range of clothing. Those interested in breast augmentation should be in good physical health and have realistic expectations about what the procedure can accomplish. Examples of the outcomes previously achieved are showcased in Dr. Ayala’s expansive before-and-after photo gallery, which can provide a good idea of how breast surgery can reshape and rejuvenate the breasts.

Types of Breast Implants

Breast implants come in a variety of shapes and sizes, allowing patients many different choices in the look and feel they would like to achieve. Dr. Ayala offers both saline and silicone breast implants at Ayala Plastic Surgery, and the best type of implant for you will depend on your needs, goals, and anatomic indicators.

Saline Implants

Saline breast implants are composed of saline solution encased in a silicone shell. They are FDA-approved for patients 18 and older, and breast reconstruction patients of any age. As implants that have been in use for decades, saline has proven to be a timeless and effective implant fill material for breast enhancement. In the rare event of rupture, these implants have the benefit of the sterile saline solution being harmlessly absorbed by the body.

Silicone Implants

A more recent innovation in breast augmentation, silicone breast implants consist of silicone gel inside an outer silicone shell. These implants are typically known for resembling the feel of natural breast tissue and can often provide a realistic-looking breast contour. FDA-approved for patients 22 and older, many types of silicone implants keep their shape in the event of rupture.

During your consultation, Dr. Ayala will discuss the pros and cons of each implant type with you so you can make a well-informed decision. You will also have the opportunity to try on different implant sizes with a special bra, which can give you insight into how each option may affect your overall appearance.

Implant Placement Diagram

Implant Placement

There are two options for placement of your breast implants: below the breast tissue or below the chest muscle. When the implant is positioned under the chest muscle (submuscularly), there is generally more coverage for the implant and a reduced risk of visible implant edges. Mammography readings can also be more reliable with an under-the-muscle approach. Additionally, the risk of capsular contracture, which involves scar tissue forming and hardening around the implant, is decreased when compared to placement directly under the breast tissue.

With that said, some patients believe implants retain a more natural appearance when placed over the chest muscle. This is only possible if there is enough skin and natural breast tissue to adequately cover the implants, as the incidence of feeling and/or seeing the implant edges—known as implant rippling— can occur if a patient has thin breast skin. Dr. Ayala can work with you to decide which implant placement is ideal for you.

Where are Breast Augmentation Incisions Located?

When Dr. Ayala places your breast implants, there are three incision options that can be utilized to perform your breast augmentation. Each technique offers its own benefits, and the most ideal incision depends on your existing breast size, the dimensions of your implants, and the thickness of your breast skin:

  • Periareolar: Placed along the borders of the areola. This incision is most successful for relatively smaller breast implants. While the periareolar incision is not recommended for women who wish to breastfeed in the future, this technique can allow post-operative scars to blend into the natural change in pigmentation between the breast skin and the areola.
  • Inframammary: Made along the crease where the breasts meet the chest wall. Inframammary breast augmentation is typically more versatile when compared to other incisions and can produce natural-looking results for implants of any type or size.
  • Transaxillary: Located in a natural fold of the armpit. With this technique, the implant is filled after insertion into the breast pocket. A transaxillary incision can only be utilized when placing saline implants, but it offers the benefit of an unscarred breast appearance.

Dr. Ayala will recommend an optimal incision based on your needs and goals for the outcome. The inframammary incision is usually the most common breast augmentation technique, as this location within the breast crease can offer more visibility when positioning the implant and scars often blend into the natural contour of the breast fold.

How is Breast Augmentation Surgery Performed?

Breast augmentation at Ayala Plastic Surgery is performed in our accredited surgical center and typically utilizes general anesthesia. First, an incision is made in a predetermined location, either around the borders of the areola; within the breast crease; or in a natural fold of the armpit. The best type of incision for you will depend on the desired size of your implant, the fill material, and your anatomic indicators. Dr. Ayala will then create an implant pocket either above or below the chest muscle and position the implant. The incisions are closed, and you will be able to rest in our post-operative center under the supervision of our experienced nurses until you are ready to continue recovering at home.

What is Recovery From Breast Augmentation Like?

After breast augmentation, a friend or loved one must be available to drive you home and accompany you for the first 24 hours of your recovery. Tightness and swelling of the breasts are to be expected, and oral pain medications can typically help manage any discomfort. Following the procedure, it is not uncommon for the breasts to appear higher on the chest wall or in an oval shape. With time, the breasts should settle into a natural position and final results are generally apparent after approximately one year. To help prevent blood clots, we encourage light ambulation, such as standing and walking around the house, as soon as you feel up to it. An important part of the healing process is close monitoring of your incisions. Please be wary of putting pressure or strain on your incisions, and try to avoid touching your incisions without gloves on. Our team will prescribe antibiotics to help further prevent infection.

For the first two weeks after surgery, you should wear a surgical bra or non-underwire bra at all times. While most patients return to work within one week, please avoid heavy lifting for two to three weeks, as well as vigorous exercise for three to four weeks.

How Long Do Breast Implants Last?

Breast implants are not designed to be lifetime devices; however, many women enjoy their implants for decades and don’t ever have the need to undergo a secondary procedure. Dr. Ayala advises remaining vigilant to changes in the way your breasts look or feel over the years to help detect any complications that may have arisen. Should an issue occur, Dr. Ayala offers breast revision to replace older implants or to exchange them for a different size, shape, or type of implant. Some women may even choose to remove their implants altogether after decades of use, which breast revision can additionally accomplish. In these cases, a breast lift may also be necessary to correct stretched breast skin and restore your breast shape to its original appearance.

How Much Does Breast Augmentation Cost?

In San Antonio, the cost of breast augmentation typically falls between $4,000 and $8,000. This range is an overall approximation that includes the usual expenses associated with cosmetic surgery, such as fees for the operating facility, anesthesia, surgeon, etc. However, cost estimates vary depending on each patient’s unique needs. Several factors can impact the price of your procedure, including:

  • The type of breast implants chosen
  • The type of incisions utilized
  • Whether your procedure is a breast augmentation revision
  • The complexity of your surgery

Since each individual’s treatment plan differs, our office will be able to provide you with a personalized quote after your goals are discussed in a consultation. Ayala Plastic Surgery accepts plastic surgery financing plans through CareCredit®, a leading healthcare lending company that offers qualified patients both long- and short-term financing options to help make surgical costs more manageable. If you have any questions about the price of breast augmentation, a member of our team would be happy to assist you.

Will I Have Visible Breast Augmentation Scars?

Scarring after certain surgical procedures cannot be avoided. Fortunately, breast augmentation scars can be very well-hidden within the natural contours of the breasts. The shape and location of your scars will depend on which incision was utilized to place your implants. A periareolar incision typically creates a scar that blends into the borders of the areolas when fully healed, while the scar from an inframammary incision can be camouflaged along the contour of the breast fold. If you opt for a transaxillary incision, the scar is usually hidden within a crease of the underarm and should only be visible when the arms are raised.

What is Breast Augmentation Revision?

Whether your original results from another plastic surgeon were not what you expected, or complications such as implant rippling, implant rupture, or capsular contracture have compromised the outcome, Dr. Ayala performs breast augmentation revision to address your concerns and improve upon the results of your initial procedure. Common reasons why some patients seek a secondary breast augmentation surgery include:

  • To exchange saline implants for silicone implants
  • To resolve a complication
  • To enhance the results of an initial breast augmentation
  • To remove their implants altogether

Most individuals who receive breast augmentation are very pleased with their final results; however, when an unqualified plastic surgeon fails to communicate openly or adequately address patients’ needs, some women seek a revision breast procedure elsewhere. Dr. Ayala is committed to helping you maximize your original results with a personalized breast revision treatment plan designed to achieve your goals. To gain a sense of your concerns, he will thoroughly discuss your needs and expectations with you to learn how he can help you achieve the appearance you desire.

Is a Non-Surgical Breast Augmentation Possible?

Unfortunately, there is no method of enhancing the fullness and volume of the breasts without surgery. Placing breast implants is considered the most effective and long-lasting approach to augmenting the breasts, and this technique requires cosmetic surgery to achieve an aesthetic, symmetrical result. Although the procedure cannot be performed non-invasively, patients can be confident that breast augmentation surgery has decades of research and clinical results to support its safety record. At Ayala Plastic Surgery, Dr. Ayala utilizes only the most advanced, FDA-approved implant options to maximize your health and well-being. He will only recommend breast augmentation procedure if your consultation reveals that you’re an optimal candidate for surgery. We encourage you to reach out to our team if you have any questions or concerns about what you can expect with regard to breast surgery.

Are There Alternatives to Breast Augmentation?

While breast augmentation should allow patients to attain a more youthful breast shape, those who would rather not use implants have other treatment options that may be more ideal for their goals. In some cases, an individual’s concerns have less to do with the size of their breasts and more with the elasticity of their breast tissue. The breasts stretch and lose shape over time, commonly resulting in a sagging or drooping look. If these are issues you’d like to improve, you may benefit more from a breast lift when compared to implant placement. Mastopexy can address the shape, positioning, and projection of the breasts to create a more youthful bust, marginally increasing the actual breast size. Alternatively, a joint breast lift with implants procedure can also be performed to yield the benefits of both options in one all-encompassing treatment plan. Your consultation will help Dr. Ayala identify the most ideal procedure to achieve the results you envision after surgery.

Additional Breast Augmentation FAQs

  • How should I sleep after breast augmentation?

    The best way to sleep after breast surgery is generally flat on your back with pillows propped up behind your head and on your sides to avoid accidentally rolling over. This should help reduce swelling as well as facilitate optimal healing of your new breast contours. Do not sleep on your sides or stomach immediately after breast augmentation to prevent placing unnecessary pressure on your implants or disrupting your incisions. Dr. Ayala will let you know how long you can expect to sleep in a supine position based on the details of your treatment plan.
  • What type of bra should I wear after breast augmentation?

    A surgical bra or non-underwire bra should be worn continuously for at least two weeks after surgery. Ideally, patients should select a comfortable sports-like bra with front-facing clasps and wide shoulder straps to minimize the need to raise the arms. Our team can provide additional details about the best type of post-operative bra to wear after your consultation. Choosing the right bra can offer many benefits for healing after breast augmentation, such as reduced swelling, improved blood circulation, and the ability to minimize the shifting of your implants.
  • How much do breast implants weigh?

    Saline and silicone breast implants have approximately the same weight, with each implant amounting to roughly 0.21 pounds per 100 cc’s. On average, most patients wish to enhance their breast size by two cup sizes (300 to 400 cc’s), translating to about 1.5 pounds of additional weight for both implants.
  • What are the most common breast implant complications?

    While serious complications from breast augmentation are extremely rare, breast implants are not designed to last forever and certain issues can potentially arise. The most common concerns that patients face after their procedure include implant rippling, capsular contracture, and rupture. Rippling refers to the ability to see or feel the edges of an implant through the skin, while capsular contracture involves the hardening/tightening of scar tissue around the implant(s). In cases of implant rupture, the shell of an implant suffers a tear or break. This can cause a visible loss of shape in the appearance of the breasts for saline implants; however, silicone implants typically keep their form in the event of rupture, highlighting the importance of periodic check ups and follow-up visits after your procedure.

    Should they occur, these complications typically develop years after implant use. A simple breast revision procedure to replace implants or remove scar tissue is usually enough to resolve most implant-related complications.

  • Is there pain after breast augmentation?

    Although most patients do not experience a painful recovery period, feelings of soreness, swelling, weakness, or tenderness during the healing process are common. Discomfort is often well-managed with ice packs and oral pain medication. As your recovery progresses, you can expect to feel stronger and more energetic with each day. Each person has a unique rate of healing, but most patients feel back to “normal” within three to four weeks.
  • How many cup sizes will I go up after breast augmentation?

    The answer to this question depends on the type of implant chosen and the size of the implants you desire. In general, 200 cc (cubic centimeters) of breast volume equate to an increase of approximately one cup size. However, it’s also important to note that cup sizes vary based on distinctions between bra manufacturers. You will have the opportunity to “try on” different implant sizes during the consultation process in order to find the option(s) that best align with your silhouette and cosmetic goals. We offer a wide variety of breast implants so patients can find the most optimal selection for their unique needs.
  • When can I drive after breast augmentation surgery?

    It’s typically advised that patients avoid driving for at least three days after the procedure, although this timeframe may vary from patient to patient. Immediately after breast augmentation, a friend or loved one will have to drive you home from our surgical facility since you’ll still be under the effects of the anesthesia. During your recovery, we recommend paying attention to your body and only driving whenever you feel comfortable and alert enough to do so.
  • What is a “natural breast augmentation”?

    A “natural” breast augmentation refers to a surgery in which the breasts are enhanced using injections of a patient’s own fat. This technique harvests excess fat cells from elsewhere on the body (such as the thighs, abdomen, or hips) and reintroduces the fatty tissue into the breasts. Although this will not provide a substantial size increase or match the results of implant placement, this fat transfer breast augmentation can soften the breast contours, smooth out the edges of an implant, and provide a mild volume enhancement. If desired, Dr. Ayala can discuss this technique with you in more detail during your consultation.
  • How long after breast augmentation can I swim?

    Dr. Ayala will give you a complete rundown of all activity restrictions as he monitors your recovery from breast augmentation. In general, patients should wait until their incisions are completely healed before swimming — a process that can take approximately 10 days.
  • Does insurance cover breast augmentation?

    Breast augmentation is a cosmetic, elective procedure, meaning insurance companies usually do not provide coverage for surgery. However, our San Antonio practice still accepts patient financing through CareCredit® for individuals who are seeking a more affordable option to pay for their breast augmentation. With small monthly installments and little to no interest rates offered to qualified patients, plastic surgery financing can be an effective way to better manage surgery expenses.


For more information about how you can improve your breast contour with saline or silicone implants, please don’t hesitate to contact Ayala Plastic Surgery today.

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