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There are many reasons that women choose to undergo breast augmentations. They may want to improve their proportions, feel shapelier or fit better in their clothes. Many women also opt for breast augmentations following childbirth and nursing since the breasts may either change following the increased size during pregnancy or suffer from atrophy and/or deflation subsequent nursing.

The basics of breast augmentation

There are several different types of implants that can be used during a Orange County Breast Augmentation. These include saline implants as well as silicone implants. Silicone implants have become much more popular over the past 15 years with the FDA approval of silicone implants for all women 22 and older.

There still are some women who opt for saline breast augmentations. However, silicone breast implants provide a much more natural feel to the breasts and may even give an improved, more natural shape.

Womans chest and abdomen, wearing a black bra

Breast Implant Placement

Breast implants can be placed in different positions to achieve different types of results. Breast implants may be placed on top of the muscle (subglandular position) or they may also be placed under the muscle (submuscular or subpectoral position). There are also different ways of putting implants under the muscle as well. Some surgeons like to place the implant entirely under the pectoralis major muscle, whereas others may place it partially under the muscle in what is called a subpectoral or dual plane approach. I prefer a dual plane approach for most of my patients as I feel it provides a more natural looking, sloped breast appearance, and that is what my patients desire.

There are several approaches to placing the implants. Implants can be placed by the nipple approach (the periareolar approach). They can also be placed underneath the breast in the fold or crease, which is called the inframammary approach, or via an underarm incision through the transaxillary approach. I perform all of these techniques depending on the patient’s anatomy and desire, and this is carefully chosen so as to deliver the best results from breast augmentation for each individual patient. There are advantages and disadvantages of each technique.

The periareolar approach is a nice approach for women to hide the scar, given that they have an adequate sized areola. Additionally there are times when one is undergoing a breast lift or mastopexy and we may choose to proceed via the periareolar approach as we will be making other incisions around the nipple areolar complex as well. The inframammary approach is also an optimal approach for many patients as the scar will be placed in the fold under the breast and will be difficult to visualize. The transaxillary approach is also an option. However, I prefer the transaxillary apporoach for a select group of women. I will utilize the transaxillary approach for both saline and silicone implants. With the transaxillary approach, I perform it with endoscopic visualization or assistance; that way, I am able to look on a television monitor to see the extent of the dissection directly, and to make sure that there is excellent hemostasis or minimal bleeding throughout the procedure, and is performed in a clean manner, allowing the ability to provide some of the best breast augmentation results that Orange County and Newport Beach have to offer. The incision for saline implants is only an inch long. With a silicone implant, the incision needs to be 1-1/2 to 2 inches long in the axillary approach.

Silicone vs. Saline

Breast implants come in different profiles as well. There are several different companies that offer breast implants in the United States that include Allergan, Mentor, and Sientra; Allergan and Mentor offer both silicone and saline implants, and Sientra only offers silicone implants. All 3 companies have FDA approval to provide implants to the United States for different types of implants. Saline implants were more popular back in the 1990’s and 2000’s as there was a temporary ban on silicone implants in 1992. However, about fifteen years ago, the FDA approved silicone implants for use by all women 22 and older, and for some women under 22 given reconstructive purposes, and since that time, more and more women are undergoing silicone breast augmentations. In my practice, over 95% of my patients elect to have breast augmentations utilizing a silicone implant as it gives them a much more natural feel and appearance.

All implants are warranteed by the US manufacturers for their lifetime, so if there is ever a failure, rupture or a deflation of an implant, the company will replace the implant at no charge. There is no set rule as to when somebody needs to replace their breast implants. With earlier generations of silicone implants, it was noted that there was a high rupture rate by 10 years, and in the past, it was recommended that women switch out of their silicone implants within the first 10 years of augmentation. Today, that is not necessarily the case as we know that breast implants are much sturdier and after 10 years have only a 5 to 15% rate of rupture. Thus, one may choose to wait a little bit longer and undergo radiographic evaluation of the implant to determine if an implant exchange is required.


Breast implants come in different profiles. There are low profile, moderate profile, moderate plus profile, high profile, and extra high or ultra-high profile implants. What varies, is the width and the projection of these implants. A low profile implant is much flatter and wider whereas an extra high profile implant is much narrower and has more projection. Dr. Grover will select a certain type of implant for a patient depending on the width of their chest, the width of their breasts, the desired appearance that they hope to achieve, and the amount of breast tissue they may have.

Saline implants are more prone to rippling especially in a thin patient and lower profile implants. Silicone implants have much less rippling. However, in certain patients, one can still notice rippling in the lower part, lateral part, or the outer part of the breast with a silicone implant, and this is more common with the low profile implants than with the high or ultra-high profile implants.

The Gummy Bear Implant

A new addition or option for women is the Gummy Bear breast implants or the cohesive gel-shaped silicone breast implants. There are multiple names for this including Gummy Bear, form-stable shaped implants, cohesive gel implants, etc. This implant has been approved by the FDA over the past few years. The first company to receive its approval of their shaped implant was Sientra (in 2012), and Allergan (in 2013) obtained their approval for their shaped 410 cohesive gel-shaped implants. Both of these companies provide different shapes and profiles of their shaped implants which allow for a more natural or tear-drop shape. This type of implant may be more suitable for women who hope to achieve a more natural appearance and who do not have much breast tissue, to begin with. The implant is placed via the inframammary approach as it does require a slightly larger incision. It has been touted to maintain its shape over a longer period of time over multiple years versus the other round type of silicone implants. It does require more precision in the pocket dissection and in the determination of the sizing. It is important that you have a Newport Beach Breast Augmentation surgeon who is comfortable utilizing these implants to achieve the best breast implant results possible. These implants have a much lower rupture rate than the other round silicone implants and have also been shown to have a lower capsular contracture rate.

Tear Drop Breast Augmentation

Many patients desire a teardrop or natural look for their breast augmentation results. Achieving this appearance can be done through various methods.

One effective technique for attaining a teardrop-shaped result involves using anatomically shaped silicone implants. However, it's important to note that only a limited number of U.S. surgeons use these implants due to their association with a rare form of lymphoma called ALCL (anaplastic large cell lymphoma). This association arises from the textured surface required on anatomical implants to prevent rotation. In contrast, round implants don't necessitate a textured surface and can remain smooth.

An alternative approach to achieve a natural or teardrop breast appearance is by opting for a 'dual-plane' implant placement. Dual-plane positioning refers to partially situating the implant beneath the pectoralis muscle. By releasing the lower attachment of the pectoralis muscle from the chest wall, the implant avoids an unnaturally high position and can be situated lower behind the breast, ultimately delivering the desired natural teardrop appearance.

The Saline Ideal Implant

This is a relatively new and unique type of saline implant. The Ideal Implant is designed for those who are uncomfortable with getting silicone implants, which provide the most natural and realistic feel and shape. The exterior is a soft, silicone gel, providing a round, smooth surface. The interior is made of one to three nested “baffle” shells, or floating layers within the implant. This baffle structure is designed to control movement of the saline so that there is no unnatural bouncing. These baffle shells also support the implants and keep the upper part of the breast looking round and full.

Ideal Implants have a lower rupture and capsule contracture risk, and because they are saline instead of silicone, there is instant rupture detection. They have a lower rupture rate and higher rupture strength. Ideal Implants provide a youthful shape, and they also feel and appear more natural than other saline implants.

How to select the best size of implant for your breast augmentation

When Dr. Grover sees a patient for an initial consultation for Breast Augmentation in Orange County, he likes to get an idea of what shape, size and appearance of the breasts the patient has in mind. He also likes to see the patient’s desired result by viewing their preferred breast images from the before/after gallery on the Grover Aesthetics' website and/or even magazine photos.

There are certain tools that can be used to help determine sizing including a sizing kit developed by Mentor where one can place silicone forms or implants in a bra to help determine the size that they feel comfortable with and the size that will provide them with some of the best breast implant results Orange County can offer. However, Dr. Grover’s ultimate preference is to have a multiple sizes and options of implants available during surgery so that he can create a pocket in the patient’s breasts and place temporary implant sizers in each in order to determine which sizes fit the patient’s expectations and offer the most symmetry.

Many of our Newport Beach breast augmentation patients have underlying asymmetries that they are not aware of. They may have a different amount of breast tissue on each side. Additionally, many women have some sort of chest asymmetry or chest deformity that most women do not realize until Dr. Grover references it at their initial consultation. By using temporary silicone implant sizers, it helps Dr. Grover select the final implants to get the most symmetric result.

The procedure is performed using general anesthesia in an outpatient setting.

Check out our new Natrelle Breast Implant Simulator!

Getting a breast augmentation is a big decision and it’s important to become fully informed. Dr. Grover, a Breast Implant Newport Beach specialist, will answer any questions that you may have about surgery. Click here to contact Dr. Grover and setup a consultation today!

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More About Breast Enlargementin Newport Beach

One of the most popular cosmetic procedures done in the United States is Breast Enlargement. Many women in Newport Beach desire to increase the size of their breasts for many personal reasons. Some women are born with naturally small breasts that are out of proportion with the rest of their body. Some women may experience a decrease in breast size after weight loss or nursing. Sometimes breast augmentation procedures may even be done to bring symmetry to asymmetrical breasts in which one breast is notably smaller than the other. For all of these reasons and many more, breast augmentation has become one of the most popular procedures in the United States today. Dr. Grover is a board-certified plastic surgeon and serves patients in both Los Angeles and Orange County. Dr. Grover is very well known for his beautiful breast augmentation results – view them here: Newport Beach Breast Augmentation Photos.

Ideal candidates for this procedure are in good health both physically and mentally, and should have realistic expectations for the procedure and its potential outcome. Breast implants may be able to help women who have long been bothered by the naturally small size or their breasts, women whose breasts are disproportionately small compared to the rest of their body, women who have difficulty finding clothes or swimsuits that fit on top, women whose breasts have decreased in size and/or firmness after weight loss or having children, and women with one breast significantly smaller than the other.

The most important step in your breast augmentation journey is finding the right board-certified plastic surgeon. We encourage you to have a one on one consultation with Dr. Grover.

We suggest visiting Dr. Grover’s extensive before and after gallery and also the testimonials page of happy plastic surgery patients from Newport Beach, Los Angeles and throughout the world.

Learn More About Dr. Grover


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