Breast Augmentation

For decades, the standard approach to breast augmentation involved subglandular placement, fixed sizing systems, and direct manual insertion of the implant through the incision. The procedure works. Hundreds of thousands of women each year report meaningful gains in body image and quality of life after augmentation, and the American Society of Plastic Surgeons continues to identify it as one of the most-requested cosmetic procedures in the United States. The science is well-established.

But the technique has advanced. Dual-plane pocket dissection, no-touch implant insertion using the Keller Funnel, and individualized implant selection based on chest wall measurements now define the current standard, and at Dr. Esmailian's Los Alamitos practice serving Orange County, Huntington Beach, Seal Beach, and Long Beach, the older approach is not used when a more anatomically precise version exists.

Breast augmentation done well is anatomy. Not a category.

What Breast Augmentation Addresses

Breast augmentation, formally augmentation mammoplasty, uses implants or autologous fat to increase volume, improve symmetry, and restore proportion. It is requested most often by women with naturally small breasts, women whose breasts have lost volume after pregnancy or weight change, and women with congenital asymmetry. A comparative BREAST-Q outcomes study documents high satisfaction across these groups when implant selection matches anatomy.

The procedure does not lift the breast on its own. Patients with significant ptosis typically need a breast lift performed with augmentation. Dr. Esmailian will identify which approach fits during consultation.

Benefits of Breast Augmentation

Modern breast augmentation offers numerous advantages for women seeking to enhance their figure:

• Enhanced breast volume and fullness
• Improved breast shape and symmetry
• Better proportion with overall body contour
• Increased clothing options and fit
• Boosted self-confidence and body image
• Restoration of breast volume lost after pregnancy or weight loss
• Correction of congenital breast asymmetries

According to the American Society of Plastic Surgeons, breast augmentation remains one of the most popular cosmetic procedures, with over 300,000 procedures performed annually in the United States, reflecting high patient satisfaction rates.

The Keller Funnel No-Touch Technique

Every breast augmentation at Dr. Esmailian's practice uses the Keller Funnel for implant insertion. This is the single most important infection-control change in modern breast augmentation, and it is not yet standard at every Orange County practice.

The Keller Funnel is a sterile, single-use cone that allows the implant to pass directly from its sterile packaging into the surgical pocket without contact with skin, glove, or gauze. The mechanism matters: capsular contracture, the most common reason for revision after augmentation, is now understood to be driven largely by bacterial biofilm forming on the implant surface from contact during insertion.

The clinical data is consistent. A retrospective cohort study published in Plastic and Reconstructive Surgery Global Open showed an 87 percent reduction in capsular contracture in periareolar augmentations performed with the Keller Funnel compared to manual insertion. A more recent systematic review across six studies showed a relative risk of 0.42 for capsular contracture, shorter incision lengths averaging 35.5 mm, and faster insertion times.

For patients, this means a smaller incision, lower lifetime revision risk, and less likelihood of needing a second surgery for capsular contracture down the road.