Breast Augmentation

Breast Augmentation in San Francisco, CA, With Dr. Ginger Xu

Breasts naturally come in all shapes and sizes, and each woman will also have a unique vision for what looks best on her frame. Feeling at home and confident in your own body is very important for overall well-being and quality of life. Whether you wish to increase your overall breast size or improve your breast shape, breast augmentation surgery can help you achieve your ideal breast appearance. This procedure enhances the volume, shape, and projection of your breasts using either silicone breast implants, saline breast implants, or your own natural fat transferred into the breasts from another area of the body via liposuction.

Harvard-trained plastic surgeon Dr. Ginger Xu has helped countless women achieve their ideal breast appearance by using her gifted hands, sincere devotion to patients, and an eye for elegant, natural results. Dr. Xu is committed to creating beautiful results that match your body and providing an excellent patient care experience through her soft touch and gentle approach.

Are you interested in learning more about what San Francisco breast augmentation surgery can do for you? Call Ethos Plastic Surgery at (415) 506-4300 today to schedule a consultation with Dr. Xu and learn more about San Francisco breast enhancement surgery. We proudly serve patients in and around the Bay Area.

Our Signature Approach to Breast Augmentation in San Francisco

Breast augmentation is one of the most popular procedures at our boutique plastic surgery practice. Patients most often pursue breast augmentation surgery to:

  • Increase fullness and volume to the breasts
  • Restore shape, lift, and projection for a more youthful appearance
  • Achieve more balanced body proportions
  • Improve self-confidence and self-image
  • Attain a greater sense of femininity and satisfaction with overall figure

We believe there is no one-size-fits-all approach, and Dr. Xu performs this surgery as a direct reflection of each woman’s concept of beauty for herself. There is an individualism and diversity in these beauty outcomes that Dr. Xu cherishes and is able to offer her patients because of her focus on active listening and appreciation of nuance.

Here are just a few reasons why we feel our approach sets us apart:

Small Breast Beauty

The days of “Bigger is Better” are gone, and in fact, Dr. Xu takes a more modern approach and is an active proponent of “Small Breast Beauty” – where it is not so much about size, and shape is just as important when it comes to breast aesthetics. There can be common misconceptions that a breast augmentation will make you look fake, but the real beauty of a well-done surgery is one that no one should be able to tell. Oftentimes, even a small augmentation can make all the difference. Some women are under the impression that getting a breast augmentation means you must have a large implant, and they may not be aware that small implants are even an option. Most importantly, the goal of breast augmentation is never to create an artificial or overdone look; instead, it is to give a natural but enhanced breast appearance that matches the rest of your body.

Peace of Mind Implant Surveillance – Long-Term Implant Monitoring

For our patients’ benefit and peace of mind, we offer long-term, high-resolution ultrasound follow-up surveillance of implants after insertion. This allows us to screen for potential issues that may unexpectedly occur, such as implant ruptures or fluid collections. Having this advanced technology in our office allows our team to quickly and easily check your implants to ensure they are intact and immediately address concerns that may otherwise require an additional appointment with another provider.

Transaxillary Approach

Dr. Xu offers the transaxillary approach, which involves creating an incision in the natural fold of the armpit. After carefully making this incision, Dr. Xu will create a channel to the breast and a pocket behind the breast for the implant.

Using the transaxillary approach offers several benefits, including:

  • Can be performed using either silicone or saline breast implants
  • No scarring on the breast
  • Short, inconspicuous scar along the armpit crease
  • Less likely to affect nipple sensation

Dr. Xu will let you know if she feels that this approach is suitable for you.

Awake Natural Breast Augmentation

Dr. Xu has specialized training in “awake surgery,” the practice of conducting surgery using local anesthesia while the patient remains awake. This approach can be offered to patients undergoing a natural breast augmentation, during which your own fat is taken from other areas of the body and transferred directly to the breasts.

Benefits of awake breast augmentation include:

  • Eliminating all of the risks of general anesthesia, with far fewer potential side effects.
  • Less stress is put on the body, so the recovery period is often quicker.
  • A safer option for patients who cannot undergo general anesthesia for health reasons, or prefer not to due to other concerns

Dr. Xu specifically performs awake surgery on patients who have fat extracted from one area (via liposuction) and placed into either the breast, buttocks, or hips.

Drainless Breast Surgery

While many surgeons use drains to remove excess fluid after plastic surgery procedures, Dr. Xu’s approach to cosmetic breast surgeries (breast augmentation, breast lift, breast reduction) does not routinely require them. This means that, during the post-operative period, the patient will have:

  • Lower risk of infection
  • Less discomfort
  • No risk of pulling or pain from drains
  • Less hassle with no drain care
  • A more carefree recovery

Why Choose Dr. Xu for Your Breast Augmentation?

As an Ivy League-trained plastic surgeon, Dr. Xu provides a very high level of professionalism and skill. She values getting to know each patient as a person and genuinely listens to their concerns. She considers it a great privilege and honor when a patient trusts her with their care and the opportunity to help improve their appearance.

Patients in the San Francisco area choose Dr. Xu for her warm personality, gifted hands, and eye for elegant, natural results. She is also one of few board-certified plastic surgeons on the West Coast who has completed the Harvard Aesthetic Plastic Surgery Fellowship – a rigorous and competitive program that accepts only one applicant each year.

board-certified plastic surgeon Dr. Ginger Xu

Meet Dr. Ginger Xu

Dr. Xu embraces the responsibility and transformative opportunity to alter a patient’s appearance in a way that is congruent with their own values and matches a more cohesive sense of self; to realign the external with the internal; to create an improved emotional landscape and a better life. These ideals captivate and inspire her every day.

Your Breast Augmentation Consultation with Dr. Xu

During a consultation with Dr. Xu, you’ll have plenty of time to fully express yourself and your needs by opening with a conversation that goes beyond just discussing the mere facts of breast augmentation surgery. In addition to a comprehensive intake process, Dr. Xu will explain all aspects of the procedure during the consultation in meticulous detail to ensure you are prepared and suitable for your procedure of interest. She will encourage you to ask questions about any aspects of the procedure that you are unsure of.

Ultimately, Dr. Xu wants to get to know you as a person: your likes and dislikes, your lifestyle, and what motivates you to pursue breast augmentation. Only then can she make the best recommendations to give you results you’ll love for years to come. She values honesty, education, and striving for the highest levels of safety, care, and satisfaction.

“I enjoy empowering patients and see the patient consultation process as providing a very thorough education for them to make the best decision for themselves. It’s not just about me giving them a plan but also guiding the patient and working together to determine what makes the most sense for them.”

Options for Cosmetic Breast Augmentation Surgery

Dr. Xu offers two types of breast implants (silicone and saline) for breast augmentation surgery. In addition, she offers all-natural technique (fat transfer) that involves using your own body fat.

Silicone Gel Breast Implants

Silicone gel implants consist of a silicone shell filled with medical-grade silicone gel inside. Due to their consistency, these feel the most like natural breast tissue. Gummy bear implants are a more advanced version of the silicone gel implant. The design of the gel inside makes them more cohesive and less prone to rupture than traditional silicone implants. There can also be a difference in firmness and shape, creating a more optimal breast appearance in some cases.

Saline Breast Implants

Saline breast implants have the same outer silicone shell as gel implants, but they are filled instead with sterile saline water. Unlike silicone gel implants, which come pre-filled all in one piece, saline implants are empty until Dr. Xu places them into the breast and then fills them at the time of surgery. Because of this, a smaller incision can be made for saline implants.

Fat Transfer to the Breast

Fat transfer is another technique to increase breast size and improve breast shape, though it is typically a better choice for women looking for minor changes to their breasts. Dr. Xu harvests excess fat via liposuction from a secondary location on your body, such as your thighs, hips, or stomach. After purifying the fat, she will inject it into your breasts to accentuate fullness and volume where you need it. Fat transfer breast augmentation is an especially good option for patients who are also interested in liposuction for body contouring.

Other considerations for breast augmentation surgery include size/desired volume, implant projection/profile, plane of implant placement, and incision location. Dr. Xu will discuss these and other aspects of your procedure when you meet with her in your consultation.

Breast Augmentation Procedure Details

First, Dr. Xu will make incisions according to your personalized surgical plan. The specified approach will allow her to place the implants either under or on top of your chest muscles. The best placement for you will depend on your lifestyle and the amount of existing breast tissue you have. Once Dr. Xu has inserted and positioned the implants (which you will have carefully selected during the consultation process), she will suture the incisions closed, and you will be taken to the recovery area.

Breast Augmentation Recovery

Recovering from a breast augmentation is generally minimal, but every person’s pain tolerance, response to surgery, and healing experience can vary. If you experience any discomfort, you can typically manage it with pain medication prescribed by Dr. Xu. Recovery also depends on whether the implant is placed over or under the muscle.

Most patients feel well enough to return to work after four or five days of recovery but should avoid high-intensity exercises for about a month. However, you can typically resume all non-impact activities in a week or so. After six weeks of healing, you can resume upper-body exercises without disrupting your recovery or results.

To ensure optimal breast augmentation results, carefully follow all your post-operative instructions. Dr. Xu will review this with you in detail prior to surgery, including when you can bathe, how to position your body when sleeping, and overall guidance on your activity. If you have any questions during your recovery period, do not hesitate to reach out to our office for clarification and guidance.

Who Are the Best Breast Enhancement Candidates?

If you are interested in breast augmentation surgery, it is best to be a non-smoker in good overall health and at a stable body weight. It’s also essential to have a healthy self-image and realistic expectations for your results. If you’re unsure what to expect, we will gladly answer any questions and guide you through each step of the process.

While the number of decisions to make surrounding this procedure might seem overwhelming, Dr. Xu will thoughtfully talk you through every option to help you determine the best choices for you. During your consultation, Dr. Xu will create a customized surgical plan after carefully evaluating your current breast tissue and desired outcomes.

Partner with Dr. Ginger Xu, a Leading Female Plastic Surgeon in San Francisco

Being a female plastic surgeon allows Dr. Xu to relate to and empathize with her breast augmentation patients on a more personal level. “Women face a unique set of challenges as we are confronted by societal messaging regarding idealized figures and body types. Sometimes it’s hard to know what is society’s noise versus your own true voice in the matter. As a woman, I understand what it’s like to navigate this while also trying to stay true to what you want for your own body, on your own terms, regardless of what other people think, or how it fits into norms or not. Ultimately, doing what’s right for you is the greatest act of self-care.” Dr. Xu firmly believes in plastic surgery that is an expression of self-love, body positivity, and emphasizing natural beauty. She can relate to why you may want to have a cosmetic procedure done and advise you on the best ways to reach your desired results.

Learn more about San Francisco breast augmentation at Ethos Plastic Surgery by scheduling a consultation with Dr. Xu today! Call (415) 506-4300 or fill out our website contact form to get started. We look forward to meeting you soon.


Breast Augmentation

This is an interactive process and is a combination of customizing the implant to achieve the final look that the patient wants to achieve, as well as balancing realistic factors such as the patient’s pre-existing breast size and shape and overall frame. We also take into consideration things like the patient’s lifestyle and level of activity – how heavily they use their chest muscle, as well as their tolerance for implant weight. During your consultation, Dr. Xu will have you try on sizers in the office that give you an idea of what a certain sized implant would look like on you. In addition, she will have you wear sizers at home during a trial period to get a better sense of how this works with your lifestyle, how it looks in various clothing, and how the weight feels to you. Finally, Dr. Xu will ask that you collect some photos of your ideal look to get an idea for what breast projection and overall aesthetic you are seeking.

Instead of just ordering one implant size for your surgery, Dr. Xu always makes sure she has a range of implant sizes on hand.  During your surgery, she will also use sizers in the operating room to see how different volumes look prior to deciding on the final implant; this ensures that the final size selected is exactly the right fit.

Silicone implants look and feel much more natural than saline implants, which are essentially a silicone bag filled with water. Saline implants look and feel like a water balloon. They came into popularity during the 1990’s but now most patients are getting silicone implants, which have evolved as newer generation implants are more cohesive and stable than their older counterparts.

The degree of cleavage you have can be enhanced by the increased volume you achieve through a breast augmentation with implants; however, cleavage is mostly determined by how close your breasts are on your chest, and this is something that is genetically set by the natural blueprint of your body called your “breast footprint.” Some women have breasts that are far apart with a wide space in the middle, while others have breasts that easily touch in the center making cleavage more pronounced. In general, cleavage can be accentuated with the use of bras designed to push the breasts closer together, and is not necessarily created by the use of implants alone.

As a continuation of the concept of your natural “breast footprint,” your implants should be placed where this is, centered behind the breast and nipple. Thus, it cannot be placed higher on your chest that where your breasts naturally sit – otherwise, you will have a deformity. Patients who wish for their breasts to have more volume in the upper pole will be happy to know that implants naturally boost volume in this area. If a patient is looking for her entire breast to be in a higher position on the chest, she is probably seeking something more like a breast lift (can link to breast lift section).

The Keller funnel allows placement of the implant using a “no touch” technique where the surface of the implant does not come into contact with anything else (such as gloves and instrumentation used during the surgery). The implant is pushed into the breast pocket using this Funnel, which reduces the risk of any contaminants or bacteria making their way onto the surface of the implant due to additional handling. This “limited exposure” concept is important because it reduces the risk for infection and “seeding” an artificial device in your body like an implant with potential sources for infection. It also in turn is thought to reduce the risk of biofilm formation and capsular contracture, which is the #1 long term complication with having implants.

Most patients typically don’t need something like this. It becomes relevant when a very thin patient with minimal tissue of her own wants to have implants that are likely too large for her natural body structure to support. This can be assessed during your consultation when Dr. Xu examines your breast tissue.

This depends on the position of your breasts and nipples in relation to the breast crease known as the inframammary fold. If your breasts and nipples are lower than the crease, or appear sagging and low on your chest, you may need a breast lift for an optimal aesthetic outcome. Dr. Xu will take measurements and also examine you during a consultation and give you her assessment as well as recommendations on what to do.

Yes, typically breast augmentation requires general anesthesia because the implants are usually placed under the muscle which requires partially releasing / cutting the muscle which cannot be tolerated while awake. However, if the patient is having implants placed above the muscle, it may be possible to perform the surgery using local anesthesia and IV sedation.

You are not required to have someone with you after surgery, but especially due to the effects of having general anesthesia, it is recommended to have someone look after you and just be around in case you need help the first day after surgery.

Yes, you will need to wear a post-surgical compression bra, which helps reduce swelling and closes down the breast space to minimize bleeding as well. You should wear this for 2 weeks as much as you can, after which you can transition to a different form of supportive bra, but typically wear something like this for 4-6 weeks after surgery.

Recovery will depend on whether you have a partial muscle release for implant placement under the muscle. In most cases, that is the most uncomfortable part. Assuming that is the case, you will typically be sore in your chest and arms during the 1st week, but this should get substantially better by the 2nd week. You can start gentle exercise (walking /hiking) at 2 weeks, the moderate lower body exercise at 4 weeks, and then unrestricted activities at 6 weeks. During the 6 weeks, it is important not to do any type of bouncing activities (jogging, trampoline), to keep the breasts stable, as well as avoid heavy lifting, raising your arms high above your head, or heavy use of your arms.

This depends on the nature of your work and how strenuous it is. Most patients can return after 1 week for a desk job. For jobs that are more physically active, it depends on how much you use your upper body, so it may range from 4-6 weeks. Dr. Xu can also write you a note to return with modified duty.

Yes, most mammographers are familiar with how to obtain a mammogram in the presence of implants. There are special techniques and views that they can do to get a good study. Implants may make the process a little more uncomfortable, but in short, mammograms can and should still be done.

No. Dr. Xu uses internal sutures that are under the skin and dissolve naturally over time.

You should not. This is typically not a risk with breast augmentation, but in the rare case that an individual has unusual anatomy with nerve supply to the nipple in an area that requires dissection during the surgery, it might be possible to have some decrease or loss of nipple sensation.

Implant manufacturers will each have various recommendations regarding implant replacement, with some saying to replace your implants every 10 years. However, if your implants are fine and not bothering you at all, there is usually no reason to go back in and perform essentially an unnecessary surgery and subject your body to another round of surgical trauma, wound healing, and potential risk for infection and capsular contracture. If you are developing any signs of implant rupture or capsular contracture though, it would be recommended to have your implants removed and possibly replaced.

Implant rupture or deflation, malposition, capsular contracture (hardening, pain, deformity), rippling / wrinkling, dissatisfaction with size or shape.

Yes, there is always a scar any time you have surgery and an incision is made. Scars never disappear, but they often fade and become imperceptible with time. In addition, scar placement is often strategically designed in breast augmentation to lie in the breast crease, hidden from view in the natural shadow of the fold.

Implants can rupture when the outer shell of the implant breaks. If you have a saline implant, the saline inside will then leak into the breast pocket and get absorbed by your body; in that case, your breast would deflate and become smaller and you would thus know right away. If you have a silicone implant, you would not be able to know whether the implant has ruptured and it presents as a “silent rupture” that can only be detected with medical imaging such as a mammogram, ultrasound, or MRI. The silicone may leak outside of the shell and usually stays in the breast pocket but can migrate outside of the capsule. Newer generation implants also known as “gummy bear implants” are highly cohesive and stay in place even after they are cut, making migration and leakage much less likely. A ruptured implant may aggravate the process of capsular contracture, which can thus be a sign of possible rupture. If you have any signs of encapsulation, it’s best to see your plastic surgeon for evaluation and obtain imaging if needed to confirm the diagnosis.

  • It is common for breasts to feel tight and swollen immediately after surgery. In the initial post op recovery period, it is important to follow activity restrictions and limit heavy use of your arms. If you strain or overuse your pectoral muscles, you may cause bleeding or create problems with the healing process and thus hurt your final results. 
  • If your breasts feel tight several months or years after surgery, it could be a sign of encapsulation which should be evaluated by your plastic surgeon.

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