Breast Augmentation in San Diego – Dr. Gary H. Manchester

Augmentation mammaplasty, known more commonly as breast augmentation, is a surgical procedure involving the placement of implants in the breasts to create fuller, firmer, more proportionate breast appearance. Breast augmentation is one of the most frequently performed cosmetic surgery procedures today, as well as one of the most satisfying from the patient’s perspective. When performed by a highly skilled plastic surgeon such as Dr. Gary Manchester, this procedure can increase a woman’s breasts by one or more cup sizes. While often performed as a standalone procedure, breast augmentation can also be combined with other procedures, such as the breast lift. Read on to learn more about the treatment approach of the highly regarded San Diego breast implants surgeon, Dr. Gary H. Manchester.

Breast Augmentation Surgery: Am I a Candidate?

You might be a San Diego breast augmentation candidate if you are a physically healthy woman with realistic expectations for enhancing the breast size and shape. There are many reasons why women seek breast augmentation. Some are looking to enlarge small breasts or improve unevenly-sized breasts, while others are looking to reconstruct the breast following mastectomy or restore breast volume following pregnancy or weight loss.

Breast Augmentation in San Diego: The Procedure

Dr. Manchester performs breast augmentation at his San Diego plastic surgery clinic. General anesthesia is often used, and surgical times average one to two hours. Breast augmentation is a very individualized procedure and must be tailored to the individual. The skin incision can be made in a number of ways: around the areola, in the crease beneath the breast, within a stretch mark on the side of the breast, or through the navel. Dr. Manchester often prefers placing the incision around the lower half of the nipple-areola complex as this results in a nearly invisible scar after healing and helps maintain the round contour of the breast. Working through this incision, Dr. Manchester will insert several “sizer” implants to determine the most appropriate and natural-appearing size. The real implants are then inserted in each breast, either beneath the breast tissue or beneath the chest wall muscle. The implants themselves are comprised of a silicone shell which may be filled with either a saline solution or silicone gel.

After Your Breast Implants Procedure

After your breast augmentation in San Diego, you may experience some discomfort. Any discomfort is typically mild and can be alleviated with pain medication. An adult will need to stay with you at home on the first night after your surgery to ensure your safety. The dressing applied to the breasts after surgery will be changed the next day, and at this time you will be placed in a special bra. Some degree of bruising and swelling may also occur. You will likely be able to return to work within two days after your surgery, though you will need to hold off on resuming exercise and strenuous activities for three to four weeks. Most of Dr. Manchester’s San Diego breast implants patients can resume all physical activities with no restrictions after six weeks.

Read an Article that Dr. Manchester wrote about Breast Augmentation


You are about to undertake an operation which will increase the size of your breasts by the placement of a saline or silicone filled implant behind your own breast tissue or behind the pectoralis muscle of your chest. This letter is intended to help you understand this procedure and to serve as a reference for the many questions you might have concerning your treatment and convalescent period. It is not a substitute for my personal attention, for I shall see you during each office visit. Please refer to this letter both before and after surgery.

This operation, augmentation mammoplasty, is the most satisfying operation I do from a patient’s point of view. It does just what you want it to do, enlarge your breasts, and make them attractive. I see the greatest psychological changes in my patients from this procedure. A shy, reserved woman becomes out-going and self-assured almost overnight. The surgery is quick, taking about one hour, and relatively painless. The post-operative discomfort is most frequently described as the feeling one has after a good workout.

Since everyone is different, each procedure is customized and receives special attention as to the patient’s height, shoulder, hip, and body size. Exact breast size cannot be predicted prior to surgery and should be left to the surgeon. A C -cup is what is usually needed by most breast augmentation San Diego patients while a B-cup is what is normally requested. A C -cup is what is required to fill out your present wardrobe and give you fullness and cleavage. Most patients do not have a specific size in mind but a desire to look good in their current clothes, a halter top, strapless gown, or St. John’s knit. This is usually what your dress maker had in mind. If you desire a particular breast size, please be very specific during your pre-operative visit. A photograph from either Playboy or Penthouse magazine will give your doctor a better idea what you have in mind. All C-cups are not alike or the same size. A C-cup is a percent of your hip size, like 30%. This means the larger you are the bigger the breast before it becomes a C. Conversely, the smaller you are the smaller the breast is to be a C-cup. Ask about this point during your interview.

One hour before your surgery, you will be asked to come to my clinic. Please come to the back door at the designated time wearing a shirt or blouse that buttons up the front, flat shoes, warm socks, and no make-up. My nurse will then give you medication which will allow you to relax. An hour later, you will be taken to surgery sedated. The operation is performed under general anesthesia. You are completely asleep and will remember nothing.

There are various ways to make the skin incision: (a) around the areola, (b) under the breast, (c) in a stretch mark on the lateral side of the breast, (d) axilla. I prefer to make mine around the lower half of the nipple-areola complex. This scar fades quickly and is almost invisible in the majority of cases by six weeks. It, also, does not disrupt the round contour of the breast and is easily hidden while wearing revealing clothes.

After making your skin incision, the breast is elevated from the muscles of your chest wall. Your breast is separated from the underlying muscles or the pectoralis muscles are split so as to insert the implant under the muscle. No tissue is removed in order to create a pocket for your implant. The breast is like a tent with ligaments surrounding and attaching it to the underlying chest wall. By making the areola incision, the breast (tent) is entered in the center and the tissues freed without altering the normal breast contour.

After this has been done, a number of silicone implants are then inserted to see which gives you the most natural appearance. Most women look proportional when their breast size is a “C” cup for their body type.

Following your surgery, you will be observed in our recovery room from two to four hours. You will be allowed to go home under the care of an adult whose sole responsibility is to assist you when you need to eat or go to the bathroom.

You must have an adult stay with you the first night. This is to ensure your safety since you will be groggy from the anesthesia.

You will be asked to return to the office the next day for a dressing change. Your breasts will be checked and you will be placed in a bra, and be given an appointment in four days for suture removal. All breasts have a tendency to gurgle following surgery. This is the result of trapped air which will be absorbed in the first week following surgery.

The following are the answers to the most commonly asked questions following this surgery:

Three to four weeks following surgery you may resume tennis and in four to six weeks begin jogging, jazzercize, and aerobics.

After six weeks, you should have no restrictions on your activity.

Remember, once you have achieved your desired result, your appearance will depend on “how the package is wrapped.” My staff can help you schedule an appointment with a fashion consultant who can advise you about appropriate clothing and makeup. These steps are beyond your surgeon’s domain, but remember, they are the “icing on the cake.”

Thank you Gary Manchester, M. D.


What is breast augmentation?
Augmentation mammaplasty, otherwise known as breast augmentation, is a surgical procedure which increases the size of the breasts using breast implants. Breast augmentation can make the breasts fuller, firmer and more proportionate to the rest of the body. Breast size can be increased by one or more cup sizes.

How do I know if I’m a candidate for breast augmentation?
If you are physically healthy and have realistic expectations for enhancing your breasts in size and shape, then you may be a candidate for breast augmentation. You may be seeking to enlarge small breasts, even out a difference in size between the breasts, restore breast volume after weight loss or pregnancy, or reconstruct the breasts after mastectomy.

What are breast implants made of?
Breasts implants have an outer shell which is made of silicone. This shell can be filled with either a saline solution or a silicone gel.

In addition to helping breast implants San Diego patients realize their dreams of more voluptuous bustlines, Dr. Gary Manchester also performs breast reduction and breast lift in San Diego. He is also pleased to provide a range of body sculpting procedures such as liposuction and abdominoplasty for patients who wish to improve their overall figure. To learn more about these procedures, please visit the respective pages.

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