The most-performed breast surgery. Refined at NCSS.
Breast augmentation is the highest-volume cosmetic breast procedure in the United States and remains the workhorse of our breast program. At NCSS, five of our affiliated surgeons perform breast augmentation as a routine part of their practice, and each brings decades of experience to implant selection, incision planning, and pocket technique.
Two of our senior surgeons at Pacific Center for Plastic Surgery, Drs. Nichter and Horowitz, have refined variants of the standard augmentation approach that they market under their own names: Rapid Recovery Breast Augmentation (a protocol designed to minimize downtime) and Scarless Breast Augmentation (an approach designed to avoid visible chest-wall scarring). Patients considering augmentation at NCSS should ask about these variants during consultation.
Every augmentation at NCSS is performed under physician anesthesia — no CRNAs, no exceptions — in our AAAHC-accredited operating rooms with endocrinology on call. The room, the anesthesia, and the perioperative program are the same regardless of which surgeon you choose.
Who this procedure is designed for.
Breast augmentation is the right choice for patients seeking implant-based volume enhancement with realistic expectations about the commitment involved.
Wanting a substantial size increase
Typically one-to-three cup sizes. This is the primary reason augmentation is chosen over fat transfer.
Post-partum or post-weight-loss deflation
The breast tissue is present but has lost volume. Augmentation restores fullness.
Asymmetry correction
Different implant sizes on each side can address moderate-to-significant asymmetry.
Congenital hypoplasia or tuberous breast deformity
Implant-based reconstruction of the underdeveloped breast, often with additional shaping.
Willing to accept implants as a lifelong commitment
Implants have a maintenance profile: they are not permanent devices, and most patients will need at least one exchange or removal at some point in their lifetime.
Realistic understanding of tradeoffs
Augmentation adds volume with a specific projected shape. Patients wanting soft, natural volume without projection may prefer fat transfer. No imaging system can promise you an exact final look — every surgeon's honest counsel will emphasize this.
Every scheduled surgical patient is offered a free Rest-Assure pre-operative consultation with Dr. Rand Scott personally — medical history, medication planning, and discharge coordination before surgery day.
Three stages, one procedure.
Breast augmentation is a single-session procedure with multiple technical choices made together during consultation. The choices that most affect the outcome:
Implant type
Silicone (feels more natural, most patients choose this today) or saline (simpler, adjustable during surgery). Cohesive silicone gel implants are the current standard.
Implant profile and shape
Round vs. shaped (anatomic). Low, moderate, high, or extra-high profile — the projection off the chest wall relative to base width.
Pocket placement
Above the pectoralis muscle (subglandular) or beneath it (submuscular). Each has tradeoffs in appearance, feel, and long-term behavior.
Incision location
Inframammary (under the breast), periareolar (around the nipple), transaxillary (through the armpit — the Scarless approach), or transumbilical. Each choice has its own tradeoffs.
Honest counsel about outcome
No honest surgeon will promise you an exact final appearance; aesthetic outcomes involve too many variables to predict with that precision.
Every augmentation at NCSS is performed under physician anesthesia — no CRNAs, no exceptions — in our AAAHC-accredited operating rooms with endocrinology on call.
Two sites. One recovery.
Breast augmentation recovery is manageable for most patients, with return to desk work typically within the first week.
Discharged the day of surgery with your dedicated nurse. Multimodal pain protocol. Some tightness across the chest, especially with submuscular placement.
Restricted arm movement and lifting. Surgical bra worn continuously. Most patients return to desk work within 5–7 days — sooner with Rapid Recovery protocol.
Progressive return to normal activity. Restrictions on strenuous exercise remain. Implants are still settling into their pocket.
Return to full exercise, including upper-body work, once your surgeon confirms complete healing.
Implants settle into their final position and softness. Final aesthetic result becomes apparent.
Regular monitoring recommended. Implants are not permanent devices; most patients will require at least one exchange or removal within their lifetime.
Every breast augmentation patient at NCSS is covered by our Rest-Assure program: physician anesthesia on the day of surgery, one nurse from arrival through discharge, and post-operative direct access to your surgeon — not an answering service.
Five surgeons. Different approaches.
Each surgeon brings their own preferred technique and implant preference; the free Rest-Assure consultation with Dr. Rand Scott helps you match a surgeon to your goals.
Dr. Toohey
Practice Focus · Long-Term Implant ResearchAll-UC training; breast surgery is his favorite area; participated in long-term implant safety research.
View surgeon →Dr. Nichter
Rapid Recovery & ScarlessTriple-boarded; developed the Rapid Recovery and Scarless augmentation protocols with Dr. Horowitz.
View surgeon →Dr. Horowitz
Rapid Recovery & ScarlessEmory + UVA under Milton Edgerton; co-developer of Rapid Recovery and Scarless variants.
View surgeon →Dr. Bernett
Female Surgeon · Full ContinuumUC Irvine trained; female surgeon offering the full continuum of breast augmentation; in our building.
View surgeon →Dr. Leong
Female Surgeon · Selective NCSS UseBrown-trained female plastic surgeon; performs augmentation at NCSS on select cases from her Westcliff practice.
View surgeon →The right starting point is a conversation.
Every consultation at NCSS begins with time — time to understand your goals, your health history, and which of our affiliated surgeons is the right fit for your specific situation.
Call (949) 644-8182Monday–Thursday, 8am–3pm · Friday by appointment only.
Related procedures.
Rapid Recovery Augmentation
Nichter/Horowitz refined augmentation protocol — designed to minimize downtime and speed return to activity.
Learn more →Fat Transfer to Breast
The alternative for patients wanting modest, natural enhancement without implants.
Learn more →Vertical Mastopexy
The Nichter/Horowitz limited-scar breast lift — often combined with augmentation for patients wanting both size and lift.
Learn more →