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Breast Augmentation in Mountain View

Breast Implants in Mountain View, San Jose and the Bay Area

Breast augmentation is a personal and private decision that can potentially have life-changing effects on a person. Highly skilled Dr. Samuel Pearl and Dr. Alexander Ereso have been performing breast augmentation procedures for Mountain View, Los Altos, Sunnyvale, and Bay Area women for over two decades. Dr. Pearl and Dr. Ereso are known for their artistic touch and extensive surgical experience. View his before and after work from patients who have undergone a breast augmentation in San Jose and the Bay Area.

Breast augmentation can enhance natural body proportion and frequently correct the evolutional changes of the breasts noted after pregnancy. Improved self-confidence and image are common after this procedure. Through a variety of incisions, a soft, natural-shaped breast implant is placed behind the breast tissue and frequently behind the chest muscles to achieve the desired size and shape. If you are contemplating breast augmentation through the permanent insertion breast implants, you should consult Dr. Pearl and Dr. Ereso, experienced and knowledgeable surgeons.

Ideal Breast Augmentation Candidates

Women who choose to have breast augmentation surgery do so to improve their self-image. Some breasts never developed to a size that meets their expectation. Often, women want the breast augmentation procedure to restore their natural breast volume, which may have decreased as a result of pregnancy, weight loss or aging.

Any one of the following feelings or conditions may indicate that you are a good candidate for breast implants:

  • You are bothered by the feeling that your breasts are too small
  • Weight loss has changed the size and shape of your breasts
  • After having children, your breasts have become smaller and have lost their firmness
  • Dresses that fit well around the hips are often too large at the bust line
  • You feel self-conscious wearing a swimsuit or form-fitting top

In addition, there are several “musts” for anyone considering breast augmentation:

  • Breast development must be complete
  • Candidate must be emotionally mature and fully understand their motivations for wanting the procedure
  • Candidate must have realistic expectations, knowing that the procedure can bring improvement, but not perfection

If you believe you can benefit from the cosmetic enhancements of breast implants, San Jose, Sunnyvale, Los Altos, and Bay Area residents can contact Dr. Pearl and Dr. Ereso, the breast augmentation experts, in Mountain View, California.

Your Personal Breast Augmentation Consultation

A personal consultation is the first step. Dr. Pearl and Dr. Ereso will assess your physical and emotional health and discuss your specific cosmetic goals for breast augmentation surgery.

You should arrive at the consultation prepared to provide complete information about:

  • Previous surgeries
  • Past and present medical conditions
  • Treatments you have received
  • Medications that you are taking, including nutritional supplements and herbal remedies
  • The results of mammograms you have had
  • Any history of breast cancer in your family

If you would like to arrange a consultation to discuss breast implants or breast augmentation, contact our premier cosmetic plastic surgeons.

Breast Augmentation Sizing

To make sure you are happy with your breast augmentation procedure, we offer 4 separate opportunities for the sizing of breast implants at our Mountain View practice. Dr. Pearl and Dr. Ereso believe the most important sizing takes place in the privacy of your own home, and we give every patient specific instructions on how to best determine the appropriate size and shape of their breast implants.

During your initial visit, Dr. Pearl and Dr. Ereso will discuss appropriate size and give you the opportunity to see what you would look like with different sized breast implants. The second, and most important sizing will occur at home. Dr. Pear and Dr. Eresol instruct our breast augmentation patients in Mountain View, San Jose, Los Altos, and across the Bay Area to create and experiment with their own home-made breast implants in order to determine what size works best for their body.

  • Begin by cutting a 12 inch segment of old pantyhose (not the foot area), tying a knot on one end, filling the pantyhose with approximately 8-12 ounces of rice, and tying the other end in a knot. Remember, you pick the size, and one ounce = ~30 cc’s.
  • Purchase a lycra bra (with no underwire) in the cup size that you are looking to achieve with surgery. Make sure the bra doesn’t fit too tightly, and purchase several sizes if you are unsure of the look you are going for.
  • Place the “rice implant” inside the bra, and add or remove rice until you find the most flattering size.

Now is your opportunity to try on clothes, bathing suits and lingerie in stores or in the privacy of your own home. Consult your friends, families and partners for advice, and spend as much time as needed. At your pre-op appointment, you can bring your rice implants to the office, and Dr. Pearl and Dr. Ereso can measure the rice and compare it to the goals that were discussed during your initial appointment. You may discover that your preferences have changed, and your final implant size may be larger or smaller than what you initially desired. During your breast augmentation procedure in Mountain View, Dr. Pearl and Dr. Ereso will have one final opportunity to adjust the size and position of your breast implants to best satisfy your desires.

Dr. Pearl and Dr. Ereso offer this series of sizing steps for all of our breast augmentation patients in Mountain View and across Sunnyvale, Los Altos and the Bay Area because we want to make sure they achieve their aesthetic goals. We believe that sizing at home gives you more control over your final result, and empowers you to experiment with size in a way that may have been uncomfortable in an office. When patients are comfortable with their breast augmentation treatment plan, they are more likely to be satisfied with their results.

The Breast Augmentation Procedure

The technique used for your surgery depends not only on Dr. Pearl and Dr. Ereso’s preferences but also on your desired results. The incision is small and is usually made in one of three locations, underneath the breast just above the crease, around the lower edge of the areola, or within the axillary fold.

Once the incisions are made, our plastic surgeons create the pockets into which the breast implants are inserted. This pocket is made either directly behind the breast tissue or more frequently beneath the pectoral muscle located below the breast tissue and above the chest wall.

Safety of Breast Implants

Each year, thousands of people have breast augmentations and experience no major complications. However, it is important for you to be informed of the risks as well as the benefits. Breast implants have been used with great success for more than 30 years. Dr. Pearl and Dr. Ereso have been performing breast augmentation for over 20 years! Recently new medical studies have confirmed that breast implants do not increase the risk of breast cancer and they are not directly responsible for causing autoimmune diseases (Lupus, Rheumatoid Arthritis, Scleroderma, Fibromyalgia, etc). In our opinion, both saline and silicone gel-filled breast implants are medically safe.

We will inform you of the possible complications of breast augmentation surgery. In addition to listening carefully to what we tells you, be sure to raise any questions you may have about the safety of the procedure.

By carefully following our advice and instructions – both before and after surgery – you can minimize some of the risks.

FDA Approves Silicone Gel Implants

Silicone gel implants have been reapproved by the FDA since 2006. Dr. Pearl and Dr. Ereso have always believed that, for most patients, gel implants offer the most natural look and feel. They are particularly good for patients that are thin and have minimal breast tissue.

“In 2018 we use silicone gel implants in over 90% of our patients!”

What are shaped textured highly cohesive gel breast implants?

This type of implant is sometimes referred to as the “gummy bear” implant because it is made with an extremely cohesive silicone gel. It retains its shape and reduces rippling, and recent studies have shown a reduced incidence of capsular contracture, which is responsible for firm breasts that can feel hard and cause pain. Gel leakage appears to be less than with traditional gel implants. In addition, the anatomic teardrop shape helps to produce a very pleasing natural result.


The most significant disadvantage of shaped textured implants is that they are TEXTURED! The use of textured implants has become an extremely controversial in the past year. Why is this? The answer is ALCL. What is ALCL? PLEASE READ THE NEXT SECTION CAREFULLY!

ALCL is a rare type of lymphoma (type of cancer) that is found in the capsular scar tissue surrounding all breast implants. It does not ever involve breast tissue and it is NOT breast cancer. It is usually cured by removing all of the capsular scar tissue. ALCL has occurred in all areas of the world and to date has only has been found in patients that have received textured implants. There does not appear to be any relation to the type of silicone gel or saline placed in the implant as well as to the shape of the implant. It is not known with certainty what causes the the development of ALCL, but it is known that the textured surface implants usually cause a low level of inflammation, which is thought to play a role in the development of ALCL. The most common presentation of ALCL is the development of a large seroma (collection of fluid), usually in one breast, making the involved breast look and feel considerably larger than the opposite uninvolved breast. ALCL has been reported from 2 years to 28 years after breast implant placement!

Because of the controversy surrounding ALCL and textured implant, we are no longer utilizing these implants. If you have textured implants of any type, please consider calling the office to set up an appointment to see Dr. Pearl of Dr. Ereso.


What is ALCL? ALCL is anaplastic large cell lymphoma. It is a rare and treatable type of T cell lymphoma that can develop around breast implants. ALCL is not a cancer of the breast tissue itself. The lag time between implant insertion to diagnosis is between 2 and 28 years with a median of 8 years. The current reported incidence of ALCL is approximately 1 in 30,000. No cases to date have been reported in patients that have received smooth implants. The association of ALCL and textured implants may be related to increased surface area of the texturing, the chronic presence of fluid around the implants, the presence of bacteria around the implants and genetic factors. The disease has been associated with both silicone and saline implants in cosmetic as well as reconstructive patients.

The majority of patients present as a delayed seroma or collection of fluid around the implant. This usually presents as an enlarging breast without infection. Diagnosis is made by fine needle aspiration of the fluid which is assessed by immunochemistry for CD 30 positive and ALK-negative T-cell lymphocytes. Following a positive diagnosis, PET-CT and MRI scans are obtained. Mammograms are not helpful.

Consideration should be given to a multidisciplinary approach including when required, an oncological breast surgeon and an oncologist specializing in lymphoma.

The majority of patients can be cured of their disease by bilateral total capsulectomy (removal of the scar tissue around the implant) and implant removal. This is the current treatment recommendation because a small number of women have disease on the opposite breast found incidentally. Rarely patients require radiotherapy and chemotherapy. Incomplete capsular resection has been associated with both recurrence and lower survival.

ALCL is a rare disease worldwide in women who have breast implants for any reason. It is important to call your plastic surgeon or family MD if you experience sudden enlargement of one or both breasts. Remember the most common time that ALCL is discovered is approximately 8 years after breast implant placement. At the present time only patients that have received textured implants have developed ALCL. If you are not experiencing problems, at this time there are no recommendations to remove your implants.

For more information regarding ALCL you may find to be most helpful.

Please remember that Dr. Pearl, Dr. Ereso and their staff are available to help you! Feel free to contact our office if you have questions or need assistance.

The Keller Funnel

Silicone gel implants are a lot like really tough water balloons. Up until now, surgeons needed to poke the pre-filled breast implants by hand through small incision sites, potentially bruising surrounding tissue and weakening the implant shell. The Keller Funnel is a soft, cone-shaped, sterile device made of nylon. The Funnel allows Dr. Pearl and Dr. Ereso to use a no-touch delivery technique, which is believed to reduce capsular contracture, a painful complication associated with breast augmentation procedures. The Funnel has a special interior coating that creates a super slick surface. Once the Funnel tip is placed through the incision, Dr. Pearl or Dr. Ereso quickly propels the implant gently into place with minimal force, bypassing the implant’s contact with the skin.

The Funnel was introduced to surgeons in 2009, shortly after silicone gels were FDA-approved and re-entered the U.S. market. Designed by a plastic surgeon, The Keller Funnel improves the delivery of silicone gel implants during breast augmentation procedures. Now we can give you the aesthetic advantages of silicone gel implants, combined with a gentler surgical approach. Benefits of using the Keller Funnel include:

  • Shorter incision lengths
  • Improved comfort and faster healing
  • No touch technique
  • More choices for incision placement
  • Reduced force on the implant and incision
  • Reduced risk of contamination and infection

The Keller Funnel allows our plastic surgeons to make smaller incisions, similar to those used in saline implant procedures.

Women and their surgeons have increasingly selected silicone gels for their natural look and feel, and today, according to the annual report provided by the American Society of Plastic Surgery, more silicone gels procedures are performed than saline.

According to a recent survey conducted among surgeons with experience using the Funnel:

  • 91% reported that use of the Funnel reduces incision lengths
  • 92% of physicians using the Funnel believe use of the Funnel reduces force on the implant shell
  • 43% feel that incisions heal better with the use of the Funnel, and believe patients appear less swollen and bruised
  • 75% reported using the device reduced the risk of infection
  • Nearly 70% believed it lessened patient bruising and may reduce the incidence of capsular contracture, a painful complication associated with breast augmentation procedures

Other benefits attractive to both our plastic surgeons and patients like you include a reduced force of the implant shell which may prevent a rupture of the implant and the ability for Dr. Pearl to use a no-touch technique during the procedure which can lessen the chance of contamination.

EXPAREL® & Breast Augmentation

Recently, Dr. Pearl or Dr. Ereso have begun to offer EXPAREL® to our breast augmentation and tummy tuck (abdominoplasty) patients. EXPAREL in selected individuals can dramatically reduce post-operative discomfort.

To help control your pain after surgery, Dr. Pearl or Dr. Ereso will inject EXPAREL into your surgical incision just before the end of the procedure.

  • EXPAREL is a local analgesic that contains the local anesthetic bupivacaine. Local anesthetics provide pain relief by numbing the tissue around the surgical site.
  • EXPAREL is specifically designed to release pain medication over time and can control pain for up to 72 hours. This is fantastic!
  • In addition to EXPAREL, we may provide other pain medications to control your pain.
  • Each patient is different and responds differently to pain medication. Depending on how you respond to EXPAREL, you may require less additional pain medication during your recovery.

Be sure to ask our plastic surgeons or staff about this exciting way to reduce your discomfort, enhance your experience, and help you achieve the superior result that you deserve!

Recovery from Breast Augmentation

Within a day after surgery, you should be up and around. Most of the discomfort that you feel can be controlled with medication prescribed by your surgeon. Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

Within the first week

  • Bandages will be removed, and you may shower 3 days after surgery
  • Sutures will be removed at one week after surgery
  • You may return to light activity, non-strenuous work usually at 5 days after surgery
  • You can resume sexual relations (as long as the breasts are treated gently)

After several weeks

  • You may resume exercise
  • Most of the swelling will subside and you’ll start to see your ‘new shape’
  • You may resume vigorous exercise and arm movements

Avoid straining, bending and lifting during the early postoperative period. You may resume most of your normal activities within several weeks.

Breast Augmentation Results

If you are like most women who have the procedure, you’ll be very pleased with the results of your breast augmentation. You will no longer need padded bras or other breast-enlarging undergarments. Your new, natural curves will let you wear a greater variety of fashions – even dresses with low-cut necklines and form-fitting tops. Many women find that their new figure gives them a greater sense of self-confidence, whether they’re on the beach or in the boardroom.

You are likely to be happy with your results for many years. However, keep in mind that breast implants are not immune to the effects of weight fluctuations or aging. The life span of breast implants is approximately 8-20 years. Therefore, you can expect to have at least one or two additional procedures during your lifetime even if your initial breast augmentation procedure has a ‘perfect’ result.

If you would feel you could benefit from breast augmentation, breast lift or breast reduction in Mountain View, Los Altos, San Jose, and Bay Area women should contact our plastic surgery center today.

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