Tasteful & Thoughtful Aesthetic Surgery in San Francisco

Unlike most others, our practice is founded on extraordinary attention to the details of your expectations, anatomy, and what options will allow safe and predictable results. This means lengthy, multiple, educational visits and customizing a plan for surgery…or knowing when not to do a surgery.

Dr. James Romano

Voted Top Doctor

A recognized leader in the medical field and active Assistant Clinical Professor at UCSF, Dr. Romano has been honored by Castle Connolly’s Top Doctor Award every year. In addition, he is recognized in the annual SF magazine guide to Top Surgeons each year. Voted on by his peers, he has been a part of these prestigious groups for over 20 years. His volunteer work, training in top institutions, and zero paid or settled malpractice cases have driven him to this elite status within the plastic and cosmetic surgery fields.

Dr. Audrey Nguyen

Plastic Surgery as Art

Dr. Romano is pleased to introduce his patients to Dr. Audrey Nguyen. He has worked with her for many years in his capacity as an Assistant Clinical Professor of Plastic Surgery at UCSF and is delighted that they will together contribute the latest state-of-the-art visions and techniques to patients, delivered with sensitivity, care and compassion.

Compassionate Care, Exceptional Expertise

It has always been a pleasure and a privilege to provide the most sensitive, compassionate plastic surgery care and education to my patients while treating them with dignity and respect.

Compassionate Care, Exceptional Expertise

It has always been a pleasure and a privilege to provide the most sensitive, compassionate plastic surgery care and education to my patients while treating them with dignity and respect.

What We Offer


Dr Romano performs the full spectrum of facial surgery with special attention to facelift and dramatic and safe results, and importantly, very natural. He uses the latest state-of-the-art techniques which are customized to accommodate your expectations and anatomy. Healing is rapid with minimal bruising and no pain.

Buffalo Hump

Dr Romano has consistently been predictably treating and curing this condition in patients. It is performed by specialized liposuction. The procedure takes one hour. There is very little pain and a rapid recovery. Results are profound, dramatic and immediate.

Facial Liposuction

If you’re looking for a safe and reliable solution to excess fatty deposits in your face and neck area, turn to the professional treatment from Dr. James Romano. His advanced technique will take little time, but dramatically rejuvenate your face and neck.

Breast Augmentation

Patients are extremely happy with our very extensive consultations and comprehensive education. The surgery is very well planned so you obtain the size and look you want with rapid healing and VERY LITTLE or NO pain, and quick return to work, exercise, and daily activities.

Tubular Breast Correction

This is a super specialized area of breast enhancement dealing with correction of an abnormal shape, foundation, tightness and puffiness of the breast. Through the typical small incision, extensive internal release of tight tissues, reshaping breast foundation and creating roundness is artistically and carefully performed.

Breast Augmentation Revision

Dr Romano has enormous and extensive experience with this condition in patients that have already had implants and now problems. Using customized techniques and technologies he has perfected this surgery to totally correct the full spectrum of problems such as pain, fatigue (Breast Implant Illness), positioning, irregularities, deformity, contractures, asymmetry, and size.

Buccal Fat Pad Excision

This is a very specialized surgery that requires a keen aesthetic eye, evaluation and counselling. It is not that invasive, but the skill is in evaluating your expectations and how your anatomy will allow this safely and predictably. It may be done alone or in combination with facial liposuction or facelift. The results are dramatic, and this is why we must be very careful.

Belly Button Surgery

Dr Romano has treated and corrected all the different deformities of the belly button area that may be congenital from birth or acquired as a result of hernia, laparoscopy, piercings or other procedures. The skill and artistry involves performing this surgery and yet hiding all the incisions deep and on the inside.

Nipple Surgery

Even though a small area of the body in relation to all else, it is profoundly important to look and feel and function naturally. Dr Romano has throughout his career operated and cured inverted, enlarged, scarred, asymmetric, or deformed nipples. It is a 1-2 hour operation under local anesthesia with return to work and full activity the same day.

Out-of-Town Patients

Dr Romano sees patients from all over the US and beyond. His surgical prep, custom anesthesia, and painless recovery allow your stay to be more like a vacation than a procedure. Our concierge services will arrange tours and experiences throughout the Bay Area.

Meet Our Patients

Dear Dr. Romano, I remain ever grateful for your mentorship, friendship, & continual support. It has meant so much to me over the years. Thank you for being genuine & sincere with me always, & setting an example as a surgeon & person I aspire to be like as well, with your grace, wisdom & humility. Warmly, Ginger UCSF Plastic Surgeon

Thank you James for such a great job! My breasts look so natural and feel so soft that my boyfriend still doesn’t know that I did breast augmentation. I have been living with him for 2 years. And I think he is very proud of my breasts. Also I stopped wearing bras. I hated them a lot! I feel happy and free. Thank you again!

Dear Dr. Romano, You have made the last year of my life wonderful!!! When you look good you feel good. You are the best of the best…But more importantly you are a good person as I would say a good soul. With extraordinary talents! My best! Please enjoy the wine! You made a comment about your brother being the artsy one in your family. Your skills are like an artist. 

Patient Intake Form

Complete your online patient registration effortlessly. Simply utilize the secure password provided by our office to get started.

Latest Blog Posts

Get Started

We are proud of our extraordinary service and prompt attention to every call and every detail. Contact us today to prove it to yourself.