Making the decision to explore breast augmentation requires research and a detailed consultation to walk you through the steps. In Sherman Oaks, Southern California Center for Surgical Arts and Dr. Husam Elias, work with many women to help them achieve their desired breast enhancement goals. Every woman is different and so are their expectations for the way their breasts should look and feel. We understand that this decision takes time, years even, for many of our clients to seek consultation. We fully support our female clients in their decision to seek breast augmentation as it can help replenish fullness and with the positioning of the breasts.

Dr. Elias walks through the process of decision making with each of our female clients as they plan out the eventual look of their breasts. Breast augmentation requires a skilled hand and visionary mind, which is why Dr. Elias of Southern California Center for Surgical Arts is known for providing the most natural looking results. As every client is different and has varied opinions on breast augmentation regarding size, texture and position of the implant, Dr. Elias will recommend the best of all options, as there are many, during your consultation. Dr. Elias will take dimensional measurements to properly formulate the best plan for proportion to your features and a natural look.

Video on the Breast Augmentation Procedure

Saline or Silicone-Filled Implants

As you make your decision to have a breast augmentation, the first step is to talk through the best options for implants with Dr. Elias. This decision is solely based on preference and whether or not you like the feel of the implant. Both types of implants are safe, effective, and FDA-approved. Each implant can be sampled during your consultation with us, and we encourage every client to try them on while Dr. Elias explains the benefits of each.

As you decide on the type of implant you will choose during your breast augmentation, we will explain what each one is made of. Every implant has a silicone capsule that is filled with either saline solution or silicone gel. Remember, that you will get to try them on during your consultation; we expect you to take some time to think about this and highly encourage it. Your breast implant decisions will stay with you over a long period, and you should be sure that you are making the best choice for you.

Saline-Filled Implants

What is this saline solution, you ask? Saline solution is a simple solution contained within the silicone capsule of the breast implant, and it is a sterile solution made of saltwater. Saline solution is something that is present in the body all the time to perform the necessary metabolic functions; saline solutions are used every day in hospitals. Saline-filled breast implants are firmer than silicone-filled breast implants. These saline implants are filled during the breast augmentation procedure to the client’s specified volume.

Women are required to be 18 years of age when deciding on saline implants. Saline-filled implants are a bit firmer than silicone implants, but you will have a chance to test them in comparison. Since these implants are filled during the surgery, once the silicone capsule is inside of the breast, they require a smaller incision than silicone-filled implants will.

Silicone-Filled Implants

Silicone-filled implants are enclosed in a silicone capsule just like saline-filled implants, but instead of a saltwater solution, they are filled with a silicone gel. The silicone gel is often preferred as they’re known to feel more natural to clients. Silicone and saline filled implants look very similar to the eye once they’re done and healed, but the feel is slightly different. Silicone is filled with gel and has a cushioned feel to it whereas saline is solution filled, so it’s firm.

Women must be 21 years or older to choose this type of implant during breast augmentation. There is another type of silicone gel-filled implant called a ‘Gummy Bear’ implant. This type of implant feels just like the name sounds, like a jelly gummy bear. Ask Dr. Elias if this breast implant type is for you. The incision size for silicone implants (Gummy Bear implants or regular silicone implants) is a little larger than the saline incisions because these are already filled as they’re inserted into the breasts.

Shape and Texture

Saline implants come in a wide variety of shapes such as round and teardrop shaped, as well as smooth and textured surfaces. These implants are great for firmer breasts, but look as natural as silicone implants. It’s important that you feel and see these implants in person as they depend on the senses during your decision-making process.

Gummy Bear implants are slightly firmer than regular silicone implants we offer, but they come in a wider variety of sizes to fit your frame and desired look. These implants can be modified to your particular needs, and are less likely to shift as they move during normal activity throughout your life.

Implant Placement

As there are different types of implants, there are a few different placement options for your implants. The position of your implants has much to do with your natural proportions and the type of look you’re going for. Dr. Elias will go through these options with you to help you decide on the best one for your current breast shape and size.

Two options:

  • Submuscular placement requires placement of the implant beneath the pectoral muscle that are beneath the mammary glands. This placement is recommended for those with more sag in the breasts naturally.
  • Subglandular placement is the placement of implants beneath the mammary gland directly, but over the muscle. This placement is recommended for women who have a mild sag in their breasts naturally.

The Four Incision Types

Inframammary and Periareolar incisions are the most common incisions we perform here at Southern California Center for Surgical Arts. However, Dr. Elias is skilled in using the Transaxillary and Transumbilical incisions with patients at risk of keloid scar formation or severe scarring. Transumbilical can only be used for saline implants.

  • Inframammary incisions are done beneath the breast and made within the breast fold directly, to minimize the appearance of breast augmentation surgery scarring.
  • Periareolar incisions are done around the areola and can be useful for patients looking to reshape their areola, or those who are having a breast lift combined surgery, as this area is trimmed around the breast and pulled up to tighten the skin.
  • Transaxillary incisions are done through the armpit, directly in the fold of the armpit to minimize scarring. There will be no scarring on the breasts at all with this incision as we go through the armpit completely. This incision is however only used once, should you ever need repositioning or want to change your implants, you will need to utilize other incision options.
  • Transumbilical incisions are only used when Dr. Elias is performing breast augmentation with saline implants. This incision moves through the belly button, up into the breast, because the silicone capsule is completely empty. After the implant capsule is inserted Dr. Elias will insert a filling tube up through the belly button and into the implant to pump in the saline solution to the required size and shape.


Any swelling should go down within three to six weeks. Full recovery after breast augmentation is anywhere from three to six months. It is recommended that during this time you refrain from high physical activity that could be bothersome to the stitching and placement of the breasts. You will be fitted with a special compression bra to help support and care for the breasts during this time.

If you feel that you need some help making the decision on the type of implant, shape and texture, we encourage you to bring someone close to you with you during your consultation. Ultimately the decision is yours, and you should decide on the options that will make you happy. Dr. Elias will get to know you during this process so that he can deliver the best results for your aesthetic wishes.

This breast augmentation procedure with implants can be combined with a breast lift and liposuction should you need it. During your consultation, Dr. Elias will talk with you about your breast enhancement goals and will explain the best method of treatment and combination of procedures.