Breast Augmentation

hero-breast-augmentationWomen undergo breast enlargement for many reasons. Some just feel that their breasts are too small. They want clothes to fit better and find that clothes that fit well around the hips are often too large up top. Other women have found their breasts became smaller and lost their firmness after having children. Others may find that weight loss has affected the size and shape of their breasts. Some women have one breast that is noticeably smaller than the other. Breast augmentation surgery can treat these concerns by improving the breast size and shape. It is one of the more common procedures performed by members of the American Society of Plastic Surgeon.


If you are considering surgery, the first step is having a consultation with a board certified plastic surgeon. During the consultation, you should candidly discuss your desired breast size and anything else related to your breast appearance that you feel is important. This will help your surgeon understand your expectations and whether they can be realistically achieved.

During the consultation, your medical history will be reviewed in detail. Of particular importance is any previous breast surgery including biopsies, medications you are taking, a family history of breast cancer and results of any mammograms. If you have a strong family history of breast cancer or are over 40, I usually obtain a mammogram before breast augmentation surgery.

If you are a smoker, you will be asked to stop smoking for at least six weeks prior to surgery. Smoking decreases blood flow in the skin, which impairs wound healing.

There is no evidence that breast augmentation increases the risk of breast cancer. However, the presence of breast implants requires a special technique when taking a mammogram. Following breast augmentation, you should obtain mammograms at a facility that has experience with this technique.

The Implant

Your desired enhancement, body frame and existing breast tissue will all determine the size and type of breast implant recommended for you.

All breast implants are composed of a silicone rubber outer shell. The implants are either filled with salt water (saline) or silicone gel. Saline filled implants tend to have a less natural feel when placed in a patient with less breast tissue. They can also be prone to rippling. On the other hand, silicone gel implants have a more natural feel and have fewer problems with rippling. Because they are pre-filled, gel implants require a longer incision for placement. Gel implants are also somewhat more expensive. In patients with minimal existing breast tissue, I usually recommend gel filled implants. In patients with a moderate size breast, such as a woman who wants to go from a full B cup to a full C cup, saline implants are a reasonable choice.

The Incision

The incision for placement of the implants is usually made underneath the breast in the crease. When using a saline implant that is filled after being inserted, only a small incision of an inch or so is needed.

Other possible locations for the incision are around the lower edge of the areola or a small incision in the armpit. Once the incision is made, a pocket is created for the implant. This pocket is usually underneath the pectoral muscle, which must be carefully dissected from the chest wall. Placing the implants through incisions in the belly button do not allow adequate exposure to develop the pocket and often result in poorly placed implants.

The Risk

Every year, many thousand women undergo successful breast augmentation surgery. However anyone considering surgery should be aware of the potential risk. Some potential complications of breast augmentation surgery include reactions to anesthesia, fluid accumulation that may require drainage and infection. Infection may require temporary removal of the implant. Infection may also result in increased scar tissue around the implant. To minimize this complication, I irrigate the pocket with antibiotics during surgery and give oral antibiotics for several days following surgery.

When an implant is placed in the body, scar tissue forms around it as part of the natural healing process. This scar capsule occurs to varying degrees. Rarely, it can become severe that it causes discomfort and changes in the breast’s appearance. If this occurs, surgery may be needed to remove the excess scar tissue.

Breast implants are not lifetime devices and can sometimes rupture. This is sometimes due to chest trauma but more commonly occurs without apparent cause. If a saline-filled implant ruptures, the salt-water contents are harmlessly absorbed by the body. A definite change in the breast size will occur. Surgery will be required to replace the implant.

Several years ago, there was a concern that silicone gel implants caused immune-related diseases. This resulted in silicone gel implants being removed from the market. Women without implants also have these disorders, so the key question became whether breast implants increased the risk of developing these disorders. Since then, several studies have shown that women with implants do not have an increased risk of these diseases, and silicone gel implants were made available again.

The Surgery

Breast Augmentation surgery may be performed in an office or hospital operating room. Following surgery, you will spend a few hours in the recovery where you will be closely monitored. In the great majority of cases, you will then be allowed to go home to further recover.

I use an occlusive dressing that will allow you to shower a couple of days after surgery. The skin is closed with stitches below the skin, so they do not need to be removed. A day or two after surgery, you should be up and about. Some bruising and swelling will occur, but will resolve quickly. I have my patients wear a soft support above the implants to keep them positioned while they are healing.

The Results

Breast augmentation surgery will make your breast fuller and enhance their shape. The results will be long- lasting. However, aging and the effects of gravity will eventually affect the shape of your breast. Following surgery, you should return to the office for follow-up care. You should also schedule routine mammogram exams as recommended for your age group.


Breast Augmentation

Breast Augmentation

Breast Augmentation

Breast Augmentation and Lift

Breast Augmentation and Lift

Breast Augmentation

Breast Augmentation

Breast Augmentation

Breast Augmentation


I grew up a very flat-chested girl and went through some tough self esteem issues as a teenager and a young woman. After I realized I wasn’t just a “late bloomer” (my mother is a 36C and I figured I would at least get close to her size) at age 20 I started contemplating breast implant surgery.
After graduating high school and getting out into the real world, I had gotten past being embarrassed about having a small chest and had even somewhat embraced the fact I never had to wear a bra. At this point I had great hips and butt, a thin waist, but as you moved upwards, it was as if my breasts has just decided not to grow along with the rest of me. I was a 32A with size 5 hips and weighed about 125. I am only 5′ 3″. Still, I always felt like I was less of a woman than those blessed with breasts. I would have even been content with a B-cup but as I got older and my boobs never got any bigger, it really began to affect my self-esteem again, especially when it came to swimming and summer parties. If I found a bathing suit to fit my hips, I could not fill the chest and it was so embarrassing to me. Especially being in the presence of other women my age that actually had boobs! I know it sounds stupid, but I felt like I was the girl that the guys never thought of as being sexy. I was popular, but I eanted to feel like a WOMAN, AND WOMEN HAVE BREASTS!

When I went in for the initial consult, I specifically remember being put at ease immediately by the staff despite my nervousness. I knew nothing about what breast enlargement would cost, or what came after the initial research and deciding to actually go see a surgeon. When Dr. Canoun came into the exam room (with a female nurse of course) and we began talking about what I wanted, I was so at ease. It is definitely awkward at first to have a stranger touching and moving your breasts but it was so professional I never even thought twice about it. It was also hilarious because I remember he rarely looked at my face when we talked, he stared at my chest practically from start to finish. I realized it was because he was very serious about his work and wanted to analyze my body as much as possible to get the best results. Pre-op came, then surgery day.

I was on the operating table and Dr. Canoun was very cheerful, as was the entire operating staff, which put me at ease. A nurse said, “You will start to feel sleepy.”  I did. I opened my eyes what seemed like only seconds later and thought something had gone wrong and he couldn’t do the surgery. I asked the nurse standing beside the table, “Did it work?” Lol! And she gently picked up my arm and hand and placed it on top of my chest which definitely HAD BOOBS! It was wonderful! Recovery went well and 14 years later, my breasts are still perky and beautiful! He changed my life that day. My self-esteem in the breast department is great. If you have the opportunity to have Dr. Canoun as your surgeon, you can feel confident you will be getting wonderful results! Thanks Dr. Canoun!

Jo M. Bumpass, VA - 3/22/2014

I saw Dr Canoun in June for breast augmentation and chose Walnut Creek quite honestly because the hospital fees are much lower than SF and that savings gets passed on to me.  I have found him to be personable and a professional at what he does.  I am very happy with the results and all of the staff in his office and at the surgery center.  It was a smooth and easy process and I would recommend him to anyone else looking for cosmetic surgery.  After discussing the options, pros and cons of each type of implant, I chose to have saline implants under the muscle and everything worked out great.

I am a pretty active person and so it has taken me the full 6 weeks to be back to all of the things I like to do but I knew that beforehand and it was expected.  I am back to being a massage therapist, riding horses and keeping up a regular yoga practice.


Kamalijt B. San Francisco, CA - 8/6/2014

Dr. Canoun performed reconstructive surgery (breast implants) following my bilateral mastectomy last year. Besides being a very professional, skilled, and meticulous surgeon, he also had a friendly, gentle manner about him that reduced any nervousness or anxiety I felt about the surgeries. He also offered excellent advice when I had questions about the procedures, and I feel as though he tailored the results to my particular needs and lifestyle. I would highly recommend Dr. Canoun, as I feel that he is a superior plastic surgeon.

L.H. Oakley, CA - 1/30/2008

I just recently had a breast lift & augmentation done by Dr. Canoun. I had gone to several doctors for consultations & am more than happy & fulfilled about choosing to go with Dr. Canoun! He fully educated me before & after which was comforting as well as just really listened to my wants. He asked me several questions to confirm what I wanted & would feel happy about & explained each scenario. Definitely making sure my wants could become a reality with his magic!

Previous to my operation I was very insecure with my deflated breast & loose skin which also gave me back and shoulder pains. And besides bringing the beauty back to my breast… my shoulders & back no longer hurt! And my posture is magically improved! I am so happy! I even received several compliments as soon as a week after surgery! I look forward to hearing & seeing successful results from my friends & business partners who all asked for Dr. Canoun’s number!

Oh & in addition, two other qualities that stuck out to me were that he gives his cell phone number out & was responsive to my calls never leaving me waiting or concerned. The other was something I’ll always remember… When I first woke up from surgery I asked him a non relevant question, about my soccer team & he on the spot looked up the answer for me. It has nothing to do with surgery but shows me the extra mile of comfort he offers to his patients.

Monica G. San Jose, Ca