Background: Breast augmentation is one surgical plastic surgery procedure whose numbers performed per year continue to rise. One such reason is that the desire for larger breasts encompasses a wide variety of desires from being just a little bigger to very big and a large number of implant styles and sizes to match. On both ends of the breast implant size spectrum (the proverbial bell-shaped curve) are a minority of patients. While many easily perceive of the woman who wants DD size breasts after augmentation, few realize that there are just as many women who want to stay small and just want a little more fullness and shape to their breasts.
Women who request small volume breast augmentation always have good reasons to do so. The main reason is that they have always been small-breasted and see that look as natural and attractive for their body. They may have lost what breast volume they had due to pregnancies and are looking merely for breast restoration. A woman may have never had any breast tissue to speak of (A cup or less) and now wants something but still wants to maintain a thinner body look. She may be athletic, a runner, and wants to avoid being too top heavy or interfere with exercise.
The sizing of breast implants has to take numerous factors into consideration. Breast base width, implant projection and the amount of overlying breast skin are several of the most important. But, in the end, what matters most is what type of breast look the patient desires. For most small breasr augmentations implant volumes are going to be 250ccs or less with implant base widths less than 13cms or so.
Case Study: This 38 year-old female wanted breast implants to restore her breast volume. While she always had small breasts, what little volume she had shrunk after her two children. She was very concerned that she did not end up too big…as defined by not being bigger than she was earlier in life. Her goal was to be a full B cup. She was very favorable for a good breast augmentation result given that her nipples were well above the inframammary fold and she had no sagging/ptosis.
Under general anesthesia, an inframmary approach was used with submuscular implant placement of 250cc silicone gel moderate profile Sientra breast implants. This filled out her breast skin sleeve nicely without too much projection. She was placed on a rapid recovery breast augmentation with immediate physical therapy of her arms and pectoralis muscles.
Her recovery was indeed very rapid, returning to work in 4 days and back working out and running in less than 10 days. She had obtained a nice full B cup result, returning back to a breast shape and volume that she was over a decade ago.
Breast implant size choice is a personal one and ultimately is driven by the desires of the patient. While plastic surgeons must choose implants based on volume (ccs), the look of the breasts is how the patient defines their satisfaction with the result. When a woman specifically says they want a mild increase in breast size, very proportionate to my small body, or no more than a B cup, they truly mean a ‘small breast augmentation.’
1) The choice of breast implant size is somewhat related to body and chest size and completely related to a woman’s personal choice.
2) Small breast augmentation refers to those women who state they want a ‘B cup’ or smaller, which makes up a small minority of the total breast augmentation population.
3) Most small breast augmentations are going to be implants sizes that are 250cc or less.
Dr. Barry Eppley