18 years old, almost no breast tissue. What kind of breast augmentation would be right for me?

I am 18 years old and have literally no breast tissue at all. My body overall is not bone thin, I have fat on the rest of my body except for my chest area. I'm worried that saline implants will look unnatural and awkward on my flat chest, even though I have a decent amount of fat on my arms and armpits. Where do I begin choosing a surgeon and the right kind of surgery for me? Thank you

Doctor Answers 18

Breasts augmentation with implants

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Dear Lillia,

   Congratulation on your decision to have breasts augmentation with implants. This procedure will be on of the best investments in yourself. It will increase your confidence, your self esteem, your sense of femininity and will make shopping fun...

    Not all results are the same, because there are different techniques and different implants. Additionally, experience, skills and aesthetic eye are critical for good outcome. So, do your due diligence carefully and choose your surgeon wisely, in order to avoid bad result and a need for corrective surgery.

   Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking.

   I have been in practice for over 29 years and performed breasts augmentation surgeries with implants on thousands of patients, many of whom, had similar anatomy to yours. I use almost exclusively smooth, round , moderate profile saline implants, due to many reasons which are too numerous to discuss in this session. I will be happy to detail them to you , if you contact my office.

   Many of my patients are mothers , daughters and sisters. It is inconceivable that they would have referred me their family, if they were unhappy with their breasts augmentation results.

              Best of luck,

                                     Dr Widder

Breast implants

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You would need to be seen in person to determine what might be appropriate for you. You can start by going to the ASPS or ASAPS websites to find a plastic surgeon in your area. Good luck.

Pros and Cons

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Silicone implants will feel more natural.  However at your age it is off-label and your implants will not be warrantied most likely.  There is little medical evidence as to why this is the FDA rule and I think nearly all plastic surgeons believe it to be nonsensical, but regardless, this is an important consideration.  Some surgeons may be willing to place the silicone for you as long as you understand the off-label implications.

Saline implants are approved for patients under 22, but do have limitations in terms of feel and rippling. 

As a middle ground, there is another product called an "ideal implant" which is relatively new to the market.  It is a saline implant that produces less rippling and can be more like a silicone gel implant for shape.  I would definitely consider this option in your case.

Hope that helps,

Christopher C. Chang, MD

Washington DC, Maryland and Virginia

Breast implants at 19.y.o.?

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Even with scant natural breast tissue, you can expect a natural result with appropriately selected implants. At less than 22 years old, you are not a candidate (in the eyes of the FDA) for silicone implants. While you are a candidate for saline implants right now, your options include waiting until you are 22 if you are convinced that silicone is the best choice for you.

Plan to consult a Board Certified plastic surgeon who can demonstrate plenty of experience with breast augmentation for individuals with thin body proportions such as yours.

Breast augmentation customized for you

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An experienced board certified plastic surgeon would be able to achieve natural looking results with saline or silicone implants. As long as the implants are suitable for your body, this shouldn’t be a problem. 

At your age, I suggest you wait a couple more years as your breasts may still be developing. The female breasts normally reach a level of maturity at about 19-21 years old. Your breasts may fill out in the next year or two. 

Breast Surgery at 18

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Thank you for your questions.  A good place to start can be asking your primary care physician or gynecologist who they would recommend.  If you are not comfortable with asking that question of them, they look to either the American Society of Aesthetic Plastic Surgery, the American Society of Plastic Surgeons or the American Board of Plastic Surgery for a list of names of Board Certified Plastic Surgeons in your are.  Visit their website and call the office, if you feel comfortable with the receptionist answering the phone then you next step would be to make an appointment to speak with the physician and review your goals and options.

Breast augmentation

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Unfortunately, at 18, only saline implants are approved. Nice, natural results are still possible with proper size, projection selection based upon your mesasurements and goals. These would be determined during an exam and consultation with a plastic surgeon to discuss your options and expectations. 


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Due to your age your are limited to saline implants but you can obtain a natural result with these when placed in the dual plane (below the pectoralis major muscle) and with a conservative size.  

Breast augmentation

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Thank you for your question. In your case, we can use two different type of implants: round or anatomical. This would be determined on your medical evaluation. It is important to choose a plastic surgeon with expertise in this surgery. The size and boarding way will also be determined on your medical evaluation.

I hope my answer will help you to your question.

Before undergoing any surgical procedure, please seek a board certified plastic surgeon

Jairo Ulerio, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 92 reviews

Breast augmentation

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Thank you for your question.

I would recommend when looking for a surgeon to perform your breast augmentation that you choose one who is board certified and specializes in breast augmentations. You may also want to look on the ASPS website as this lists board certified plastic surgeons in your area. I would also look at the surgeon’s credentials, memberships, educational background, reviews and before and afters. Before and afters are a good indicator of their techniques and outcomes from these surgeries and reading reviews from other patients is a good way to see what their experience with the doctor was like. Once you have found a board certified plastic surgeon that you like, I would recommend that you schedule a consultation with them so they can perform a physical examination and take measurements so they can recommend the best implant type/sizes for your body. There are 3D simulators that can show you what you would look like with different types of implants and different sizes, this can be helpful when trying to decide what size would achieve your cosmetic goals. Best of luck in your endeavors!

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.