Breast Augmentation with Minimal Natural Breast Tissue?

My fiance is Asian and has little or no breast tissue. She wears a bra that is essentially all foam, as there is no need to wear one. She is very self-conscious about it and wants to have breast implants.

I am concerned that with so little natural tissue that it would not look right, and she might be even more self-conscious.

Would breast implants look natural on a woman with little or no natural tissue, and if so, how much enhancement could she expect ? She is very thin with very tight skin.

Doctor Answers 41

Natural Looking Breast Augmentation Small Breasts - With Proper technique results can look very natural

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It is very common in my practice to perform a breast enhancement that changes the breast profile from an A cup to a B cup.  Take a look at my breast augmnetation gallery of more than 100 women. May of them start with very minimal breast tissue. I have an area specificallly about femail athletes. These women very often have very limited breast tissue.  They all can have a beautiful, natural looking result. 

I rarely have patients in my practice requesting large implants anymore.
Most women are opting for smaller, more realistic appearing breast augmentation. Professional women (including physicians!) want to look their best, but they don't want to look done.
Women with very small breasts and very little breast tissue can acheive a natural looking result provided a plastic surgeon with expertise in performing natural looking breast augmentation chooses uses an implant of the appropriate size in the ideal postion.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Natural breast augmentation

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Most women having breast augmentation fit the description of your fiance. There are some considerations:

1. Silicone implants in this situation will not only feel more natural they will look more natural because they have a softer consistency. The edges are less obvious than saline. Wrinkling occurs less often but it does still occur.

2. Submuscular place will increase soft tissue coverage and will give a more natural appearance as well.

3. Choose a conservative size implant. This is the most important point. This will give the most natural result. The most common mistake women make is choosing an implant that is too large. This will overstretch the skin and breast tissue. They will take longer to settle.

Ralph R. Garramone, MD
Fort Myers Plastic Surgeon
4.8 out of 5 stars 69 reviews

Breast implant sizing/type

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The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size. 
Much of the final “look” achieved after breast augmentation surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.

2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.

3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.

4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.

Under Muscle Breast Augmentation Best for Little Natural Breast Tissue

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Thank you for your question.

In patients with little natural breast tissue, usually thin patients, a big concern is that the Breast Implant can be visible since there is little tissue covering the Breast Implants.

Breast Augmentation in people with little natural breast tissue is best performed by placing the Breast Implant Under the Muscle. This is called a Submuscular or Subpectoral Breast Augmentation.

This adds muscle tissue covering the implant and will make the Breast Implant less visible after Breast Augmentation.

Breast augmentation for asian patients

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I use a technique called dimensional breast augmentation which involves taking in a number of factors and measurements, so each patient is unique. That being said, given your height, weight, and your activity level, along with the fact you are considering a lift, I would say you are probably not that far off in choosing an implant in that range. Best thing to do is to see a qualified plastic surgeon that has good breast expertise.

This technique has helped my Asian patients achieve beautiful, natural looking results. 

Breast Augmentation with Minimal Natural Breast Tissue?

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Ample breast tissue is not necessary for a breast to look natural after a breast augmentation. Even, men with zero breast tissue sometimes get implants and can look natural. Suggestions to achieve a natural appearance are:1 - choose aconservative size. It is much easier to create a natural looking breast when the patient has significant breast tissue. A larger implant will look like a mound on the chest, however, with minimal tissue. 2 - Use a silicone implant, which is less likely to show wrinkles, and it will feel more natural, 3 - Place the implant under the pectoralis muscle so that she has more tissue covering the implants. 4 - consult a plastic surgeon certified by the American Board of Plastic Surgery. Best of luck.

Breast implant visibiltiy in individual with minimal (small) breast tissue

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I know this is a crude example but it helps to make the point. If you hide a golf ball (implant) under a silk sheet (tissue), the appearance will be very ball-like. However, if you hide the baseball under a thick comforter, the thickness of the comforter will greatly influence the result. A very thick comforter may make the ball barely visible. The comforter will determine the overall appearance of the result. If you change the golf ball to a volley ball, it may appear more round.

In individuals with very little tissue ( thin athletic women with low body fat and an A cup breast), the breast implants may be more noticeable and will ultimately have a significant role in determining the appearance of the outcome.

In individuals with C or D cup breasts, the overall breast tissue and position of the gland will have a greater effect on the overall appearance of the final result

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast Augmentation Works Well for a Slender Small Breasted Woman

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You can expect excellent results!

Your concerns are very appropriate and should be expressed just as explicitly during consultation.

Of course, many women who seek augmentation fit the very description you've given.

With any surgery, there will be tradeoffs; it's important to know what these might be, before undergoing surgery. A frank discussion with the plastic surgeon should clarify reasonable expectations, and achievable goals to obtain a gratifying cosmetic improvement.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 45 reviews

Very thin patients get good results with implants but gel is preferred over saline.

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Patients with little breast tissue and subcutaneous fat will get nice results from breast implants but I feel that silicone gel is vastly superior to saline in this situation.  With silicone gel, I'm not convinced that going under the muscle is necessarily aesthetically better although I will get some argument from other plastic surgeons on that opinion.  As long as capsular contracture doesn't occur, you girl friend will be delighted with her results.

Dimensional selection of Implants is Critical

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In any patient, it is important that the desired outcome of surgery be frankly discussed in the context of the patient's starting anatomy and examination. This becomes more important the less natural breast tissue is available, as more of the resultant breast mound will be due to the implant.

As long as your friend's goals and the dimensions of her chest wall and breast diameter are not at odds (in other words, as long as she doesn't want breasts that are larger than what would look natural for her given her current body type), and as long as she is able to find an experienced surgeon sensitive to these issues, she should be able to look forward to a very nice outcome despite her lack of natural breast tissue.

In my practice, I like to point out to patients such as your friend that her anatomy and the existing soft tissues will often dictate the implant that will give the best result.

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.