Right Breast Implants for Average Built with Small Breast Size?

I'm about an average sized 19 year old female (140 lbs) with a barely 32AA chest. I am wanting to get Breast implants in the next year but I have no idea what implant type to go with that will look the most natural. I am so worried that because of how small I am at top, my implants will look fake. I don't need anything large I just want something there for me to work with. What is the best implant for me to use and should it be placed under or above the muscle?

Doctor Answers 8

Very Small Breasts Before Augmentation

You are wise to have concerns about looking natural after surgery.  A very young woman with limited breast tissue can have a beautiful and natural result from breast augmentation surgery.  However, there are limitations with regard to the size and shape of the implant. Placement is also important. We all have seen even very small breast implants appear unnatural because the implant size or shape was not ideal, or the implant placement wasn't ideal. So often, small breast implants are too high or too far apart. Larger implants come with many, many problems.

By using biodimensional planning principals, your plastic surgeon can help you find the ideal breast implants for you. Be sure to view many many before and after photos to determine that the plastic surgeon you choose a) has considerable experience in the surgical enhancement of very small breasts and b) shares your aesthetic sensibilities  

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 120 reviews

Sizing breast implants


Sizing really depends upon what you have in the way of tissue to cover things and your breast measurements. I would go under the muscle. Implant type is debatable. Silicone gel feels more natural, but has a higher chance of encapsulating (getting hard) over the long term. Most of my patients go with saline unless they want quite large results.

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 27 reviews

Breast Implant Sizing

This is not something that you can choose. You need to have a consulation with a board certified plastic surgeon to go over the details with you and discuss your options. The surgeon will then make a recommendation based on the desires that you put forth.
Take your time finding a plastic surgeon, make sure that they are board certified and that they show the ASPS logo.
Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 78 reviews


 The questions you pose are all very good. That is why you have a consultation with a doctor.  Volumes and shapes of implants are discussed so that the right choice is made with you.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Implant choice

Being only 19 years old means, unless you have a congenital deformity that allows use of silicone implants as a reconstructive device, you can only get saline implants. It is difficult to get saline implants to look and feel very natural when your tissue coverage is lacking. First of all, if you move your breasts around gently on your chest, you should be able to see the outline of your natural breast, however small they are. The most natural implant will be a low profile implant whose diameter is no greater than the diameter of your natural breast. This will translate into a certain volume depending on the manufacturer. From this, you can gauge what size increase you will get. If it is not large enough to satisfy you, you will need to go wider and/or higher profile implant. Each increase in profile and width will produce a more and more unnatural result. You will need to decide with your surgeon at what point to compromise naturalness for size. Placing the implant under the muscle, although not a natural place since the breast normally lives above the muscle, will allow for less show of the implant. Implant surgery is a series of decision based on compromises and trade-offs.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

I recommend using disposable breast implant SIZERS during surgery.


You can certainly have a natural looking breast augmentation with rather small breast implants under the muscle. Make sure your surgeon understands exactly what you want.

Then, we use disposable sizers during surgery to see which is the best size for you. This is done before opening the permanent implants, and it takes the guess work out.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Smooth round breast implants

In my experience a simple smooth round implant provides the best outcome in most cases. The teardrop or anatomic implants have other associated problems and I feel they provide no real benefit in most cases.

Submuscular placement is typically preffered as it tends to keep the implant surface smoother with less apparent ripples. Likewise movement of the muscle over the implant provides an internal "massage" and may minimize capsular contracture.

Gel or saline implants would be the next choice and each have their own merits. Gel perhaps the more natural in patients with a minimum of overlying tissue. The decision best made after physical exam and discussion of cost, follow up, potential for ripples, etc.

Hope this helps!

Michael A. Marschall, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 9 reviews

Implant choice

Just because you are small chested does not mean you have to go with a large implant at the time of your augmentation. Breast implants come a many sizes and diameters. As a matter of fact, a smaller implant will have a more natural appearance and feel in someone your age and cup size. Your surgeon would most likely choose a saline implant for you because you are under 22 years old. (You are not entitled to have silicone implants unless you have a breast condition that can be interpreted as a need for a reconstructive augmentation as opposed to a cosmetic one). The placement of your implants should be under the muscle since you have little soft tissue coverage in the form of breast tissue to hide the implant.

See a board certified plastic surgeon in your area. I am sure they will assist you in making all the right choices.

Leslie H. Stevens, MD
Beverly Hills Plastic Surgeon
4.2 out of 5 stars 10 reviews

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.