Can I achieve a nice slope and voluptuous results when starting with small and flat breasts? (photo)

Question

30 years old, fair, 5’ 7”, 125 lbs, small 34A. Are voluptuous results possible for someone with a chest like mine? I have so little breast tissue, and it’s spread so far out, that I worry any implant will look overly round even going under the muscle. My chest and shoulders are also more broad than a lot of the before and after shots that catch my eye, so I’m afraid my goal is just not possible for someone with my physique. Could you offer any insight into my options and how close I can get?

Daniel Barrett, MD · Answer

Dear LHG1993,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Finny George, MD · Answer

Hi, thank you for sharing your question. You will be able to achieve your desired results with implants but if your concern is whether they will look natural, you may require some fat grafting to create your ideal shape.

Chet Mays, MD · Answer

Thank you for your inquiry!  We would love to sit down with you to discuss your concerns.  Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals!

Tyler Frew, MD · Answer

Hi there,
Post some photos of the results you are looking for and we can help better.
In general, yes you can achieve the results you want. You will not look overly round or fake if you go under the muscles and choose the implant based off your specific breast and chest wall measurements. This will be discussed with you at your consult.
IF you want very larger breasts you may have to get there in two surgeries. The first surgery with a more modest implant size, which will stretch the skin and shape the breasts, then a few months to years later do a remove and replace to a larger size. 
It really depends on how large you are talking however. You don't want to put an overly large implant in for your first time as the amount of stretch your body has to undergo can be unpredictable and lead to asymmetry or bottoming out. 
So it is certainly possible for you however may take two surgeries to get there. Be sure to take photos to your consult of what you are looking for
All the best

Gianfranco Frojo, MD · Answer

I would go see a board certified plastic surgeon (American Board of Plastic Surgery) with preoperative 3D simulation capabilities (Vectra, Crisalix, etc) to be able to show you the outcome.

Brian K. Reedy, MD · Answer

Thanks for your question! This is a tricky one to answer based on the photo you provided. I would love to see a picture straight on and perhaps some wish pics. Keep in mind that a lot of women with very large breast implants didn't get there with one surgery. Good luck!

Warren Schutte, MD · Answer

Hi, it is very realistic to expect nice results with a breast augmentation given your body habitus. Maybe stay away from the ultra-high projected implants for a more natural look. I would encourage you to take time and try on breast implant sizers at your surgeon's office so you can confidently decide what cc volume you are comfortable with.

Ram Kalus, MD, FACS · Answer

Thank you for your question and photos. As you undoubtedly know, a precise treatment plan or specific implant recommendation can only be determined with a careful examination and detailed discussion with your plastic surgeon. Volume (300 versus 400), is far less significant than implant width and projection. Implant width is similar to shoe size. The implant literally needs to fit into your breast and chest. A 350 Moderate Plus may well “fit” your breast, but the volume and projection are what will determine the “look” you want, similar to the style or type of shoe you would select. It is true that for a given volume a high profile implant will have a narrower diameter, and it is also true that a person such as you with a petite frame will require a narrower diameter implant than a patient with a broader chest or larger frame.  Other considerations such as saline versus silicone are also important, as are "round" versus "anatomical" or "form stable" or "shaped", smooth surface versus textured, and softer versus firmer with the different levels of gel cohesivity.

The term “natural” or “”voluptuous” can mean different things to different people and the profile of the implant does not necessarily determine that. As a rule, the larger the implant and the higher the profile, and certainly if the implant is positioned too high, the greater the chances you will look “augmented” because of exaggerated upper pole fullness or convexity.

In my practice, besides a thorough interview process and physical examination with careful measurements, we use on lay sizers within an unpadded bra to help you understand what you are likely to look like in a bra, bathing suit, or T-shirt with a given size implant. In addition, and this is critical, we ask all of our patients to provide us with photos of their desired final look, with images of women’s breasts that most closely resemble the look they are trying to achieve. This serves as a visual guide that thankfully rarely leads us astray. The most common reason for patient disappointment after breast augmentation is size-too big or not big enough. This algorithm which we have been employing for over thirty years has proven to be very successful.

Because all of these factors can leave you quite confused, it is crucial that you select an experienced board certified plastic surgeon whose aesthetics align with your own, and with whom you feel comfortable. Don't be reluctant to seek a second or even third opinion if necessary to be sure and feel confident about moving forward with scheduling surgery. Expressing your desired cup size is notoriously inaccurate, and final breast size is the most common reason for patient disappointment after breast augmentation, either too big or not big enough.

Take your time, do your research. Best of luck to you.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, if interested. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Hilton Becker, MD · Answer

You may want to consider fat grafting the thicken th breast tissue together with small breast implants

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