Thin women with very little breast tissue, 5"5, 106lbs, fat transfer breast augmentation or implant to get a B cup? (photo)

Question

My breast become completely flat after nursing two children, I always wanted to do fat transfer so I can have some natural breast like a B cup(never want to go big!), but not sure do I have enough fat to be grafted. If I choose a 200cc implant, i am still concerned that I will get a really fake looking because I don't have enough breast tissue to cover the implant, And I am afraid I can feel the edges of the implant easily when I touch them. Also, can my saggy/droopy nipples be fixed?

Asif Pirani, MD, FRCS(C) · Answer

There is no way to guarantee a particular bra size. Bra sizing varies greatly between bra manufacturers and a C in one bra will be a D in another. What matters more than the assigned bra size is the way the implant looks on you. The best option for your body and aesthetic goals can be determined in a thorough implant sizing session.Implant sizing depends on several factors. One of the most important factors is your breast width. Generally, your surgeon will measure your breast width, and then provide you with a range of implant sizes appropriate for your native breast size. There are more nuances to it than just what I've described, but this approach works for most women.I usually have my patients bring in a large bra and a tight t-shirt to do sizing. I'll then choose 3-4 implants that I feel are appropriate, and have my patients place them in the bra under the tight t-shirt. My patients can then look in the mirror and get a good sense of what they will look like with the provided implant sizes. My patients like this approach and get a great idea of how they will look.By using this technique, your surgeon can outline a range of appropriate implant sizes that will be aesthetically pleasing, and you make the final decision.I hope this helps. Good luck!
The foregoing information provided is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only.You assume full responsibility for how you choose to use this information.Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition.

Ricardo A. Meade, MD · Answer

I
suggest that you schedule a consultation with a board-certified plastic surgeon
to fully discuss and learn about your options. A plastic surgeon will consider
the width of your natural breasts at the base and the amount of tissue to
recommend the implant material and size that may work well for you. Adding
volume to your breasts may help restore your nipples to a better position and
shape.

Justin Yovino, MD, FACS · Answer

I perform fat transfer to the breasts a lot and you will likely acheive about a 1/2 cup increase in size with fat transfer. You may achieve more than a cup increase if you undergo two or more sessions of fat transfer. On a different note, If you're concerned about coverage over an implant, then performing fat transfer and then placing an implant is an option. It can also be performed at the same time. Hope this helps.

Dallas Buchanan, MD · Answer

Thank you for your questions and picture. This is a very common question in women with thin frames and very little fat tissue. While there is some success with fat grafting for breast augmentation, it can be unpredictable, costly, and require multiple surgeries to get the desired result. With a breast implant, the results are much more predictable and usually more cost effective. I think that based on your pictures, you could have a good result from a breast augmentation. You should have a consutlation with multiple local baord certified plastic surgeons and get some differing opinions. Only then can you make the choice that is right for you.Best of luck!

George Marosan, MD · Answer

Thank you for your question and photo. Based on this single two dimensional photo it is impossible to evaluate how much fat one can obtain for transfer and estimate the cup size. An implant placement can guarantee  a certain volume, but fat grafting cannot. Placement of any kind of implant, shaped or round will give you the same result, contrary to what some surgeons promote on this forum. I just came back from the ASAPS's (American Society for Aesthetic Plastic Surgery)annual meeting in Las Vegas. In the breast surgery panel, it turns out that less than 10% of surgeons use shaped implants in their practices and 75% of the attendees could not differentiate between shaped vs round implants in the pictures. Only 25% guessed it correctly! In your case, I would suggest a small round low profile implant with fat grafting at the same time, mainly at the inferior and lateral borders of the breasts for better implant coverage. See a board certified plastic surgeon for an in person consultation/evaluation.Good luck.

Austin Hayes, MD · Answer

It's a good question. I don't think that you would have enough fat to give you a B cup breast augmentation. Fat transfer to the breasts is best for patients whose number one goal is to have liposuction, but also wouldn't mind a subtle increase in their breast size.Given the fact that you have little shape to your natural breasts. You may consider anatomic implants. These implants are filled with silicone gel and are shaped like a teardrop. They provide volume AND shape to the breast. They give a more natural appearance with less fullness in the upper pole (top of the breast).You could consider a nipple reduction. The surgery can make a long nipple (papule) shorter.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

The size of implant best for you is dictated by your
chest wall measurements.  Once we determine that we can choose the profile
based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.

Anatomic gummy bear implants under the muscle would be good choice for you.

These highly-sought-after, anatomic
implants offer a look that more closely resembles the natural silhouette of a
breast, and, therefore, are a very attractive option for individuals seeking a
natural-looking, aesthetic primary breast augmentation. Additionally, these
implants are an especially excellent option for patients undergoing restorative
or corrective breast surgery because they provide more stability, shape, and
reduced incidence of capsular contracture. Compared to other types of silicone gel
implants, the silicone in the cohesive gel implant is more cross-linked;
therefore, should the implant shell “rupture,” it maintains its shape and
silicone does not leak.

During your breast augmentation
consultation, you should feel the different types of implants available, and
try on various implant sizers in front of a mirror to help you to get an idea
of how you will look following the surgery. You should also bring pictures of
the look you would like to achieve, as well as a favorite top to wear when
trying on implant sizers.In my office
we also use the VECTRA system.  It takes photos of you from different
angles to create a 3D image. It leaves you with a 3D image of your breasts you
can see from angles you have never seen before. I have found it incredibly
useful for my patients when discussing breast augmentation.  What I
love about the VECTRA is how it helps my patients. It helps YOU see your
breasts. Really see your breasts. Photos can be unforgiving, and a 3D photo
really shows it like it is.

VOLUME:  Is one breast larger than
the other? This has 2 different ways of looking at volume, which takes into
account ribcage and position differences.

WIDTH: Is one breast wider? Is your
chest ribcage asymmetric?

CLEAVAGE:  What is the natural
spacing between your breasts? Cleavage is an area many of my patient really
want to improve and fill when they do an implant. For sure implants help this
area, but there are natural differences in the cleavage spacing which we can’t
control. Vectra does an analysis of this to show where your natural breast
ends.

IMF:  Our fancy doctor term for the
bottom of the breast fold is the inframammary fold. The IMF is where your
underwire would go, i.e. where your breast starts from. Turns out our breasts
don’t usually start at the exact same place. This difference in position can
make the breasts look different and affect nipple position.

NIPPLE POSITION: This one tends to be
more noticeable. Where are your nipples? Are they even?The best way
to assess and give true advice would be an in-person exam.

Please see a
board-certified plastic surgeon that specializes in aesthetic and restorative
breast surgery.Best of luck!

Dr. Schwartz

Board
Certified Plastic Surgeon

Director-Beverly
Hills Breast and Body Institute

#RealSelf100Surgeon

Steven J. Rottman, MD, FACS · Answer

Thank you for your excellent question. Based on the photo provided, it does not appear that you have enough fat available to transfer to the breast. However, you appear to be an excellent candidate for breast augmentation. I would suggest a shaped implant to avoid the "fake" look. Please see a board certified plastic surgeon who specializes in cosmetic breast surgery for an in-person examination. Hope this helps.

Gregory Baum, MD · Answer

Based on the photo you provided, I don't think you would have enough donor fat to make the breast size you desire. 200cc implants are small implants and thus will not give you that "fake" look. I would recommend using smooth, round silicone implants as they are softer than the anatomical, silicone gel implants. Although the smooth, round implants can give you a more "fake" look, this is usually not that noticeable in the smaller implant sizes such as you are looking at. I have had some thin patients regret getting the anatomical, silicone gel implants because they can feel the edges of the implants due to their stiffness. Best wishes.

Curtis Wong, MD · Answer

and both scenarios would work for you.  If you go the fat grafting route, consider getting the BRAVA system to help expand your tissue and improve your graft take.  The highly cohesive gel implants aren't supposed to ripple if your body heals around it as designed.  So see a board certified plastic surgeon to find out what will work best for you.

Thin women with very little breast tissue, 5"5, 106lbs, fat transfer breast augmentation or implant to get a B cup? (photo)

Answers (16)

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