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

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?

Doctor Answers 16

Fat Transfer Breast Augmentation?

It is possible to achieve a modest breast augmentation by autologous fat transfer but the procedure is subject to a number of limitations. First is the compliance or stretchability of your breast skin. This can limit how much fat is transferred at any one surgical procedure. If the surgeon tries to maximize the amoung of fat transferred, and attempts to keep adding fat after the envelope has become tight, then it will cause much of the transferred fat to die, resulting in a compromised result and unsatisfactory augmentation. For this reason, more than one fat transfer session is often required for patients to achieve even a modest augmentation. The alternative is to use the BRAVA breast expansion device, but this must be worn for several hours over a number of weeks and most patients find it impossible to comply with this regimen.

The second problem is having sufficient donor site to provide enough fat to graft to achieve a modest increase in breast size. If fat is over aggressively harvested it can result in irregularity or a deformity of the donor area. This is usually not a good tradeoff. So as a practical matter, autologous fat transfer breast augmentation does not work well for many women. Despite this, the procedure is still heavily promoted by some surgeons. You should carefully review a number of before and after photos of a surgeon's results before committing to this approach.

Alternatively you can consider augmentation with a new generation highly cohesive silicone gel implant. The gel implants are much softer, although if your tissues are extremely thin it is possible that you may still slightly feel the implant through your tissues. The key to a natural result in someone with very thin tissues is to use a teardrop shaped or anatomic implant. When a person has very thin tissues a round implant will look like a round ball on your chest. A teardrop shaped implant has a gradual slope off your chest wall and will look natural even in someone with thin tissues. I use these implants frequently and the results are very pleasing. I have referenced a few videos on the procedure.

Kirkland Plastic Surgeon
4.8 out of 5 stars 52 reviews

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

First of all, yes it is easy to correct the nipple shape. Fat graft may be all you need but an exam is required to determine if you have enough fat in your tummy and hips and thighs to make it worth while. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

How to see the best results

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.

Ricardo A. Meade, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 119 reviews

Fat grafting for a very slender woman?

I've been doing fat transfer for several years now and think it is a terrific procedure for ladies who want just a little increase in size and who have good donor areas for the fat.  From your photos, I would be challenged to "find" enough fat in you to make fat transfer worthwhile.  You do not want to end up with divots and contour deformities in the area of the fat harvest. 

Implants don't have to look fake even in slender women like you.  A small low profile gel would likely give you a nice result.

You should get the opinion of a surgeon who does a lot of implants and fat transfers.  He/she will be able to examine you and your potential donor sites and also help with selection of implants appropriate for your build and your goals if fat transfer is not an option.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 72 reviews

Natural Breast Augmentation

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. 

Justin Yovino, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 91 reviews

You do have options

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.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

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

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!

Dallas Buchanan, MD
Spokane Plastic Surgeon
5.0 out of 5 stars 30 reviews

Thin woman with very little breast tissues, fat transfer vs implant augmentation to get a B cup?

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.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 reviews

Breast Augmentation in Thin Women

You are not alone when you ask this question as it is a pretty common concern. While many women really want natural feeling breast and thus gravitate to fat grafting, they do not understand that it takes a lot of fat to get even a single cup size change and that fat grafting for breast augmentation is not without its problems including oil cysts and calcifications that can be problematic for future breast cancer screening.

The natural feeling gummy bear breast implants may be a better alternative to consider. These implants have a better safety profile than the older generations of breast implants and give very nice results. Just make sure you do your research before making any decisions.

I have added a video on these implants as well as a web reference for you.

I hope that helps.

Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 62 reviews

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

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.

Austin Hayes, MD
Portland Plastic Surgeon
5.0 out of 5 stars 32 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.