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Background: Many may perceive that breast augmentation is about getting bigger breasts  but for many women is merely about getting back to what they once had. Usually due to pregnancies and breast feeding, a woman’s actual breast volume will almost always become less through a normal biologic phenomenon known as involution. This may not be so evident after one pregnancy but becomes more manifest with two or more pregnancies.

Besides fat injections, saline or silicone gel breast implants are the only surgical method to restore lost breast volume. What size implant a women desires is a personal choice and many women will end up picking an implant size that is bigger than they were before having children. If one is going to have surgery and incur costs and recovery one might as well be better than how one was originally made.

But this is is not true for all postpartum women undergoing breast augmentation. Some women may only want to get back what they had lost. An implant can do that well provided that the soft tissue envelope of the breast is not overly stretched and sagging. If some sagging exists more breast volume than desired may be needed to fill it out adequately.

Case Study: This 28 year-old female presented for breast augmentation. She has her last and final child six months ago. She opted for a silicone implant to get the most natural feel given her nearly complete lack of any breast tissue.

small breast augmentation result front viewsmall breast augmentation result oblique viewUnder general anesthesia, she had 270cc silicone gel breast implants placed in a dual plane position from inframammary incisions. They were of moderate profile with a base width of 11.5cms. While she had a bit of breast skin sag beforehand her nipples remained largely above the lower breast creases.

small breast augmentation result side viewBreast augmentation can be modest and can be done to just fill out the deflated breast envelope. This can also create a bit of a ‘breast lift’ with the volume expansion. This is not a true breast lift per se as it is just lifting up the nipple through restoration of previous breast volume.

Highlights:

1) Breast augmentation for many women is only about restoring lost breast volume, not necessarily being bigger than they originally were.

2) Small breasts that have lost volume from pregnancies only need a small breast implant, often below 300cc.

3) As long as there is no ptosis (sagging) and the nipple is above the inframammary fold a small breast implant will adequately restore breast volume.

Dr. Barry Eppley

Indianapolis, Indiana

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