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Background: Breast augmentation can be successfully done in any female regardless if their body size or weight. But the body frame and habits of the patient does play a role in some of the finer details of the aesthetic outcome.

It is no surprise that in very thin female that they frequently have little to no breast tissue. There is some correlation between body weight and breast size for many women even if is not a direct linear relationship. With virtually no visible breast mound a surgically created one by implants is always going to appear a bit ‘unnatural’. Meaning that it would be a body mismatch to have a very thin body frame and larger breast mounds.

But most women can accept that body mismatch when considering breast augmentation surgery and approach it by trying to have a ‘body appropriate’ implant size. While that size estimate is open to personal interpretation, most women would view that as a small to moderate size implant.

But implant size is not the only consideration to consider in breast augmentation in the very thin female.

Case Study:  This young very thin female (5’ 4”. 104 bs, A cup) presented for breast augmentation. She opted for saline implant placed through a high transaxillary incisional approach.

Under general anesthesia 325cc moderate profile saline breast implants were placed through a 3 cm ling axillary incisions. The implant fill volume was 375ccs per side.

Her aesthetic result showed a breast size that most would consider a C cup. Due to her thin body frame the outline of the breast mounds was visible as well as some rippling in the outer pole of the enlarged breast mounds.

If possible very thin females should have silicone implants to lessen the risks of inferolateral implant rippling that can occur despite a partial submuscular or dual plane position. The aesthetic issues of implant visibility, edge transition and rippling, would be ever further magnified in the subglandular or above the muscle position.

Case Highlights:

1) Very thin females with little breast tissue can be successfully augmented with implants.

2) But they are very prone to implant ‘reveal’ with visible edging and ripping if saline implants are used.

3) A partial submuscular position with silicone implants is the best aesthetic approach to the very thin female breast augmentation patient.

Dr. Barry Eppley

Indianapolis, Indiana

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