The actual breast implants sizes may have little to do with the postop appearance since other variables such as the existing tissue or amount of “coverage,” the chest and breast measurement, the innate shape of the breast, the areola position, and even the torso all have their impact.
Breast augmentation surgery for very small breasts has its challenges, although acknowledging the anatomical limits is one way to achieve impressive results.
First and foremost, small breasts have insufficient coverage that makes them prone to visible rippling and more palpability, as suggested by celebrity Los Angeles plastic surgery expert Dr. Tarick Smaili. To minimize such risks, he says that smaller implants are highly ideal for small-breasted women.
Smaller or conservative-sized implants are less likely to cause scalloping, rippling, and other telltale signs of surgery because the overlying skin and breast tissue is not overstretched, Dr. Smaili adds.
Aside from the actual size of implants, which is determined by cubic centimeter (cc), the leading plastic surgeon says their profile or forward projection, width, and base should also match the preoperative measurement of the breast and chest.
By acknowledging the anatomies and their limitations, Dr. Smaili says it would be easier to achieve natural results from breast augmentation or any type of body contouring surgery.
To further minimize the risk of unfavorable waviness and palpability, he highlights the importance of using submuscular, which is also referred to as subpectoral implant placement. The idea is to increase soft tissue coverage by positioning the upper half of the prosthesis beneath the pec muscle.
The opposite of submuscular is the subglandular in which the implants are placed above the muscle, only covered by the tissue and skin. For patients with sufficient coverage this could provide good results, but for small-breasted women and female body-builders this could spell trouble.
Aside from increasing soft tissue coverage, Dr. Smaili says the submuscular also provides more natural results by making the breasts appear more like a teardrop rather than too round (especially in the upper cleavage), which is a dead giveaway that an implant is underneath the skin.
Women with very small breasts are also generally advised to choose silicone implants whose cohesive filler material can make up for their lack of coverage. Saline implants, meanwhile, could make them susceptible to less natural results, too rounded appearance, more palpability, and rippling, Dr. Smaili warns.
But one downside of using silicone implants is the longer incision than saline implants (2 cm vs. 3.2-4 cm) because they are implanted “intact.” On the other hand, saline implants are only inflated with salt water solution once in position, so the resulting scars are shorter.
Nevertheless, the use of Keller Funnel technique in which a funnel-like device is used to propel silicone implants to their pocket is an effective way to reduce the length of incision by almost half, so the resulting scar is almost like that of a saline implant’s.