To the average person, this doesn’t seem to make sense, but it’s true. The ideal candidate for a breast augmentation is often a woman who doesn’t need one. As an experienced plastic surgeon, I’d like to offer my wisdom on one of the most popular plastic surgery procedures performed worldwide.
The breast augmentation procedure has proven reliable, the safety profile of breast implants is acceptable for many women and the results are gratifying, if not life altering in many positive ways. You would think that breast augmentation is best suited for women who have small breasts. Indeed, the vast majority of patients in my practice who seek out breast implants have particularly small breasts. They are tired of wearing padded bras and looking like a “boy” in comparison to their fuller breasted family and friends.
So then why is the ideal candidate for a breast augmentation a patient who does not have small breasts? The answer relates to the engineering principles of a breast implant in a soft tissue home. The more tissue you have relative to your breast implant, the more coverage you will have on top of the breast implant. This means you are less likely to feel the implant or the ripples and creases, which are not uncommon, particularly with the saline implants.
Intuitively, the larger your natural breasts are, the less volume you need from the breast implant to achieve your goals. A smaller breast implant means a better implant-to-tissue ratio as well as a lower likelihood of stretching the skin and causing sagging. With heavier implants, say above 350cc in volume, the surrounding tissue and skin will become thin and stretched. The ultimate goal is to choose the smallest breast implant that gets you “the look” that you seek.
Another benefit to starting off with larger breasts is that the end result will appear more natural. In general, silicone breast implants feel more natural than the saline variety. This difference is much less noticeable when a patient has a lot of natural breast tissue to begin with.
Women with small breasts are still often the strongest desire to undergo a breast augmentation. And even though the ideal candidate is a patient with more natural breast tissue, patients with small breasts do just fine with their augmentation as long as they choose a size that will work best with their anatomy.