Introduction These days women are all about happiness in one’s own skin. Sometimes, if you dare to say you are not happy with the way your body or just a part of it looks, you are immediately shamed for thinking such a thing. Yes, you need to be happy with who you are, but if you are not happy, then why force yourself otherwise? Think of this: you may be thin and consider yourself sexy enough, but you might still feel uncomfortable wearing tight clothes without padding your bra. If you suffer from small breasts, you have a condition called breast hypoplasia. Thankfully, modern medicine has given us a way to make this issue go away and, for those who do not feel well or confident because of this, a solution for being happier. This is through breast augmentation surgery. When you decide to have this elective plastic surgery, you need to plan very carefully ahead and make some important choices. Apart from choosing an experienced, certified, and good surgeon to perform the procedure, you will then have to decide upon a myriad of things. During this process you will not be alone in it, because a good doctor will always accompany you in decision-making and make sure you choose not only what you want, but also what suits you. Size matters The first thing you need to decide is the size you want. Having such a small chest, you will probably want to go as big as possible, but you need to have reasonable expectations. There is no way a small purse can fit a big wallet, so there is no way an AA cup can transform into an E. First it is anatomically impossible, and then it will probably look strange on you and pretty fake. Your surgeon will take your measurements: tissue elasticity, chest width, natural breast tissue, weight, height, etc. All these data will show him or her the best implant size to fit your shape and form. You will also find sizers in his or her office, like implants put inside a special bra to give you a physical image of what you will look with a specific size or shape of the implant. Some practices will also have 3D imaging software that will show you an even precise image of you with a specific size. You need to be flexible in your decision and accept the surgeon’s advice in terms of size. If you insist on getting a bigger size, then it is possible you might be in for some serious complications and risks. Your tissue (skin) is not able to sustain twice or even thrice the weight. The skin will sag, you will get droopy breasts, the implant could ripple, etc. Women with small breasts have very little glandular tissue, so they will not be able to go over 1 cup. A smaller implant will also be safe for your health, and it will make you get a more natural look. Women with small breasts are usually also thin, so a fuller chest might look a little off, not to mention it may also cause back problems. Implants also have profile, apart from size. Profile refers to the forward projection of the implant, i.e. the amount of cleavage. There are high-profile implants that are usually recommended for women with small breasts and a small chest. Low-profile implants are recommended for those with small breasts, but with a wider chest. Saline or silicone Implants can be of many types, but the most used ones are saline and silicone implants. They are both made from an outer shell of silicone, but the saline one is filled with sterile saline water, and the silicone one is filled with a cohesive silicone gel. Plastic surgeons usually recommend the silicone implant for those who have small breasts. Saline implants tend to look fuller since water is liquid, and you will not be able to achieve a very natural look especially if you are naturally a small size. Also, saline implants tend to ripple, like waves of water showing under your skin. If you have little natural breast tissue, then these ripples will show; maybe not always, but surely when you bend over or lean. Silicone implants are made from a cohesive silicone. They do not ripple, and they will give you a more natural look and feel since they have the consistency of a natural breast. Furthermore, silicone implants are known to last longer than saline ones. Saline implants are prone to rupture 5 years from the surgery, while silicone ones can last as long as 20 years. They are usually recommended for 10 to 15 years, but they can last much more. Because you are a person with small breasts, you will probably want to have implants that last as long as possible. The only downside of silicone implants is that their rupture might be a silent one, and the incision to insert them is a bit bigger than in the case of saline ones. Since saline implants are filled with water, you will notice immediately when they break, because water will soon spread over your body and the breast will deflate. Being a cohesive substance, silicone might take a very long while until you notice something is wrong, and silicone is not a very healthy substance to float in your body. Yet, opinions are now divided on this matter since some medics say the silicone used in today’s implants are very safe and will not pose any threats to the health of the patients. Incision During your surgery, the doctor will need to make an incision and then create a pocket inside your breast to accommodate the implant. The incision he or she makes is usually made in any of these three sites: armpit (transaxillary), around the areola (periareolar), or in the fold beneath the breast between the chest and the breast (inframammary). The size of your natural breasts is not an influence on the place of the incision. The type of implant and your specific demands have an impact on this. Saline implants are usually inserted through a transaxillary incision. The reason is that a saline implant comes as a deflated silicone shell that is inserted in the pocket created and only then filled up with saline solution, so it needs a smaller incision. Doctors prefer the inframammary location since they have a better view of the surgical site and they can better manipulate the implant to position it. Above or under the muscle Another important aspect of your procedure is the placement of the implant. There are two main places where your surgeon might choose to make the pocket: between the glandular tissue and pectoralis muscle (above or below the muscle). In the first case, the surgeon will separate the breast tissue from the muscle and create a pocket there before inserting the implant. In the second case, he or she will pull up the glandular tissue together with the muscle from the chest and make a pocket there. The below muscle placement is recommended for women who have little natural breast tissue because this tissue, together with the muscle, will be able to accommodate the implant better. This type of placement is always preferred in the case of saline implants because it is said to prevent rippling. Many doctors also recommend this particular placement because it is more effective in protecting the implant and avoiding rupture. In this placement, there are two layers that protect the implant: the breast tissue and the muscle, compared to the above the muscle placement where you only have glandular tissue. If you are an athletic person that does a lot of exercises, then you might consider an above the muscle placement because your muscle will be tighter than normal, so you might get into other complications like the double bubble, which is when the muscle separates from the implants and goes down, and the implant goes up. There is one more thing you need to be aware of and is particularly important for those who have naturally small breasts: you will not see the desired results immediately after the surgery. It takes up to six months and sometimes even a year for the implants to settle (drop and fluff as they say), and for you to finally have that beautiful cleavage you have always dreamed of. Conclusion No matter what people think or tell you, the first thing you need to be confident about is your own judgement. So if you feel that your breasts are small and you really think changing them will make a difference for you, then you just need to do it.