Small-volume breast augmentation: A natural and subtle enhancement

There's no doubt that breast augmentation still reigns as one of the top cosmetic procedures offered around the world. Yet, even with its steady state of popularity, the perspective around the desired outcome has shifted in recent years. Specifically, we've seen a shift from dramatic, noticeable volume increases towards more natural, understated-looking enhancements. Enter the small-volume breast augmentation.

An emerging approach to breast augmentation focuses on proportion, subtlety and individual body harmony rather than simply prioritizing size. The trend of small-volume breast augmentation can be attributed to a wide variety of factors, from changing beauty standards to a focus on fitness-oriented lifestyles and beyond. Many patients are opting for smaller implants or fat grafting techniques that add just enough volume to improve shape, symmetry or fullness, without making a bold statement.

To learn more about the growing popularity of small-volume breast augmentation and the ways in which it can be achieved, we reached out to ASPS Member Surgeons Lara Devgan, MD, and Karen Horton, MD, MSc, FACS.

The booming popularity of small-volume breast augmentation

Breast augmentation is, without a doubt, one of the most popular plastic surgery procedures, and small-volume breast augmentation is quickly becoming a favorite. But what is considered "small volume"?

"This is really just semantics," said Dr. Horton. "Small volume, in my mind, would be any volume less than 400 cc, since that is the median breast volume that is commercially available to most women. My patients have usually gone for volumes ranging from 220 cc to 375 cc over the last 20 years, which would fit this category!"

Several factors have contributed to the growing popularity of this type of procedure.

"In recent years, I have seen a notable shift toward smaller-volume breast augmentations in my practice," said Dr. Devgan. "Patients are increasingly seeking refined, proportionate enhancements that align with their natural anatomy and active lifestyles. This aesthetic shift mirrors a broader cultural movement toward subtle, elegant beauty over conspicuous transformation."

Current trends point toward small-volume breast augmentation growing in popularity, but this trend is not new for plastic surgeons.

"I have always attracted patients who are specifically looking for a more natural-looking result to their breast augmentation, as this is my personal preference and I 'walk the walk,' as I've had a subtle breast augmentation myself," said Dr. Horton. "However, over the last five years or so, I have certainly seen more women who might previously shy away from considering breast implants consider surgery now, since they have learned that you don't have to look fake or obvious to others."

Ideal candidates are patients looking for a natural fullness in the top part of the breast and a natural "teardrop" shape. Plus, they are healthy enough to have surgery.

Small-volume breast augmentation techniques

There are several approaches that a surgeon can take to achieve small-volume breast augmentation.

"My approach always begins with listening," said Dr. Devgan. "I assess the patient's goals, anatomy and lifestyle, then develop a tailored surgical plan. Key techniques include precise pocket dissection, placement under the muscle (dual plane) and selecting implants with appropriate width and projection. For some, fat grafting offers an even more natural look. The art lies in enhancing what is already beautiful without overwhelming it."

Implants are often still used for small-volume breast augmentation, but fat grafting is another alternative that can provide a subtle enhancement.

"For patients seeking the softest, most natural results, autologous fat grafting is a popular alternative, often harvested from the flanks or abdomen," said Dr. Devgan.

Patients can be assured that results will be subtle and natural.

"I reassure patients that without a bra, no one will know they have breast augmentation," said Dr. Horton. "They can wear a push-up bra to enhance their results in certain outfits, but results should be proportional to their frame and match their particular personal aesthetic."

These results are consistent and long-lasting, but may require some retouching or replacement implants in later years.

"Implants – especially modern cohesive silicone implants – offer long-term durability, typically lasting 10 to 15 years or more with proper care," said Dr. Devgan. "Fat grafting is permanent to the extent that the grafted fat survives, though resorption of 30 to 50 percent is common within the first six months. Long-term outcomes with fat tend to look and feel extremely natural, but may require touch-ups. Ultimately, both methods can offer stable, lasting results in the right candidate."

Tips for small-volume breast augmentation

As with any other surgical procedure, there are key steps that patients can take to set themselves up for success with a small-volume breast augmentation procedure.

One of the most important steps to ensure you achieve the results you're dreaming of is to gather reference images to show your surgeon what you want.

"Collect 'wish pictures' to best illustrate to your surgeon the look, shape, size and overall proportion you are going for," said Dr. Horton. "Find pictures of women who look like you."

Another tip is to ask surgeons to see before and after photos.

"Scour your prospective surgeons' websites to ensure they have other patients with the type of results you are going for," said Dr. Horton. "Ask to speak to other patients with similar aesthetic goals."

We may all be accustomed to the mindset of "bigger is better," but it's not a hard and fast rule when it comes to aesthetics.

"Small-volume breast augmentation represents a sophisticated evolution in aesthetic surgery," said Dr. Devgan. "It embodies the principle that less can be more – when done with intention, precision and artistry. As surgeons, we are not just enlarging breasts; we are restoring confidence, elegance and proportion in a way that enhances identity rather than reshapes it."

Whether patients are on the hunt for a soft enhancement following pregnancy, better symmetry or simply a refined silhouette, small-volume breast augmentation offers a thoughtful, modern solution. Options range from modest implants to fat transfer techniques. A board-certified plastic surgeon can deliver results that truly align with your goals, proving that sometimes less really is more.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.