What Causes Small Breasts? Surgical and Non Surgical Solutions

By Dr. Glenn Lyle, Board-Certified Plastic Surgeon, Raleigh, NC 

As a plastic surgeon  specialising in breast and body surgery , I’ve had countless conversations with women who feel self-conscious about having small breasts. For many, breast size is more than just an aesthetic concern—it’s deeply tied to confidence, femininity, and self-expression.  

If you’re struggling with this, I want you to know that you’re not alone, and there are solutions available to help you feel more comfortable with your breasts. Every woman deserves to feel confident and empowered in her body, and through modern advancements in cosmetic surgery, there are now more options than ever to achieve your desired look.

Why Some Women Have Small Breasts 

Breast size is primarily determined by genetics, but several other factors can play a role. Some women naturally have smaller breasts due to their family history, while others may experience a loss of volume over time. 

Genetics is the most significant factor influencing breast size. If the women in your family have smaller breasts, there’s a high likelihood that you will too. However, other biological and environmental factors come into play as well. Hormonal imbalances can impact breast development—particularly during puberty. If estrogen levels are lower than usual, breast growth may be stunted. Additionally, body fat percentage plays a crucial role. Since breasts are primarily composed of fatty tissue, women with naturally lean body types or those who engage in high-intensity exercise may notice a smaller bust. 

For some women, life events such as pregnancy and breastfeeding lead to changes in breast size. The body goes through hormonal fluctuations that can increase breast volume temporarily, but once breastfeeding ends, some experience a loss of fullness. Aging is another common factor—over time, the body produces less collagen and fat, or breast tissue get replaced by fat which can contribute to a reduction in breast size and firmness.

What Can You Do About Small Breasts? 

If you’re looking to enhance the size or shape of your breasts, there are various options available. The right solution depends on your desired results and level of commitment. Some women explore non-surgical options before considering surgery, while others choose breast augmentation for a more defined transformation.

Surgical Solutions for Breast Enhancement of Small Breasts 

Breast augmentation is one of the most effective ways to achieve a fuller, more proportionate appearance. In my practice, I customize every procedure to match the patient’s body type and aesthetic goals, ensuring that the results look and feel natural. Breast implants come in a variety of volumes and profiles to allow for the best fit for your chest. It involves precise measurements and a degree of artistic sense. 

- Breast Augmentation with Implants 

Implants are the most common option for women looking for a reliable and noticeable enhancement. Silicone implants provide a softer, more natural feel, while saline implants allow for small adjustments in size after placement. Many of my patients tell me after surgery: “I finally feel like my body matches the way I’ve always imagined myself.” 

- Fat Transfer Breast Augmentation 

For women who want a modest increase without implants, fat transfer offers a more natural approach. This technique involves removing fat from another part of the body—such as the abdomen or thighs—and injecting it into the breasts. It’s an excellent option for those who prefer subtle enhancements while also benefiting from body contouring. It is rare to go up more than a cup size. With 1/2 cup size more common. Overfilling can result in fat necrosis , oil cysts and excessive calcifications. 

- Breast Lift with Augmentation 

Women who have lost fullness due to aging or pregnancy may benefit from a breast lift combined with augmentation. This procedure not only enhances volume but also reshapes the breasts for a more youthful, lifted appearance. This procedure is indicated for patients with breast ptosis or drooping. Usually the nipple position has fallen to or below the inframammary fold. While augmentation alone may help with minor ptosis, mastopexy either with vertical incision or anchor incision with implants is often needed to lift the breast, narrow the shape and improve upper pole fullness. 

One of the most rewarding parts of my job is seeing the joy on a patient’s face after surgery. “I finally feel like myself again” is something I hear all the time from my patients.

Non-Surgical Options 

For those looking for subtle improvements, lifestyle changes such as strength training can create more upper body definition, giving the illusion of a fuller chest. While these exercises won’t physically increase breast tissue, they can enhance the overall appearance of the bust.  

Some women consider hormonal therapy if they suspect a hormonal imbalance is affecting their breast development, but this should only be pursued under medical supervision. Of course, an easy and immediate way to create the look of larger breasts is by using padded or push-up bras—though these are temporary solutions. 

External vacuum expansion devices such as BRAVA now called EVEBRA utilize external vacuum cups to stretch the breast tissue and in some cases increase breast size to a small degree. This device is often recommended for those wishing for more effective fat transfer as it prepares the breast to receive your own fat prior to surgery. 

Creams and Pills sold online promising breast enlargement are best avoided. 

While these methods may work for some, many of my patients express a desire for a lasting, natural enhancement. That’s where breast augmentation comes in.

Recommendations for Different Age Groups 

→  Younger Candidates (20s-30s) 

Young women often seek breast augmentation to enhance confidence and achieve better proportions. They tend to favor silicone implants for a natural look and feel. But saline implants still remain a good option - usually for those seeking smaller implants. Submuscular placement is usually recommended when using saline implants to minimize palpability. 

→  Middle Age  Candidates (40s-50s) 

Many women in this age group look for a way to restore lost volume post-pregnancy or due to aging. A combination of augmentation and a breast lift is often the best option but this entirely depends on nipple position and degree of ptosis. Many times, aging results in a condition called “ pseudo ptosis “ where the breast tissue sags but the nipple stays above the fold. In this situation, implants alone can “ lift” the breast. 

→  Mature Candidates (60s-70s) 

Breast augmentation in this age group is not as common but can be a safe and effective treatment. Fat transfer may be less effective as we age and also can lead to changes in mammograms. 

Before and After Photos – Seeing Real Transformations 

One of the best ways to understand the potential results of breast augmentation is by reviewing before-and-after photos  of real patients. I always tell my patients: “A picture is worth a thousand words. Seeing other women’s transformations can help you visualize what’s possible for you.” You can browse real patient results in my online gallery to see the incredible transformations we’ve achieved here in Raleigh. 

I also use the CRISALIX 3D imaging system which uses your own images and shows what you might look like with different size implants.

My Perspective on Breast Augmentation

Breast surgery is about more than just aesthetics—it’s about confidence, self-expression, and feeling comfortable in your body. My goal is to create results that look natural and complement your unique shape.

I believe in open, honest conversations. “My job isn’t to tell you what you should do—it’s to give you all the information and support you need to make the best decision for you.”

Preparing for Your Consultation with Dr Lyle 

If you’re thinking about breast enhancement, scheduling a consultation is the first step. We’ll discuss your goals, review your options, and determine the best approach for your unique body. 

It’s important to come prepared with questions. Some key topics to consider include the different types of implants, the recovery process, and any potential risks associated with the procedure. I also encourage patients to bring reference photos of the look they hope to achieve. Additionally, a thorough review of your medical history ensures that we choose the safest and most effective approach for you. 

Further Reading 

Explore additional resources and articles to help you understand more about breast augmentation.   

• Read Dr Glenn Lyle’s Blog on Beautifying the Chest--How Breast implants can have dramatic results.  
• Read Dr Glenn Lyle’s Blog on Can You Have a Breast Augmentation After age 50?  

About Dr Lyle - Plastic Surgeon in Raleigh NC 

Dr. Glenn Lyle is a board-certified plastic surgeon serving the Durham and Raleigh, NC community at Lyle Plastic Surgery & Aesthetics Center since 2002. With over 30 years of experience, he specializes in breast surgery and body contouring , including tummy tucks, to enhance patients' appearance after weight loss, pregnancy, and aging. 

Dr. Lyle completed his medical degree at Wayne State University School of Medicine, followed by a general surgery residency at the University of Massachusetts and a plastic surgery residency at the University of Texas Medical Branch. He is certified by the American Board of Plastic Surgery and is a member of both the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons. 

Throughout his career, Dr. Lyle has contributed to the field through research, publications, and presentations at national meetings. His practice emphasizes patient safety and personalized care to achieve natural results. 

Next Steps 

If you’re considering a breast augmentation in Raleigh, NC, and want personalized advice about your suitability, recovery, risks and results, I’d be happy to meet with you for a consultation. Let’s work together to help you achieve your best results—safely and beautifully. 

To book a consultation please fill in the contact form or phone the office.