Secondary Hybrid Breast Augmentation in a Slim Patient

2026.06.19

Before

After

Creating a More Natural Breast Contour After Previous Implant Augmentation
The patient featured in this case is a 163 cm, 47 kg female (BMI 17.7) with a very slim body frame.
She had previously undergone silicone breast augmentation at another clinic. However, she wished to achieve a smoother upper pole contour and a more natural breast appearance.
For this reason, she underwent a Secondary Hybrid Breast Augmentation at AVAN TOKYO.

The Challenge of Breast Augmentation in Slim Patients
For patients with a BMI below 18, obtaining sufficient donor fat can be challenging.
In these cases, success depends not on injecting a large volume of fat, but on:
● Where the fat is placed
● Which tissue layers are used
● How efficiently the harvested fat is utilized
Particularly important areas include:
● The décolletage
● Cleavage area
● Implant edges and transitions

Procedure Details
Liposuction Areas
Fat was harvested from:
● Circumferential upper arms
● Waist/flank area
Despite the limited fat reserves, approximately 400cc of purified fat was successfully collected.

Fat Grafting Volume
After centrifugation and processing:
● Right breast: 170cc
● Left breast: 130cc
were injected.

Injection Technique
To maximize fat survival and create a natural contour, the fat was distributed into multiple layers:
● Subcutaneous layer
● Intramuscular layer
● Subpectoral layer
At AVAN TOKYO, our goal is not simply to increase volume, but to improve both shape and long-term fat retention.

One-Month Follow-Up
At one month after surgery, the artificial appearance sometimes associated with breast implants had noticeably improved.
The transition from the upper chest to the breast mound appeared smoother and more natural.
Despite the limited donor fat available, a meaningful improvement in breast contour has already been achieved.

What Is Secondary Hybrid Breast Augmentation?
Secondary Hybrid Breast Augmentation combines existing breast implants with strategic fat grafting to improve contour, softness, and natural appearance.
This procedure is particularly suitable for patients who wish to:
✔ Improve décolletage fullness
✔ Enhance cleavage
✔ Reduce visible implant edges
✔ Create a softer and more natural breast shape

Patient Information
Height: 163 cm
Weight: 47 kg
BMI: 17.7
Procedures
● Circumferential Arm Liposuction
● Waist Liposuction
● Secondary Hybrid Breast Augmentation
Purified Fat Harvested
Approximately 400cc
Fat Grafting Volume
Right: 170cc
Left: 130cc
Follow-Up
1 Month Postoperative

Risks and Complications
Liposuction: Swelling, bruising, fibrosis, contour irregularities, pigmentation changes, sensory changes, scarring.
Fat Grafting: Infection, lumps, fat necrosis, calcification, asymmetry, fat absorption, scarring.
Breast Implants: Infection, capsular contracture, asymmetry, implant malposition, scarring.

Surgeon: Dr. Shin Moriwaki (Director, AVAN TOKYO Ginza Liposuction Clinic)