Hybrid Breast Augmentation (Motiva Mini 220cc + Fat Grafting) with Full-Circumference Upper Arm and Accessory Breast Liposuction | 11 Months Post-Op, 25-Year-Old Woman2026.09.06
This is a case of a 25-year-old woman who underwent hybrid breast augmentation (silicone implant + fat grafting) together with liposuction of the full circumference of the upper arms and the axillary (accessory) breast area, shown at 11 months after surgery. She consulted us because she has a slim build with little breast volume, and because she was concerned about the thickness running from the upper arms to the shoulders and the underarm area. Her wishes were to balance the whole upper body, and to add height to the bust within a natural range rather than a size that would not suit her frame.
A Motiva Mini 220cc implant was selected and placed in the subglandular plane through a small incision in the armpit (axilla). The Mini type has a profile that limits forward projection, so it does not add excessive width or height on a slim frame and makes it easier to create a gentle slope, which matched her wishes. The implant creates the underlying volume, and a thin layer of fat is laid over it to smooth the transition from the décolletage to the curve of the breast.
Fat was harvested from the areas she was concerned about: the full circumference of the upper arms (the underside, shoulders and front) and the accessory breast area. After the tissue was infiltrated with tumescent anaesthetic solution, fat was aspirated while changing the depth and direction of the cannula, and 360 ml was collected in total. After centrifugation (200 rpm for 1 minute) to remove oil, water and anaesthetic solution, 172 ml was injected into the subcutaneous layer in thin layers, 80 ml on the right and 92 ml on the left. The difference between the two sides reflects the original asymmetry and was adjusted during surgery while checking the shape.
The operation took about 1 hour and 40 minutes, and a compression garment was worn afterwards. The liposuction areas tend to feel firm and tight for about 1 to 3 months, and the bust also needs several months for the swelling to settle and the grafted fat to integrate. At 11 months after surgery, the line from the décolletage to the curve of the breast connects smoothly, and volume has been added within a range that does not become excessive for her slim frame. The upper arms show less fullness from the base of the arm to the shoulder, and the width of the upper body with the arms lowered, as well as the line from the underarm to the bust, are more balanced.
Even for people with a slim build who can only harvest a limited amount of fat, combining liposuction of the areas of concern with breast augmentation makes it possible to use the fat efficiently while balancing the upper body at the same time. On the other hand, there are risks such as variation in the survival rate of the grafted fat, lumps and calcification, and capsular contracture on the implant side, and the result and the time needed for recovery vary from person to person. The same result cannot be promised for everyone, so if any symptom concerns you, please consult your treating doctor rather than judging on your own. Please confirm whether the procedure is suitable for you, and which technique is appropriate, at an examination and consultation.
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Medical supervision: Shin Moriwaki, MD
Member, Japan Society of Aesthetic Surgery (JSAS) / Member, American Academy of Aesthetic Medicine
ECFMG certificate
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