is small breast: When the size of breast in girls is less than
desired by girls, they feel it to be small. The ideal breast size is 36
How Normal Breast develops: All girls have same size of breast tissue in childhood. At the time of puberty i.e. beginning of genital development female hormone estradiol, adrenal hormone androstenidione, 17-oh Progesterone, DHEAS, Growth hormone, LH, FSH, increases & SHBG
decreases, Thyroid Hormone also plays the role. These hormones then act on the various sensors (called receptors) in the breast tissue. After the interaction of hormones & receptors certain changes occurs in the functioning of cells of breast tissue so that breast cells starts growing in thickness & size & more & more fat starts depositing in the breast . thus breast size gradually starts increasing. Simultaneously it also increases the blood supply to breast tissue leading to more availability of growth factors to the breast tissue resulting in faster growth of breast tissue. These hormones & growth factors are in high concentration during peak of
sexual development i.e. puberty leading to persistent stimulation of breast tissue for next two to three years i.e. up to completion of genital development. Thus in normal girls in two to three years full breast develop.
of Small Breast: In girls the small breast can be due to following causes:
1) Female hormones deficiency i.e. estradiol in body due to many of the below mentioned causes as leading to absence of estrogen production (hypogonadotropic hypogonadism). Craniopharyngioma.
2) Second cause for small breast is resistance of breast tissue to normal level of female hormone in the body. So that even though female hormone is normal in the body, but the breast tissue of these girls do not have sufficient receptors for female hormone leading to insufficient estrogen action meaning that female hormone is unable to work & breast do not grow well. But when female hormone level is further increased by female hormone replacement treatment & certain more medicines are given so that female hormones becomes more effective on breast, then breast tissue starts growing. Breast size then fully normalizes in six months to one-year time.
3) Growth factor deficiency
4) Zinc Deficiency
5) Estrogen biosynthetic defects
6) Congenital adrenal hyperplasia
7) Congenital absence of breast bud
8) Lipoatrophy generalized
9) DSD : Disorder of Sexual Differentiation
10) Absence of estrogen receptors in breast tissue
12) Growth hormone deficiency due to hypopituiarism, pituitary disorders
12) DRUGS: Cytotoxic Agents, Cyclophoamide, Vincristine,Ionising radiation, Azathioprine
14) Structural Defects Of body fat cell so that they do not grow
15) Generalized hypoplastic syndrome
16) Dysmorphic Syndrome
17) Hyper Androgenism : High Androgen due to various causes leads to small
Investigations & Diagnosis:
For diagnosis of cause of absent or small breast we do following tests.
Complete hormone profile: LH, FSH, total testosterone, Prolactin, Androstenidione, SHBG, 17 HYDROXYPROGESTERONE, DHEAS, Estradiol, Progesterone
Suppression & Stimulation Tests,
Pro. Challenge test
High Resolution Ultrasound
E2 CHALLENGE TEST
Diagnostic Therapeutic Response Test
Options for Breast Enlargement
Before starting treatment for enlargement
of breast all above causes are investigated and proper diagnosis is made.
Then we test whether breast enlargement is possible or not.
First We Test Whether Breast Enlargement Is Possible Or Not†
After above investigation we
make the decision about whether breast enlargement possible or not. We
prescribe the hormone treatment only if the above investigations suggest
for the scope of further breast enlargement.
Diagnostic & Therapeutic Response Test
This procedure is required in some
patient, if above test still does not clarifies of the possibility of
breast enlargement. For this hormone & other treatment is given for
three month in the form of female hormone tablet, local hormone
application at breast skin, or vaginal gels & additional other
therapy. If breast enlarges in size i.e. it grows in size by more than 2
cm in these three months, it means breast of that patient has potential
for further growth. Once it is decided by above test that breast has
potential for further growth, in such patient further courses of hormone
therapy is given. By few courses of hormone treatment breast enlarges to
normal size in approximately one year time. By this therapy breast size as
well its consistency in firmness also increases. Thus breast becomes large
in size, more attractive & develops firm protruding look. This breast
enlargement treatment is very effective in those patientís in whom
investigations & physical examination shows significant abnormality.
Thus most patients achieve fully normal breast. As breast size increases
in size patient's confidence increases and feeling of well-being is
How this treatment
When we give below-mentioned hormones by
any of the below-mentioned routes. The concentration of these hormones in
blood circulation rises. This leads to binding of more hormones on
estrogen receptors of breast. After binding with receptors these hormones
leads to certain changes in the breast tissue. This leads to
multiplication of breast tissue leading to further growth. This continued
multiplication of breast tissue leads to further breast growth. This
continued multiplication of breast tissue under the effect of above
mentioned hormone treatment continues till breast size normalizes. Usually
in one-year time breast size as well as texture i.e. firmness normalizes.
Unluckily most doctors have less knowledge about hormone treatment for
this problem & also they think the problem of small breast as more of
cosmetic problem so that they neither investigate the patient nor give
hormone or other medical therapy for breast growth.
Various therapeutic options of breast enlargement are available as:
This treatment can be either:
Hormone & Other Medicine Therapy: available as pills, hormonal
skin patches or vaginal creams & other adjuvant drugs are prescribed
Surgical therapy: Breast enlargement surgeries
Medicine Treatment of Small Breast
start medical treatment only when above tests shows that breast has
capacity to enlarge. It is given in the form replacement of female
hormones & other hormone as growth hormone & growth factor
replacement. These hormones can be given in the form of oral tablets, skin
patches, ointments, gel or creams.
As this treatment has no side effects, is economical and easy to take
either as oral tablets, skin patches, or as gel, thus it is most preferred
form of breast enlargement therapy.
The various Treatment options are:
Treatment of specific disease: Once the cause for absent or small breast is found by above tests then treatment started. Abnormalities of the pituitary and abnormalities in the adrenal glands can be treated by appropriate medicines. Normally patient starts getting improvement in breast size in three to six months.
The various drugs which are required are as follows:
1) Female hormones replacement: The replacement of female hormones is one of
the common treatments for breast enlargement. The various female hormones are as follows:
b) Conjugated equine estrogen
d) Natural estrogens
f) Estrogen skin patches
g) Estrogen vaginal creams
i) Oral E & P Combination Pill
2) Growths Hormones Therapy: Growth hormone is given when
somatotropin deficiency is found & that was cause of small breast..
3) IGF-1 therapy: is given when somatomedin-c deficiency is
5) Gonadotropin therapy is also very effective in breast
enlargement in many patient.
6) Gonadotropin releasing hormone therapy is effective in many
cases of under developed breast.
7) Medicine to increase the fat in breast tissue & body.
But unluckily many doctors do not take the problem seriously leading to
patient not given proper treatment. Thus many patients remain having small
size of breast & associated lifelong inferiority complex.
of Medical Treatment:
In properly selected patient, when any of
above treatment is started the response is very good & has no side
effects. In many scientific studies when the above treatment started
breast size increases from
previous size of hardly visible breast to as big as 36 inches & in
some even larger size of 38 or 40 inches. Thus the trial of treatment
should be given to all patients with small breast before asking them to go
for surgery. It has no side effects if given in proper disease and
in-patients when it is really indicated.
Breast Enlargement Surgery
is required when medicine are not effective then there are various
surgical procedures which can lead long lasting good size firm breast. Our
Cosmetic surgeon performs all breast increasing surgery.
I Kajal Tiwari ( name
changed) age 22 year unmarried girl was having very small breast. I was
having normal menstrual cycle still my size was small.
Interestingly my sisters & mother have good size breast. I was depressed
for it. I took lot of herbal & ayurvedic treatment for last three years ,
still there was no response. Luckily one day I came to know about Dr. B.
K. Roy, Hormone centre Delhi . I took one year hormone therapy as
prescribed by him for one year MY breast SIZE HAS INCREASED by four
inches. The drug was in the form of one hormone tablet & one local
hormone gel. These medicines I bought from market my self & they were not
very costly also & no side effect. Now I am quiet relaxed, confident &
still continuing the treatment & expecting further improvement.
Thank you dr roy for helping me
I Rakhi ( name changed) from Uttar
Pradesh was unable to have sex after marriage due to severe pain
during penetration of penis. I had developed so much phobia of pain
that even imagination of sex used to make me switch off.
One day we reached to hormone centre
Dr B.K . ROY after seeing his website. He diagnosed it as vaginal
spasm then prescribed some medicine & sex therapy. After two months
treatment we are able to have normal sex. Now we both are happy.
Rakhi & Vinod
My name Sheela ( not real name) 21 years I took two year hormone
therapy for my small breast size from Dr. K. Roy hormone centre
delhi. My size has increased from 30 inches to now 34 inches.
Now I feel much confident in
interacting with friends. Previously I was fed up with wearing
padded braw. I was unable to go to swimming pool due to this
complex. To my surprise treatment was not costly also.
I wish I had taken treatment earlier
so that those suffering could have been avoided.
Finally after one month of medicine & sex therapy exercises which we
performed under guidance of dr b k roy I got orgasm during sex for
the first time 12 year after
marriage.Now for last one month I am getting regular orgasm.
Previously I used to engaze in vaginal sex & other sexual activity
foe husband satisfaction. It was a kind
of routine activity for me because I never felt the peak of sex
enjoyment. Now once I am getting the orgasm then I am realizing how
much fun I have missed in last 12
years. Now my desire for sex has also increased.
I am very thankful to dr b k roy for diagnosing & curing my dry
vagina problem. I noticed this problem of dry vagina on very first
night after marriage which continued
on honeymoon too. Due to this dry vagina I was unable to enjoy the
intercourse. Even my sex desire had decreased. Some times I used to
get pain during sex. On
vestigation I was detected that I have , hormone problem &
associated psychological fear of sex. For this he prescribed me
hormone therapy, sex counseling & sex
therapies. After three months of treatment now I am fully cured.
Thank you dr roy for the help
Your patient (I do not want to write my name)
Thanks to you dr roy, by your medical treatment & home exercises
advised by u , now I am able to reach peak enjoyment many times
during intercourse last month. I never thought I'll be ever able to
enjoy my sex life ever. But after your advice my sex life & husband
wife relationship has drastically improved. Now I get orgasm in more
than 50% time intercourse.
Surbhi (name changed
I was not getting any enjoyment during sex with my husband. So much
so that my sex desire had gone very low. this has led to our
disturbed husband wife relationship.
Then we met dr b k roy at hormone centre delhi. On investigation it
was found that one of my sex hormone was disturbed. I took six
months treatment which cured my
hormone problem & also I started enjoying sexual activity .now my
sex life is absolutely normal.
Sunita ( name changed)