We present a method for nonsurgical breast enlargement using a vacuum tissue expander and describe the first so-treated patient in Germany. The patient wore a brassiere-like system that applied a mild (average 20.4 mm Hg) vacuum distraction force to each breast for 10.6 hours/ day over a 10-week period. An increase of 5 cm chest circumference at the nipple level from 85 cm to 90 cm was measured at the end of the therapy. At 3 months follow-up visit, after resorption of the therapy-induced edema, there was still a gain of 4 cm resulting in a 89 cm chest circumference as well as natural attractive breast shape. Side effects included the brief occurrence of irritant contact dermatitis and folliculitis during therapy. The supposed mechanism is analogous to other tissue expansion methods, where tissue growth is a response to continuous controlled mechanical forces. This nonsurgical and non-invasive alternative for breast enlargement appears effective and well-tolerated. Because the only relevant side effects involve the skin, dermatologists are well-suited to perform the treatment.