We give a complete solution to the extremal topological combinatorial problem of finding the minimum number of tiles needed to construct a polyomino with holes. We denote this number by and we analyze structural properties of polyominoes with holes and tiles, characterizing their efficiency by a topological isoperimetric inequality that relates minimum perimeter, the area of the holes, and the structure of the dual graph of a polyomino. For the values of were originally computed by Tomas Olivera e Silva in 2015, and for the sequence by Kahle and R\‘oldan-Roa in 2019, who also showed that asymptotically . Here we also prove that the polyominoes constructed by Kahle and R\‘oldan-Roa with holes and tiles are in fact unique up to isometry with these fixed parameters; that is, having the minimal number of tiles for holes.