Regular Silicone or Cohesive Gel Implants for Tuberous Breasts?

I am a 34A with a mild case of tuberous breast. I would like to get breast augmentation and become a 34C, however, I am having difficulty in deciding whether I should get regular silicone or the cohesive gel (gummy bear) breast implants. The only reason I am hesitating in getting the gummy bears is that they will feel firm and unnatural. Do you think I can get good results with a regular silicone implant?

Doctor Answers (15)

Treatment of tuberous breasts

+2

It is absolutely correct to focus on the surgeon performing the procedure, not the type of implant used.

The main components of a tuberous breast are a tight lower pole, puffy nipple-areolar complexes and breast drooping, and in many cases asymmetry.

All require a specific plan to fix. An implant alone will not, in my opinion, address all 4 of those problems. It may be a combination of breast lifts, implant placement, and modification of breast shape.

The repurcussions of nipple-areolar blood supply loss, multiple redo surgeries, etc. are serious indeed.

A detailed, specific, targeted plan along with considerable experience is necessary for addressing tuberous breasts and all the various forms of constricted lower pole shapes.


Beverly Hills Plastic Surgeon
5.0 out of 5 stars 98 reviews

Regular silicone vs gummy bear implants

+2

The main issue that will determine how you like your result is how well the correction of your tubular deformity goes. Not the kind of implant. So, you are focusing on the wrong issue here. Just go with the regular silicone gels and find a surgeon who has a lot of experience with tubular patients and can show you many photos of them where you like the result.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 51 reviews

Cohesive Silicone Gel Implants for Tuberous Breast Correction

+1
Currently, there is only one type of silicone breast implant, and that is the cohesive gel type (aka gummy bear). These implants mimic natural breast tissue in feel and are more palpable than saline implants. You can certainly achieve beautiful, natural looking results with these as long as you choose an experienced board certified plastic surgeon.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 69 reviews

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Regular silicone or cohesive gel implants for tuberous breasts?

+1
Hello!  Thank you for your question!   The standard procedure would be placement of an implant (or tissue expander, depending on the lower pole of your breast) as well as a circumareolar breast lift.  These modalities would correct the issues with tuberous breast: constricted breast at the inferior pole, via breast prosthetic; scoring of the tissue to release the bands; lowering the inframammary fold; correcting the herniation of breast tissue into the areolae; and decreasing the overall size of the areolae.  These are the hallmarks of tuberous breasts.  You could likely get great results with an implant and possible breast lift.  Implant type will be personal preference.  Discuss the various implants with your plastic surgeon.  I agree that silicone implants offer a softer and more natural appearance.  Without an examination, it is difficult to tell you which implant I would recommend for you.  However, both types of silicone implants are excellent.  

Consult with a plastic surgeon well-versed in breast surgery and discuss your goals and expectations.  S/he will then be able to examine and discuss the various options and assist you in deciding which decision os the right one for you, given your desires.  I would expect a very pleasing result for you!  Hope that this helps!  Best wishes for a wonderful result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Type of Breast Implants for Tuberous Breast

+1

In regards to tuberous ( constricted)  breasts, implants can be very helpful when used appropriately during the surgical procedure. At this time, the "Gummy Bear" implants are not FDA approved.  The cohesive silicone gel breast implants that are currently FDA approved, in my opinion, give a very nice result to patients with tuberous breasts.

In general, tuberous breasts have a very narrow base, short distance from areola to inframammary fold, tight (constricted) lower pole of the breasts, relatively wide space between the breasts, "puffy" and areola and some degree of ptosis (drooping). 

Generally, the procedure involves breast augmentation with areola reduction / mastopexy procedure. The distance from the inframammary fold is increased (to create a more rounded out appearance). Proper implant positioning improves the distance (cleavage) between the breasts. The areola reduction helps to treat the pointed and "puffy" appearance of the areola.
In the most severe cases of tuberous breast, a more complete breast lift may also be necessary.  In many cases however, a lift is not necessary. The patient should be aware that the final result will take months to see and that they will need to be patient and that revisionary surgery is more likely than in patients who do not present with tuberous (constricted) breasts.
Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 779 reviews

Form stable implants define a shape, gel implants enhance it.

+1

You bring up several important questions. Since "gummy bear" implants have a defined shape, does your breast match that shape or will it require a lift to create the look. Cohesive gel implants are firm. That is not necessarily a bad thing. It depends on he rest of your breast. Having used cohesive implants, I can say that they are very good but require preoperative planning to a greater degree than conventional gel implants. The big question here is whether you need a lift and to determine what degree of enlargement you want.

Peter D. Geldner, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 13 reviews

Good surgical technique is crucial to correct tuberous breast with breast implants

+1

Most important is the technique and skill of your surgeon for correcting a tuberous breast.

There are adhesive bands within the breast tissue that tighten and constrict the breast. These must be released if the implant is going to stretch and conform the overlying breast to a more natural shape.

In severe cases I use soft tissue expanders to stretch the breast into a natural shape.

Be sure to see an expert breast plastic surgeon.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 36 reviews

Regular cohesive gel implants for tuberous breasts

+1

THE key in your case is to shape the tight breast envelope which needs to spread out and nicely cover the underlying implants.

The so called gummy bear implants are not widely available and in my opinion are way over-hyped for the stiff "done" breasts they produce. I would definitely vote for regular cohesive gel implants.

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 63 reviews

All implant choices can work well to correct a tuberous breast

+1

A tuberous shape breast is fairly uncommon though we continue to receive many questions about the condition. The term is rather unfortunate and I wish we had a better one as the breast is not exactly the shape of a fleshy root. The typical shape includes tight skin, especially in the lower half of the breast, and the nipple and areola can protrude referred to as a 'herniation'. The breast otherwise works and feels as any other breast and will support breast feeding. The solution to improving the shape includes augmentation, repair of the prominent nipple, and sometimes fat grafts just under the skin to plump the subcutaneous layer between the skin and the actual breast gland. This should not be confused with fat injections in the breast itself which is not recommended.

In order to correct the nipple, there is usually and incision all around the nipple like a partial breast lift. When a saline or a small gel implant is used it will often fit through this incision and reduce the risk of visible scar on the breast. A form stable implant will work as well. The difficulty is that the stiffer implant will require a larger incision and this may mean a separate inframammary incision in order to get it in place, and the tuberous breast is unlikely to have a sufficient fold in which to hide the scar. All implants will work to add the volume that is needed and there is no clear advantage of one over another. It is probably best to be sure to apply a technique to correct the tuberous shape, and consider the implant that will match the correction needed the best. The type of implant is a secondary concern.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 30 reviews

Cohesive gel or silicone gel implants for tuberous deformity

+1

 To choose a cohesive gel implant over a traditional silicone gel implant for a tuberous breast deformity is really dependent upon your personal choices.  The tuberous breast deformity has to be treated with a number of different techniques. Your preference for the implant depends upon you.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.