I'm 20 and I believe I have tuberous breasts, I don't want huge breasts, just less conical and more filled out at the base. I also have Von Willebrand's Disease, it is a bruising and bleeding disorder similar to Hemophilia, since breast augmentation on tuberous breasts requires more work, would this procedure be too dangerous for me? Does it typically cost more to do this type of surgery? What are my options.
Would Breast Augmentation Be Worth It if I Just Want a More Natural, Less Tuberous Shape to my Breasts?
Doctor Answers (15)
Implants for tuberous breast
Your breast are not truly tuberous breast, but there is some "herniation" of the breast tissue into the areolar causing some puffiness, which you may find unattractive. A small implant may help make this appear more proportionate, but generally implants make the breast look the same but just larger. However, with an excision of a ring of areolar at the outer edge of the areolar would make a areolar smaller, flatter, and a substantial improvement in the appearance, and the scars are usually minimally noticeable. This could early be done in combination with insertion of implants.
Tuberous breast repair
The amount of risk in correctly repairing tubular breasts vs normal breasts is not different. Tuberous breast repairs are commonly scar ridden flat and unnatural looking. The good news is that I have developed a specific technique to create natural appearing breasts with hidden scars for this type of breast shape. The procedure involves a special subfascial placement of silicone implants and a special nipple lift and areolar reduction with a hidden scar. The results are very natural appearing.
All the best,
Rian A. Maercks M.D.
Correcting your deformity involves surgery similar to placing an implant and performing a circumareolar breast lift. I have done this surgery and many others on Von Willebrand's patients with the involvement of a hematologist. Proper dosing and timing of DDAVP should make this surgery safe for you but I would consult with your hematologist first.
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Fixing Tuberous Breasts
There are a lot of answers to this question already, but I though I would try to answer in a really easy to understand way. Your breasts are not too bad when it comes to tuberous breasts. Usually tuberous breasts are narrow and long. They can be a little saggy as well. The areola on a tuberous breast sometimes sticks out. In your case, you have small breasts that are not really narrow nor do they hang down. You do have puffy areolae which plastic surgeons would call, "herniated". In your case, you would likely do well with a breast augmentation but may need to have something done to make the areolae look better. Sometimes tightening the areolae can make a BIG difference in how good the result looks. This would involve a thin subtle scar around the edge of your areola.
As for your Von Willebrand's Disease, you can still have the surgery very safely. It would be a good idea to coordinate with your hematologist because there are some things that might help right before surgery.
I hope this info helps!
Your degree of tuberous breast is minimal.Obviously your von willebrands disease needs to be addressed as to what type you have.I would think the best thing to do we be to see a hematologist to determine how an augmenattion could be done safely but I think they could be done at the same time.
Cosmetic surgery and bleeding disorders
If you're factor VIII clotting factor is increased by injection to 80% or more of normal and maintained at that level for a week or 2 after surgery your risk for surgery is no different than anyone who does not have a bleeding disorder. It should be a non-issue with the input of a hematologist.
The question is what do to get a symmetric result you are happy with. Unfortunately your posted photos are not helpful because there appears to be some asymmetry with the left breast larger than the right and the folds under the breasts at different levels. The limited bracketing of the photos and the possibility of distortion by raising your arms makes it hard to assess your current condition.
You need to see a plastic surgery face to face and make sure the asymmetries are identified with their correction planned for before you proceed with any type of surgery.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
An augmentation through an armpit incision is a procedure we have commonly performed in a variety of degrees of tuberous (constricted) breasts. From your photos, you have some slight herniation of the areola and excellent shape and dimension to your breast mound. A submuscular augmentation should yield a very pretty result.
Tubular breast deformity and correction.
I would agree that you have a form of tuberous breast deformity based on your photos. To correct this deformity, the fold is lowered, the gland is released from the areola, and often an implant is placed to balance the symmetry with the often unaffected or less affected contralateral breast. Placing an implant does not have to mean "huge breasts." The operation is not as straightforward as an augmentation, and in some instances is covered by insurance. As for the Von Willebrand's disease, the necessity for platelet transfusion during surgery depends upon the type and severity of Von Willebrand's disease (qualitative/quantitative, etc.). Your hematologist should work with your surgeon to advise on whether transfusion is necessary. The surgery is not considered dangerous, but be aware that corrective surgeries for tuberous breast often need revisions.
I have no problem recommending a breast augmentation for the tuberous breast deformity as shown in the pictures. I would need to speak to your hematologist regarding the exact severity of your coagulation problem before recommending the procedure to you specifically.
All the best,
Talmage J. Raine MD FACS
Correction of tuberous breast deformity
Correction of your tuberous breasts is usually best served through a periareolar approach, using either a dual-plane (my preference - implants are placed above and below the muscule in different regions of the breast) or a subglandular augmentation approach. A total submuscular approach will usually not allow enough breast tissue expansion and relaxation to produce the natural lower breast folds that are attractive to patients. In addition, the use of subglandular breast relaxing incisions can further assist in providing the expansion thats necessary. Some women feel it's necessary to reduce the size of the areolas. A consultation with your hematologist and surgeon will allow you to become more knowledgable about the risks and benefits, and depending upon the type (3 types) of von willebrand's disease, preoperative treatment can be performed. Lastly, I've found that most women with tuberous breasts need an implant size that's a little larger than expected to fill out and create a more natural, round appearance.
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.