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Breast Lift for Tuberous Breasts

I have been diagnosed with tuberous breasts and it was recommended I get a lift on one side, because one of my nipples hangs lower than the other. Like most ladies with this condition, when it's cold, my tuberous breasts actually look normal and my nipples actually even out. Would I have the opposite problem after getting a lift done? What would happen when I'm cold?

Doctor Answers (18)

Tuberous or Tubular Breasts

+4

Tubular breast is a condition where one or both breasts do not develop normally or completely, remaining narrow at the base and projecting in a conical or tubular fashion from the chest wall. Tubular breasts are usually somewhat small and droopy, and they tend to have overly projecting or bulging areolas. The inframammary folds are generally higher than normal, and the breasts often appear to be unnaturally far apart on the chest wall. The condition is thought to result from an early restriction of normal breast development at the time of puberty, and is present to some degree in as many as 3 to 5 per cent of patients seeking breast augmentation.

Most of the patients that I have treated for tubular breasts have described how uncomfortable and self-conscious they have always been about their breast appearance, and how it has affected all aspects of their life. Many have not known in advance of the consultation appointment that their breast problem actually has a name, and that the problem is in reality a fairly common one. The correction of tubular breasts is deeply rewarding as a plastic surgeon, as patients report that their lives are truly transformed by their improved (and more ‘normal’) breast appearance.

The appearance of tubular breasts can in most cases be dramatically enhanced, but it is very important to understand that the surgery is not as simple as merely adding a breast implant. The surgical procedure often involves elements of a breast reduction, a breast lift, and a breast augmentation – all in a single operation.

Most patients with tubular breast have severe underdevelopment of the lower pole of the breast, and the surgeon must essentially ‘create’ a lower pole by expanding the existing tissues in such a way that those tissues will accept the volume of a breast implant in a manner that appears natural. It is thus critical that patients with tubular breasts be evaluated and treated by a board-certified plastic surgeon with experience in correcting this complex abnormality, as failure to address all of the abnormalities that contribute to the tubular breast appearance will result in a poor surgical outcome and an even unhappier patient.

The surgical techniques I use to improve tubular breasts include reduction of the prominent areola, elevation of the areola to a more superior position on the breast mound, lowering of the inframammary fold, and radial and circumferential scoring of the constricted breast tissue in order to allow it to expand and accommodate the additional volume of a breast implant. In many cases the breasts are asymmetrical and this issue must also be addressed. The surgical techniques used for each individual patient are carefully selected based on preoperative evaluation.

Because so many complex issues must be addressed when correcting tubular breasts, the surgery takes longer than routine breast augmentation, and as one might expect there is a higher need for surgical revisions. However, with careful attention to detail and highly individualized surgical treatment many patients can achieve an aesthetically desirable breast appearance in a single operation.


Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 38 reviews

Augmentation and mastopexy procedures can correct a tuberous breast

+4

A tuberous breast is a not so nice term applied to a breast in which the nipple and areolar skin are prominent and "herniated" forward on the breast. The breast skin is relatively tight around the areola and the base diameter of the breast is also often tight and constricted. Indeed, when the nipple responds to cold the areola can tighten and the herniation resolve as the nipple becomes taught. The tuber reference was made to the tuberous root shape comparison to the breast, again a not so nice comparison.

The tuberous breast is normal in every other way, normal sensation and arousal, normal breast feeding. The degree of the shape constriction will vary, and often the breasts are asymmetric.

Both breast lift techniques and breast augmentation techniques can soften the differences in the breast shape and greatly improve the cosmetic appearance. Mastopexy can reduce the nipple herniation and adjust the nipple height and size. A well chosen breast implant can expand the constriction in the breast and also greatly improve the appearance.

The correction of a tuberous breast may require more experience than breast lift, or augmentation. Also there is no reason to operate on both breasts, unless of course the plan for correction dictates so. I hope you will be very careful as you select a surgeon, as one experienced in this condition will give the best advice. As we recommend start with a surgeon certified by the American Board of Plastic Surgery, and two opinions may help you understand options.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 28 reviews

Tuberous Breast Correction

+2

Great improvement can be achieved with plastic surgery of a tuberous breast.

The surgery is challenging and very individualized, because each person's situation is so unique, but the results can be tremendously gratifying.

Getting the two breasts to look like each other (symmetry) is one of the most important parts of the surgery.

The surgery should not effect the nipple response to cold, but correcting the position and shape of the nipple and the breast behind it should provide better symmetry, whether your breast is warm or cold!

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 12 reviews

Tuberous breasts are the hardest starting point for augmentations and lifts

+2

If you have tuberous breasts, they are the most challenging starting point for augmentation mastopexy surgery. Done by an experienced plastic surgeon, you should have a nice improvement, not perfect though, because of the starting point. I can't answer the rest of your question regarding the nipples but can say that I have never heard a patient complain about this after surgery. Good luck!

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

Breast lift for tuberous breasts

+1
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.  

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.  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

Tuberous Breast Surgery

+1

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.

Discuss your specific concerns with your surgeon and they will most likely put your mind at ease re: your concerns.
Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 710 reviews

Tuberous breast Correction?

+1

A true tuberous breast correction procedure can be quite difficult and challenging for a surgeon. The breast has a constricted base with a protruding nipple and most often has a small amount of breast volume. This varies from patient to patient and requires a variety of procedures from a small radial release with breast augmentation and/or release or reduction of the areolar. Sometimes this will also require a staged surgery to be done over two sessions with or without tissue expanders. It varies widely depending on the patient and the extent of the deformity.  

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 15 reviews

Breast lift to correct tuberous breast deformity

+1

There are several aspects to a tuberous breast, and different degrees of the deformity. Appropriate technique selection depends on an accurate physical examination and diagnosis of the parts of the breast that need to be corrected. Breast lift using a periareolar incision will allow repositioning of the nipple to correct asymmetry.

Olivia Hutchinson, MD
New York Plastic Surgeon
5.0 out of 5 stars 5 reviews

Tuberous breast deformity surgery

+1

There are several aesthetic problems to be dealt with in the tuberous breast patient.

1. the base of the breast is narrow and constricted vertically and horizontally

2. the breasts are often spaced far apart

3. the areola are often dilated

4. there is usually significant asymmetry between the breasts

Correction requires breaking the breast down internally and distributing it over an implant using some specialized implantation techniques (Dual Plane etc), lowering the infra-mammary fold, disrupting the fibrous constricting bands that narrow the breast, and reducing and lifting the areolar position.

As you can see, there are a lot of 'moving parts' in this operation. Seek out a board certified plastic surgeon that has treated other tuberous breast patients.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.5 out of 5 stars 34 reviews

Breast surgery for tuberous breasts

+1

 

Patients with tuberous breasts have many surgical options. Often, patients with this condition have small constricted breasts at the base and a conical appearance to the breast. Many times this affects the size and position of the areola as well. This surgery can be one of the most challenging surgeries in aesthetic breast surgery. For this reason, ensure that your plastic surgeon is a board-certified plastic surgeon who is a great deal of experience not only with breast surgery but specifically treating tuberous breasts. In our practice, many of our patients with tuberous breasts not only need a breast lift but implants at the same setting. This allows us to create an appropriate width of the base of the breast and then perform a breast lift to drape the remaining breast tissue around this new employment. Also keep in mind that it is difficult to determine exactly how your breasts will heal after the surgery. For this reason, it may be necessary to do a small revision surgery at a later date to get your ultimate result

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 65 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.