I am 24 and been researching about breast augmentation and best methods for a constricted inferior pole. I recently went to my first consultation (and have another planned) and the Dr. said that i have a constricted pole with 3 and 3.5cm, He said my breast tissue was very good and dense and would recommended a subglandular position for the implant. My goal with surgery is to achieve a fullness in the bottom. Would subglandular be the best option? I have heard that periareolar insertion helps
Are my Breasts a Severe Case of a Tuberous Breast?
Doctor Answers (9)
Breast augmentation for tuberous morphology
From the one photo provided, you do not appear to have a severe case of tuberous breasts and one may argue you do not have tuberous breasts at all. An examination would be necessary to confirm this since you would need to be examined from different angles. I would recommend you gat about 2-3 consultations from board certified plastic surgeons for their opinions as to what approach and options would be best for you.
It's difficult to fully advise you from the photo you provided. A good lateral (from the side) photograph is really needed. From the front you don't really look like you have a tuberous deformity at all.
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Not tuberous, quite common breast shape
I agree with Dr. Laverson and Dr. Rand that what you have is a short length between the nipple and the inframmary crease which in extreme cases amounts to a constriction of the lower pole of the breast. The way to understand this from the standpoint of a properly positioned breast implant is that for a round implant to be centered behind the nipple-areola, the distance from the medial edge of the breast to the nipple (or areola edge) should be the same as the distance from the nipple (or areola edge) to the inframammary crease. This sometimes means the inframammary crease has to be lowered and the lower pole expanded so that the implant volume can fill it out properly.
There are other reasons why an inframammary crease incision is best but particularly in this situation for control of the inframmary crease level, the incision needs to be in the new location for the crease. Nearly all implants should be sub-pectoral for a variety of reasons but a dual plane release of the edge of the pectoralis in the lower pole is necessary to allow the lower pole to fill out and not be restricted (double-bubble deformity).
No peri-areolar or other lift is necessary and I would condemn the use of a periareolar incision for many reasons besides the one I mentioned.
Correcting tuberous breast
Based on the photo you provided, it is difficult to determine if you are a good candidate. A side view of the breasts would be helpful. I recommend placing the implants under the muscle through a periareolar incision. Placing implants submuscularly, allows for more support and prevents capsular contracture. I recommend consulting with a board certified plastic surgeon.
On this site, I do my best to give advice without a physical examination but I want you to know that a physical examination by a board certified physician is always the best way to get the most accurate information.
Not a tuberous breast and not severe either
What you have is a short length from the crease to the bottom edge of the areola, not a tuberous deformity. The symmetry you have also makes this not a severe problem to deal with. The implants would be placed submuscular in my practice with a periareolar lift.
Augmentation for a very normal breast
Your breast is very normal is shape and form and your should be a very good candidate for breast implants. We suggest a submuscular breast augmentation, and we like the periareolar approach very much. Your breast is not at all tuberous, and an addition consult in you area would be a good idea.
Best of luck,
Your case is not severe as you have a lower pole. In the worst cases there is no pole to be seen. A small lift of the nipples might be in order. It is hard to tell without examining you.
John Di Saia MD
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