In my 30's, no children, have 32B/34A clearly asymmetrical breasts. Are my Breasts Tuberous?
Doctor Answers (19)
Triangular Shaped Breasts Are Not Tuberous
Thank you for your question. You do not have tuberous breasts or tubular breast deformity. Your breast are what I call "triangular in shape" and you do, as you point out have significant asymmetry.
In my experience a lift to correct the ptosis or sag of the left breast and placement of bilateral breast implants should correct your asymmetry and fill out the breasts. In addition the implant will improve the shape of both breasts and fill out the lack of fullness on the right side near the center of your chest.
Be sure to consult a plastic surgeon who is certified by the American Board of Plastic Surgery and very experienced in cosmetic breast surgery. Not all plastic surgeons aren't comfortable treating triangular-shaped breasts.
Breast asymmetry with tuberous shape needs internal reshaping.
1) Implants are not the key step to correct your clearly tuberous breasts. You should have moderate size implants (round, smooth walled, moderate plus profile, silicone implants OVER the muscle, larger on the right) but they are only to make you a little larger and to correct asymmetry.
2) The critical (and somewhat difficult) steps for you are: increasing the distance between the nipple and the fold underneath, releasing the constricted lower part of your breasts, making the areolas smaller, and correcting the ballooning of the areolas. All of this is done through a circular scar around your nipple.
Are my breasts tuberous?
You do appear to have a tuberous breast deformity. Implants and release of the gland will improve the size and shape of your breasts. The areolar on the left side is a little larger than the right and so, if this bothered you, it could be reduced leaving a scar all the way around the areolar.
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Tuberous breasts come in a wide spectrum for forms and you appear to be in that line. The correction involves implants (I like postoperatively adjustable salines for this) and a periareolar lift with release of the constricting tissues in the breast. Go to an experienced plastic surgeon for this not a rookie.
From your pictures it indeed appears that you have Tuberous Breast. There are two problems with tuberous breasts. The first is the placement of the implant. I stronly recommend periareolar incision and placement of a textured siicone gel breast implants under the breast tissue above the muscle. This allows the surgeon to release your breast tissue to drap over the implant and give a good shape to the your augmented breast. Second is the nipple areolar complex. It usually is larger then desired and there is often pseudo herniation of the breast tissue through the nipple areolar complex. This can be corrected by a circumareolar incision which allows the surgeon to make the nipple areolar complex smaller by removing the superficial skin from the outter portion of the nipple areolar complex and then slip the deeper skin under the peripheral tissue and there by correcting the tendency for the breast tissue to fall through the nipple areolar comlex. This results in a bit of rippling around the nipple areolar complex which will usually smooth out in time. If it is too much then an incision down the breast below the nipple areolar complex will allow the ripples to be taken out.
Based upon your pictures I think your breasts to demonstrate some of the characteristics of tuberous (constricted) breasts. For example, there appears to be a short distance from the areola to the inframmammary fold along with slightly wide, “puffy” areola. The lower poles of the breasts seem tight and lack fullness/roundness.
The breasts are also ptotic (sit low on the chest wall) an asymmetric.
I think you may benefit from breast augmentation as well as mastopexy surgery. These procedures will serve to “round out” the breasts, improve symmetry and elevate the breasts as well.
Make sure you're seeking consultation with a well experienced board certified plastic surgeon.
Success with Tuberous Breasts
I would agree you have a minor degree of tuberous breasts with asymmetry of the breast folds. The left nipple is a little lower. I would be confident that a very nice correction by an experienced plastic surgeon could produce a good result. Some minor asymmetry might persist. I suspect your nipples would require a lift of less than two centimeters and if this is the case, I would perform a benellli Mastopexy, slight lowering of the breast fold and submammary placement of gel implants. Some minimal scoring of the breast tissue might be done. Do not despair and find a surgeon with plenty of experience as this is not a beginners case
Tuberous breasts can be corrected with breast implant and lift surgery
You have a moderate tuberous 'deformity' of both breasts - the solution is a subglandular augmentation and 'donut mastopexy'. Part of this operation involves lower the fold position beneath your breast and surgically expanding the 'constricted' lower pole breast tissues. Some surgeons use expander implants for this procedure, and stage the augment and the lift. I've done these procedures as a single stage with good outcomes.
The photos are quite adequate to show tuberous breast characteristics which means the breast tissue is pushing out into the nipple-areola area of the forward part of the breast. There is also a constricted breast with an inadequate lower pole causing pseudo ptosis. Additionally the left breast is somewhat larger than the right.
I would agree with Dr. Burns' answer except that there is no reason to put the implant in the subglandular position if an adequate dual-plane release of the pectoralis muscle is done. And I would agree with Dr. Rand regarding the degree of difficulty and need for experience.
I have found it best to treat this as two different problems, one which can be addressed with a breast implant and the other with peri-areolar mastopexy-type treatment. In your case for the constricted lower pole I would recommend a properly done subpectoral augmentation mammoplasty through the adjusted inframammary crease with medium profile saline or silicone gel implants with an advantage to saline for adjusting the volume difference with the same width implant vs. the advantage of gel implants in the thin coverage of the lower pole. This may improve things enough to be all that is needed. If the forward/central part of the breast is still too tuberous/herniated then a secondary peri-areolar treatment can be done to adjust it along with the residual asymmetry. Do not count on a "crescent lift" or use of periareolar incisions for the placement of the implants.
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.