Age 18 - Is There Any Hope for Me?

I'm 18 and I've had this problem since my boobs started growing in 5th or 6th grade. Very little has changed since then, other than the areolas are much more puffy and ive sprouted a little more breast tissue. I want to get them fixed. Can i do this without implants? and if so, about how much would this cost?

Doctor Answers 23

Snoopy Nose, Tubular Breast or Tuberous Breasts

Dear Bambi369 in Castro Valley, CA:

You have tuberous breasts with a small amount of breast tissue, Unfortunately, most your breast tissue is "herniating" into your areolae (the pigmented skin around the nipple). It can be corrected without an implant, and the result will be fairly flat. Since tubular breast are often associated with small breast, it is common to use breast implants to increase the bust size at the time of surgery. Fat grafting to the breast was abandoned, with good reason, in the past. More work is being done currently in this area, but it still should be approached as experimental  procedure that is best performed under appropriate research protocol.


Walnut Creek Plastic Surgeon
4.5 out of 5 stars 9 reviews

Tuberous breasts

You have a severe case of tuberous breasts as you already most likely know. The surgery will require careful reduction of the tissue herniated into the nipple complex and scoring of the base of this tissue to open it up. You could put in breast implants at the same operation. If you want fat grafting instead of implants you cannot do the grafting at the same time as the tuberous breast surgery because that will diminish the ability of the grafted fat to survive. Since you will need more than one grafting session to achieve a desireable result I think it will end up costing you much more for all those procedures than a single tuberous breast correction and breast implants. Given the severity of your current condition there is no guarantee that one operation is all you need though it should be in good surgical hands.

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.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Good news, there is definitely hope

thanks for posting your photos, I know it takes a lot of courage just to ask for help.  you have a severe case of tuberous breasts or constriction. implants with or without expansion has been the standard along with "parenchymal scoring".  recently, vacuum expansion (BRAVA, look it up on the net) with fat grafting has shown promise for augmentation if you want to try to avoid implants.  speak to a board certified plastic surgeon and start considering options. remember there is no rush. take your time and make a decision you feel comfortable with. good luck, it may be a bit of a bumpy road but I know it can be well worth it.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 1 review

There is certainly hope for tuberous breast deformity

Your photos show fairly severe tuberous breasts.  The surgical goals include reducing the size and prominence of your areolae, and getting some volume to provide breast shape.  This is typically done with implants, and plastic surgeons will usually need to do some internal release of some of the fibrous breast tissue that is causing your current constricted shape below your areolae.  Fat injection may be an option, or as an adjunct to implants.  I would be concerned that the BRAVA would stretch your already puffy and stretched areola tissue more than the surrounding tight breast tissue and skin.  I don't use that device, so if you are considering that procedure, obviously seek out someone who uses it and make sure they have experience using it on breasts like yours.

Hope for a tuberous breast shape

We hear many questions about a tuberous breast, though your breast is the truest example. The good news is that your breast will work as any other, and even breast feeding is possible if that is on your future list. You can have just the nipple herniation reduced or corrected though we would suggest an implant as well to stretch the skin envelope and give better shape and projection to the breast. If you are not in favor of an implant structural fat grafts can be helpful for more modest breast shaping. Be very careful about which surgeon you select as correction such as yours may be out of the ordinary for some cosmetic surgeons.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 35 reviews

Tubular Breasts

Breasts come in all shapes and sizes and significant variations in breast contour are common amongst women. One of the more commonly seen breast variants is the tubular breast deformity. This is also frequently referred to as a constricted breast deformity.

This condition occurs because of constriction of the skin at the base of the breast. This often results in herniation of the breast tissue through the areola which creates a unique breast shape. The vast majority of constricted breast deformities are relatively mild and treatment may not be necessary. Severe cases of this condition occasionally occur and do require treatment because of the magnitude of the breast deformity. A variety of approaches can be used to correct this problem. Treatment should be individualized based on the specifics of the anatomic deformity and the aesthetic goals of the patient.

Your pictures and history suggests a severe tubular breast deformity. Correction of this problem will require a mastopexy with or without a breast augmentation. Correction will require consultation with a board certified plastic surgeon. This surgeon should be able to formulate a treatment plan that addresses your concerns. 

Breast Augmentation in Women with Tubular Breasts

This is a great question and more common than you might think to vary degrees. Typically a patient with breasts such as yours are treated with a periareolar mastopexy augmentation. This is where the size and shape of the nipple is corrected while placing a breast implant to help improve the overall shape of the breast. Patients do extremely well with the procedure and tend to be very happy!

It is important to discuss your options with a board certified plastic surgeon that performs a lot of breast surgery.

There are surgical options

I think that you will need surgery to address the issues that are bothering.  There are options based on your anatomy.  This is not an uncommon problem.

Tuberous Breast Correction

The goal of tuberous breast correction is to create a more rounded, regular shape and decrease large areola and large nipples, if necessary. Ideal breasts are comprised of evenly distributed tissue while tuberous breasts are characterized by tissue that is concentrated directly underneath the protruding nipples. Because of this, a common treatment technique involves releasing this constricted breast tissue by making internal radial incisions that allow it to splay out properly. These incisions are done internally so the patient doesn't see anything externally. In most cases I will suggest the placement of an implant, typically in the sub-mammary position to better influence the breast’s shape and to add greater volume. If excess or sagging skin is present, I may recommend performing a breast lift as part of the procedure as well. However, since you mentioned that you don't want implants, it is possible to do so however you should be aware that your cup size may be very small after surgery.

Patients with severe tuberous breast deformity may undergo tissue expansion, infra-mammary fold lowering and reduction to the large nipple and/or areola before the implant is inserted. This would probably be your situation.

As mentioned above, one patient’s irregular breasts can present varying degrees of deformity. This difference in size and shape may make it necessary to employ different treatment techniques for each deformed breast, as well as to properly address massive nipple abnormalities, as well as the appearance of a "herniated areola".

Best of luck!

Yes! There is hope

Thank you for having the courage to post your photos. There is certainly hope for you! The correction of tuberous breasts includes reshaping the breasts on the inside. This can be done with or without an implant, though in the long run you may desire implants. If you want a modest increase in size, you could consider fat grafting for a "natural" augmentation, avoiding implants. Seek out a board certified plastic surgeon in your area to discuss your options and pricing.

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 93 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.