My Doctor Said I Have Tuberous Breast. Do I Need Mastopexy? Subglandular or Under Muscle? (photo)

My doctor prefers subglandular implant and she said she will relase the constricting bands. However she said she will not make smaller the aerola, as it is already a hard surgery, she prefers not to perform everything in one surgery. She also did not mention about mastopexy. Do you think I need mastopexy and also subglandular implant? Thanks and Best Regards.

Doctor Answers (11)

Tuberous Breasts?

+2

I don't really think that your breasts are really tuberous though the base is slightly constricted. I don't disagree with placing the implants in the subglandular position, but I would suggest using only a modest size implant and having a lift done at the same time. The lift is needed to improve the shape and reposition the areola. Your areola could be made a bit smaller as well.


Baltimore Plastic Surgeon
4.5 out of 5 stars 30 reviews

Treatment for Tuberous Breasts?

+2

Thank you for the question and pictures.

Yes, I think your breasts do demonstrate some of the qualities seen with tuberous (constricted) breasts.
Some of the characteristics seen with tuberous breasts include 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,  correction of tuberous breast anomalies 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.

In my practice, I would probably recommend a dual plane ( sub muscular)  breast augmentation, preferably with silicone gel breast implants, along with circumareolar breast lifting. 

Given that you will undoubtedly receive a variety of different responses/options, you will need to do your own due diligence and learn about the pros/cons of each option you are offered. As you are doing your research, ask to see lots of examples of the plastic surgeons' work.

 
I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 794 reviews

I think that the best way to do this is with fat grafting

+2

From your photographs I see that you have breast asymmetry as well as a wide space between your breasts. You may well have tuberous breasts. The best way to deal with this in my experience is with fat grafting. This may take several sessions, but you do have the advantage of losing fat from an area where it is unwanted. Another advantage of fat grafting is that you can place the extra tissue exactly where you want it and you can bring your breasts closer together on your chest as well.

Rodney A. Green, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 16 reviews

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Tuberous breast

+1

  tubular   breast       is   an important   constriciton of the   breaast  realted  to  deformity   in   shape ,    fold  and areaola  complex,    for  it looks   a  pseudoptosis   rather    than a real   ptosis ,  i t  seems   that   after  liberating   the  constricted  rings ,     and   adding      ian   implant    of  a   different   size    because   there  is  also   an  assymetry  there  i s no  necessity of    breast lift 

Cynthia Disla, MD
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Tubular breasts mastopexy

+1

Hi,

  Yes, you have tubular breasts with the narrow base and the enlarged areolas.   

  You definitely need a mastopexy with elevation and centralization of the nipple/areola complex.  I personally prefer submuscular implants.  In my practice, this would all be done at once with a correction of the crease, decrease of the areolas and elevation of the NAC.  Implants would be placed at the same time.

  Some doctors do prefer to have two operative approaches.  No matter what approach, your areolas need to be reduced.  ABSOLUTELY !   It would look very awkward indeed to have your breasts look great and have areolas that are this big "taking over" the breast rather than being an accent to the breast mound.

 

Steven M. Lynch, MD
Albany Plastic Surgeon
5.0 out of 5 stars 8 reviews

My Doc Said Hve TuberousBreast.Need a Mastopexy?Subglandular orUnder Muscle?#tuberousbreast

+1

It is hard to say based on your photos if you have tuberous breast deformity, but you do have narrow lower poles of the breast and a wide cleavage. Tuberous breasts classically have 3 main features. 1. High riding inframammary folds, 2. Herniation of breast tissue into the areolar complex, and 3. Constricted (narrow) lower pole of the breast. So me of these I can not see in your photos. Your areola's are large and you do have narrow lower poles. I prefer a partial sub-glandular and sub-muscular implant and use silicone for a more natural feel. You will likely need scoring of the lower breast tissue of the lower poles where things are tight to help open up that part of the breast to accept an implant without continuing to be tight. I do think you could benefit from making the areola smaller to fit the breast appearance better. Most of my patients do need a lift and I would have to see you to know if it needs to be staged or done in one operation. True tuberous breasts usually need to have these procedures staged. I like to do the lift and reposition the nipple and reduce it if necessary at the first surgery followed by an augmentation at the second operation. Many surgeons handle these cases different. Every case is special an that is why you need to make sure you see a board certified surgeon who specializes in breast surgery and does many of these tough cases. You need to also be very patient because your final result will take 6-12 months.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 21 reviews

My Doctor Said I Have Tuberous Breast. Do I Need Mastopexy? Subglandular or Under Muscle?

+1

Yes you have the tuberous deformity. I recommend to consider a staged operative approach. First the lifting with possible fat grafts. Than after 3 to 6 months implantation. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

Tuberous breasts

+1
I do think you have elements of tuberous breast syndrome from your photos, though there is no true substitute for a full examination. You do appear to have a constricted lower pole of the breast, enlarged areolas, and a wide separation of the breasts. You certainly would need a mastopexy to achieve optimum aesthetics. I am not a big fan of subglandular implants, though they are appropriate in properly selected patients. I tend to favor a "modified vertical" incision approach as I think the circumareolar (aka periareolar, or circle around the areola) approach is limited in how far you can lift the breast. The larger the implant you desire, the less likely you are to be a good candidate for a circumareolar approach, in my opinion.
 

Tim A. Sayed, MD, FACS
Palm Beach Plastic Surgeon
5.0 out of 5 stars 14 reviews

A breast lift with implants is likely your best option for tuberous breasts

+1

Thank you for your question and the photos.


A breast lift with implants is likely your best option. The lift can make your areola smaller and the implants will widen the base of the breast.  Speak with your plastic surgeon about whether over or under the muscle is right for you.


To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery. I hope this helps

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 41 reviews

Breast lift and implants

+1

A breast lift and implant surgery can be performed together. Some surgeons feel more comfortable staging it. I do them together often.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 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.