Would You Recommend Fat Grafting to Correct my Tuberous Breasts and Am I a Candidate for a Tummy Tuck or Lipo? (photo)

Overweight as a kid, also been underweight, now I'm 160 and 5'9. I have always had a fat stomach even when thin. Can this be corrected with lipo or is a tummy tuck needed? Also, what is your opinion of fat grafting with lift to correct breast deformity?Iwant to be a C cup. The discoloration on the areolas is from self injury- picking my skin. Is there anything that could be done to restore pigmentation? Can you recommend a good surgeon in my area (Seattle) or somewhere on the west coast? Thanks

Doctor Answers (13)

Mommy Makeover

+1

  Breast augmentation and breast lift with liposuction may give good results.  However, the issue of skin laxity and fat deposits should be assessed in person.


Los Angeles Plastic Surgeon
5.0 out of 5 stars 191 reviews

Mommy Makeover

+1

Thank you for your question and photos.

I would recommend that you have a breast lift procedure and if you would like to increase your breast size, have breast implants placed.  In regards to your tummy, I think liposuction may give you nice results.

Please visit with a well experienced plastic surgeon and ask to see examples of their work.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 701 reviews

Fat grafting not recommended for tuberous breasts

+1

Your breasts are too far apart and too low.  You need your breasts repositioned and reshaped.  This can be done using a circumareola approach that will lif your breast tissue higher, displace it more medially and change the shape of your breasts to increase projection.  If you want to be bigger then implants can be placed through the same incision.  I recommend silicone gel implants placed retro-pectoral since they look and feel more natural.  Your abdomen could be improved with either liposuction or an abdominoplasty.  However, I would not do a tummy tuck if you are considering pregnancies in the future.  If you are done having children then an abdominoplasty can be done with mesh reinforcement, which will decrease your weight and help maintain the reduced weight.  Also, the abdominoplasty will make your breasts appear to be larger and you can use smaller implants, which are more stable long term.  In summary, I recommend Breast Augmentation with Mini Ultimate Breast Lift and Abdominoplasty with Mesh Reinforcement. I have never recommended fat garfting as it is unproven and can lead to complications.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
5.0 out of 5 stars 123 reviews

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Would You Recommend Fat Grafting to Correct my Tuberous Breasts and Am I a Candidate for a Tummy Tuck or Lipo?

+1

Yes I would consider all those surgical options you wrote about. Best to seek a few IN PERSON consultations in your city. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
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Tuberous Breasts and fat grafting

+1

I would not recommend fat grafting for your breasts. You need a concentric lift and an implant.  In terms of  your stomach you may do very well with liposuction. You do not need a tummy tuck. 

You will have more areas to pick after your surgery which could lead to more scarring so you need to get that under control before surgery.

Robert Kearney, MD, FACS
La Jolla Plastic Surgeon
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Tuberous breasts and fat grafting

+1

Here is my approach to tuberous breasts, and the information in your photos.

  • Avoid fat grafting. Most of the fat will absorb over a year.
  • A combined lift, tuberous release to reshape the breast and a small implant.
  • To find a surgeon, go to the American Society of Plastic Surgeons for the Board Certified Plastic Surgeons in your zip code. Seattle has excellent surgeons.

Do you still pick at your skin? It has to stop before surgery or you may pick at the surgical incision and get an infection. Sorry you have been under such stress. Be sure to have the support, even the therapy you need.

Hope this helps!

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
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Treatment of tuberous breasts

+1

Hi, you have correctly identified yourself as having tuberous breasts - big areolae, a droopy appearance, the crease under the breasts is high up and the breasts are further apart. I think you will get the best results with an augmentation, rearrange the breast tissue at the same time (I unfold the lower breast so that it is more even on the chest), and a circumareolar lift.

If you do just fat grafting, your areolae will still be large and the breasts will not radically change in shape. It would be better, especially with a lift, but not a home run. There are also some issues to fat grafting when rearranging/lifting breast tissue - basically surgeons can only graft into the tissue that is NOT be moved at the time of surgery.  As a surgeon, that picking thing bothers me - why are you doing that? If you were my patient I would yell at you. Don't pick your incisions after surgery. Never pick anything unless you just washed your hands, that will stop you at least from absentmindedly picking all day. Try IPL (often called "fotofacial") to get rid of it, a Cosmelan treatment, or topical hydroquinone to lighten or eradicate the spots. No picking.

Lisa B. Cassileth, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 6 reviews

Options for a not so tuberous breast

+1

Actually your breast is ptotic and asymmetric, and options involve lift, implants, or both, though fat grafting is certainly possible depending on your goals. Your abdomen is likely to need only liposuction and the fat could be put to use in the breast if you wish to avoid an implant, but only a lift will get the nipple up front and center.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 26 reviews

Lipo and a pexy

+1

Lipo and a pexy will probably be all you need. You did not mention anything about having kids, I usually save tummy tucks for women who have stretched out the skin and muscles with pregnancy or extreme weight loss.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.0 out of 5 stars 9 reviews

Tuberous Breasts , Tummy Tuck or Lipo?

+1

Tuberous breast

There are a number of features that define a tubular breast:
•Wide and puffy areolae
•widely spaced breasts
•high breast fold
•constricted lower pole (deficient tissue in lower half of the breast
•minimal breast tissue
•high breast fold
•narrow base of the breast

Most of these are present in your photos. To improve the breast appearance, a breast lift will be required, and some volume increase, and in this setting, an implant is, I believe, more predictable. 

Abdomen 

Tummy tucks are done to remove excess skin and fat and to tighten the abdominal wall. Although without a side view I cannot be certain, but your abdominal wall looks fine. There is no excess of skin, so liposuction would most certainly be the better choice.  

 

Pigment

It looks like some of the "scar" might come out with the breast lift. Tattooing can improve the areola color

 

When you ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S.


Thank your for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 30 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.