Surgeons with expertise in this area, please provide your thoughts. I would prefer a natural look, so perhaps tear drop would be best?
Suggested Procedure for Tuberous Breasts
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Suggested Procedure for Tuberous Breast
For your particular case, I recommend a one-stage procedure in which implants are placed under the muscle. I do prefer silicone for appropriate patients because they feel more natural and based on the measurements of the breast, they may be high profile. The other essential steps are reducing the nipple-areola where tissue is protruding out via a peri-areolar lift and releasing the tight constricted bands that are limiting the growth of the breast.
I would not recommend a tear-drop implant because these have the possibility of rotation and malposition.
On the East Coast, I have had several patients travel from NJ, West Virginia, and North Carolina to our office in DC for just this type of procedure.
A two-fold approach to your tuberous breasts
My approach to the tuberous component in your breasts, which I have used in many cases, is twofold.
Initially, through a periareolar incision, I would perform a dual plane augmentation releasing the tight and constricted inferior pole (re: the lower portion of your breasts). This allows the prosthesis to sit lower on the chest and creates a slight upward rotation of the nipple areola. The 2nd part of the procedure is a periareolar mastopexy which allows for diminution in the size of the nipple areolar complex and improvement in the herniated subareolar tissue, particularly on the right side.
Complete correction can be achieved in one operation with an excellent aesthetic result. The periareolar incision should heal quite well since there is not a great deal of elevation involved to cause tension. I prefer to use silicone implants and certainly would not use an anatomic or tear dropped style prosthesis.
Please see the case linked to below for an example of the above. Hope this helps and good luck with whatever you decide to do.
Tuberous breasts: There is a solution!!!
Tuberous breast repairs are commonly scar ridden flat and unnatural looking. The good news is that there is a specific technique to create natural appearing breasts with hidden scars for this type of breast shape. The procedure involves a special subfascial placement of silicone implants and a special nipple lift and areolar reduction with a hidden scar. The results are very natural appearing.
All the best,
Rian A. Maercks M.D.
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Tuberous breast correction
There are many different variants of tuberous breast or constricted breast developmental deformities. You do have a variant of tuberous breast, with some areolar protrusion ("pseudoherniation" of the areola), and a very short distance from your nipple to the inframammary fold with deficient tissue in the lower pole of the breast. You also have a rather wide distance between your breasts. You can benefit from a breast augmentation, but it should be performed by a surgeon experienced in dealing with turberous breasts. Your inframammary folds will need to be lowered (otherwise the nipples will be too low on the breast and be downpointing), and the tight "constricted" lower pole of the breast will need to be "released" by some scoring incisions on the undersurface of the breast tissue to allow it to expand under the weight of the implant. The protrusion of the areola that you have will benefit from a periareolar "telescoping" excision similar to a periareolar lift, leaving a scar surrounding each areola and helping to flatten the areola.
there are many ways to improve the appearance of a tuberous breast. I believe that a periareolar mastopexy or tuck will flatten the "tuberous portion" at the time of augmentation. In addition while dissecting the pocket for the silicone implants, the bands of tissue that are causing this can be released allowing the breast to expand and become rounder. I believe that the implants should be place beneath the muscle. On the right side you may also require an extension of the scar around the areolar making it into more of a lollypop shape.
Tuberous breast correction
There is no consensus on the best surgical treatment for tuberous breasts. I personally prefer silicone implants performed through a peri-areolar incision, with a reduction of the areolae and submuscular placement of the implants. Teardrop implants are great, but silicone teardrops are not yet available in the US for general use. I agree with Dr. Rand, however, in that you should expect a significant improvement, but not perfection, as tuberous breasts are extremely challenging to correct. Best wishes, /nsn.
Treating tuberous breasts
You can achieve a nice improvement, not perfection, from your slightly more difficult starting point than some tuberous breasts. You would need periareolar lifts, and in my practice, I believe that an expandable saline implant will give you the best result placed under the muscle because you can stretch the tissues gradually adding fluid after surgery and can best correct the asymmetry and you also get to control the final size you like best.
Tuberous breast options
Tuberous Breast Correction
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. You may require a breast lift for your right breast, however a more accurate assessment can be obtained through a physical examination with an experienced board certified plastic surgeon. Best of luck!
Suggested procedures for tuberous breasts?
Consult with a plastic surgeon well-versed in breast surgery and discuss your goals and expectations. S/he will then be able to examine and discuss the various options and assist you in deciding which decision os the right one for you, given your desires. I would expect a very pleasing result for you! Hope that this helps! Best wishes for a wonderful result!