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Suggested Procedure for Tuberous Breasts

asked 10 months ago by Surgery2011
Latest answer by Rian Maercks, MD
Question viewed 1,055 times
Tags: expertise, natural appearance, tear drop, tuberous

Surgeons with expertise in this area, please provide your thoughts. I would prefer a natural look, so perhaps tear drop would be best?

21 answers to Suggested Procedure for Tuberous Breasts

+2

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... more
William F. DeLuca Jr, MD

Albany Plastic Surgeon

www.delucaplasticsurgery.com

+2

Tuberous breast

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... more
Rick Rosen, MD

Norwalk Plastic Surgeon
+2

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... more
Nina S. Naidu, MD

New York Plastic Surgeon
+2

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.
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

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.
Rian Maercks, MD

Miami Plastic Surgeon
+1

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... more
Robert M. Grenley, MD

Seattle Plastic Surgeon

www.seattleplasticsurgery.com

+1

Tuberous Breast

Tuberous Breasts have a very narrow base and usually a long skin envelope. In the most severe cases of Tuberous Breast, a breast lift can be done through an incision around the areola, making the breast into a more rounded shape that the patient will be happy with. 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. Generally, the procedure involves breast augmentation with areola... more
Tom J. Pousti, MD

San Diego Plastic Surgeon

www.poustiplasticsurgery.com

+1

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... more
Navin K. Singh, MD

Washington DC Plastic Surgeon

www.WashingtonianPlasticSurgery.com

+1

Tuberous Breasts Augmentation

Like many cases in the world of plastic surgery, tuberous breast can be treated by several different surgical techniques. Essentially the goals are to expand out the tight skin envelope of the breast, relax the conical shape of the breast tissue, and finally reduce the enlarged ("herniated") areola. Depending upon the severity, all this can be accomplished in a single operation for mild-moderate cases or more safely/reliably done in a series of two operations for severe... more
Ryan Stanton, MD

Beverly Hills Plastic Surgeon
+1

Surgery for tuberous breasts

Your posted photos show a constricted base of the right breast with a narrow tube like projection of the breast outward/forward from this base. The fold under the right breast is high and the areola is large/stretched out. On the left there is little breast tissue and no fold under the breast to speak of. The left nipple is also further from the midline than the right nipple. The tuberous nature of your breasts and significant asymmetry between your breasts make your case a very difficult... more
Aaron Stone, MD

Los Angeles Plastic Surgeon
+1

Tuberous breast

Hello, Well you have plenty of advice and information to consider given all of the good recommendation answers you have received. Take a look at Dr. Hammond's tuberous breast before and after photos and that should solidify the treatment plan. He practices in Grand Rapids MI and I trained with him. Single surgery procedure, subfacsial/subglandular position of silicone implant with lower breast scoring to relax the tissue and fold. You're going to look... more
Remus Repta, MD

Phoenix Plastic Surgeon

www.aaaplasticsurgery.com

+1

Correcting tubular (tuberous) breast shape

In the case of correcting tubular (tuberous) breast shape, I prefer a moderate profile implant. The correction must address all 3 components of the basic characteristics: a constricted breast base (small breast base perimeter) The small breast base makes tubular breasts narrow so the base needs to be expanded to make the breast appear more normal. Note: A small breast can have a constricted base without being a tubular breast. Any correction must enlarge the base perimeter of the... more
Ricardo Rodriguez, MD

Baltimore Plastic Surgeon
+1

Tuberous breast problems

There are a number of ways to treat this difficult problem, and a "perfect" result is difficult to obtain. As has been mentioned in other answers, tuberous breasts usually include some degree of "constricted" breast base, a widened peri-areolar complex and often herniated breast tissue. You also have in your pictures some significant asymmetry between your breast which is quite common with this condition in my experience. Your plastic surgeon will... more
Jerry Lugger, MD

Dallas Plastic Surgeon
+1

Tuberous breast deformity

Based solely on the photos a breast augmentation can help along with a circumareola reduction to control the areola diameter and to reduce some of the herniated tissue. It is hard to say from the photos whether or not you need scoring of the lower pole of the breast to open it up a bit.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Treating a tuberous breast deformity

A tuberous breast has the combination an enlarged areola, herniated breast tissue and a tight constricted base of the breast. There are many alternatives for correcting and improving the appearance of a tuberous breast. The base of the breast can be expanded with an implant or tissue expander. Many times a total correction will require more than one surgical procedure. The first stage may involve expanding the base of the breast with an implant, placing the implant... more
Jeffrey Zwiren, MD

Atlanta Plastic Surgeon
+1

Tuberous breasts need reshaping of the breast tissue itself.

Hi. 1) You have difficult anatomy and asymmetry. The key to success is not the implant, but the surgery on the breast tissue itself. The lower part of the breasts needs to be released; the folds need to be lowered; and the areolas need to be reduced. So implants are not primarily to correct shape, but to increase size and to correct asymmetry. 2) You do need implants, but avoid tear drop. They have no advantages and more problems. We use smooth... more
George J. Beraka, MD

Manhattan Plastic Surgeon
+1

Tuberous breasts

With your tuberous deformity, I have found that the best results are achieved with full mastopexies and small submuscular round silicone implants. The mastopexies reduce the size of the areolae and place them in a better position. The pexies also change the shape of the breasts so that they are more round and normal. The implants will help to stretch the skin that is constricted at the bottom of the breasts and add to their fullness. You also have... more
Diane L. Gerber, MD

Chicago Plastic Surgeon
+1

Expander implants for tubular breasts

There is a lot of misinformation about teardrop implants, also known (incorrectly) as "anatomical" implants, but correctly called "form-stable" implants. An important thing to know is that round implants also form a teardrop profile in the upright position, but round out when lying down - like real breasts, but unlike shaped implants. One of the most difficult aspects of the tubular breast is that the skin envelope is often tight, especially over the lower part of the... more
Richard Baxter, MD

Seattle Plastic Surgeon
+1

Tuberous breast respond remarkably well to expanders and can avoid a periareolar scar

Although you have asymmetry and other issues to deal with, I would suggest only placing tissue expander first--under the breast glands. As the tissues respond to the expanders, the areolar bulges will flatten--I have seen patients in whom no periareolar reduction was needed. Let Nature do her work first. Then when the expanders are replaced, your surgeon can correct any remaining asymmetries. That way you can be sure that every visible scar is really needed. Good luck. more
Mark B. Constantian, MD

Nashua Plastic Surgeon
+1

Treatment for tuberous breasts

Tuberous breasts are challenging to treat. Despite the type of implant used, a periareolar mastopexy is necessary to correct the prolapsed breast tissue under the areola. I like using adjustable saline implants because they allow for some stretching of the tight tissue and for size adjustments as the swelling subsides. Very often, tuberous breasts are not symmetrical, so these size adjustments are useful. Of course, if a patient is dead set on silicone, we can still... more
Bruce Genter, MD

Abington Plastic Surgeon

www.drgenter.com

+1

Tuberous breast can have great results with silicone gel under the breast

Looking at your breast it appears that your nipple areolar complex on both breast are large and you probably have pseudo herniation of your breast tissue through your large nipple areolar complexes. In you case I would recommend a peri areolar reduction of your nipple areolar complex by removing the superficial layer of skin around the enlarged nipple areolar complex and placing the remaining skin under the breast skin thus reducing the size of your nipple areolar complexes and correcting... more
Carl W. "Rick" Lentz III, MD

Daytona Beach Plastic Surgeon

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