Breast Augmentation: Q&A

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Where is the Best Placement of Implant when Dealing with Constricted Breasts? (photo)

Was told I have contricted breasts. I have 2in of tissue under my areolas and told it would be best if silicone implant was placed over the muscle (subgladular) and my lower breasts would be scored. I'm really worried about capsular contracture. Am I doomed to have Capsular Contracture because of the position of the implant & would scoring also increase my chances? Is it possible to go under the muscle and still have good results? Does scoring incr chances of bottoming out? Am I headed for compl

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19 Doctor Answers | Asked by Houston3058

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Tuberous Breasts and Breast Augmentation

Hello Houston3058, You have mild to moderate constriction of the lower pole of your breasts, a lesser form of 'tuberous breasts'. Regardless, it does present with some difficulties in breast augmentation. Here is a line of reasoning to follow: Like any sagging breast, subglandular placement of the implants does not help, therefore should be avoided and subpectoral placement performed. That will eliminate much of the risk of capsular contracture. Your breasts... more

Treatment of Constricted Breast

You have a fairly mild form of a constricted breast in that the problem is mostly a tight lower pole of your breast with a small amount of sagging (based on these photos). I think you would do well with silicone breast implants placed in a partially sub-muscular pocket (dual plane approach) while lowering the breast fold by 1- 2 cm. You would not need extensive scoring, just release of any horizontal constricting bands just above the breast fold. Also, don't pick an implant with a base... more

Implant Placement and the Constricted Breast

Thank you for sharing your photos. I would concur with you that you indeed have a mildly constricted breast. This does make your case a bit more challenging. However, do not worry - I think you still can achieve a very nice result! To give you formal recommendations would require a formal physical exam so I could actually assess the distribution of your tissue, your skin quality, and actual degree of ptosis (sagging if any). Most likely, I would recommend... more

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Pocket placement for constricted breasts

There is no question that constricted breasts are more of a challenge when considering augmentation mammaplasty. That does not mean, however that you are destined for complications. Scoring of the breast tissue to spread it out does no increase your risk for capsular contracture. I prefer to use a dual plane for breast augmentation which keeps the muscle over the upper portion of the implants and you keep the advantages of implants under the muscle. This technique... more

Constricted (Tuberous) Breasts

Thank you for the question and pictures. Constricted (tuberous breasts) generally have a very narrow base, a short distance from areola to inframammary fold, a tight (constricted) lower pole of the breasts, a relatively wide space between the breasts, a "puffy" and areola and some degree of ptosis (drooping). Generally, the procedure involves breast augmentation with areola reduction / mastopexy procedure. I prefer the dual plane (... more

Pocket selection and constricted breasts

There is still some controversy in regards to which is the best pocket to use when treating patients with constricted breasts. Traditionally only subglandular (above muscle) pockets were recommended along with inferior pole scoring with or without a mastopexy. Many surgeons are now getting excellent results with subpectoral pockets as well. Pocket selection is probably not near as important as adequate inferior pole scoring. Scoring does not increase one's chances of developing capsular... more

Augmentation and constricted breast tissue

Hello, It is important to note that not all constricted breast syndrome cases are the same. Each patient and each set of breasts require different treatment based on the surrounding tissue as well as the goal that is desired. One of the more important decisions that you should make is which surgeon to go to as not all plastic surgeons have equal experience with constricted breast tissue. Subglandular or subfascial breast augmentation does not necessarily expose you to... more

Breast augmentation in constricted breast

Your breasts are constricted, which means that the lower breast is shorter and tighter than normal. In order to provide you with a satisfactory result, the loer pole must be released and lowered. I would actually place the implant under the muscle, releasing the lower edge of the muscle so that the implant can fill the lower pole. I would make cuts in the tissue if it remained tight once streteched by the implant. One has to be careful not to release the inferior fold of the breast too musch... more

Above or below muscle placement of implants for constricted breasts?

Constricted breasts do present challenges for breast augmentation. The short "constricted" distance from areola to the inframammary fold must be increased or, since the bottom of the implant lies at this fold, the nipple will reside too close to the bottom of the breast mound and point down. The only way of increasing this distance is to lower the fold, and then one must release the constricting bands holding the breast tissue too narrow and too tight and try to obliterate the old fold so... more

I have placed implants both sub glandular and sub muscular

My experience with constricted breasts or tuberous breasts has taught me that there are many different types and ways to treat the problem. If there is satisfactory breast tissue in the upper half of the breast, I prefer the sub glandular approach place in the implant on top of the muscle. If there's not enough tissue then I go sub muscular and use the dual plane approach. Some patients require scoring or cutting of the base of the breast glands in order to spread it. All my patients... more

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