I have small 34b slightly tuberous breasts. My PS thinks the best idea would be to release the constricted tissue with internal incisions and use under the muscle silicone implants. I am very worried my nipples will be huge! Does it look like I need a lift or nipple reduction as well? I am 24 years old, never had any children and have my surgery scheduled for 2/25. Starting to second guess and freak out!!
Tuberous Augmentation. PS Said No Lift/nipple Reduction? (photo)
Doctor Answers (19)
How to treat your sagging breast.
You really do not have a classic case of tuberous breasts. You have saggy breasts. You have to weigh the possibility of scars vs the perfect areolar size if you want the areolars reduced. If you go large enough with the implant the nipple/areolar complex may not seem as large relative to the breast size when the breast is enlarged. It is possible to so with a large enough implant and place the implant lower i.e lower the inframammary fold so the nipples are not so low relative to the position of the breast without having to do a breast lift. I would side with your plastic surgeon and release the inferior constricted tissue and place the implants under the muscle. If the breast is not shaped as perfectly as you desire then a breast lift in the futures can be selected. Usually in my practive 9/10 of my patients are happy with just this procedure alone.
To me, it looks like you need a lift. I don't have measurements, or benefit of exam however. Your doctor is the best source of opinion.
This is a judgement call for sure. Worst case scenario, he is wrong. In this case, you can go back and do the lift later.
Tuberous / tubular breast
Your deformity is very mild and without physical exam it is hard to see how much release you need. The areolar expansion will be related to implant size. If you are willing to have more extensive scars, a lift is possible but can always be done later after the implants have settled. That may save you significant scars.
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Lift or no lift tuberous breast
By the photos you submitted I think you would benefit from an uplift as well as internal scoring to release the bands. This will correct your nipple complex from remaining low on your breast "mound" and also correct the size of your areolas and help round out the breast.
I would suggest you return to your plastic surgeon and discuss your concerns regarding nipple position, nipple size etc. It is better to discuss it all in advance then wait and possibly be less that fully satisfied.
Thanks for the photos. Your NAC is positioned low on the breast mound, the areolar are large and there is some constriction of the breast tissue in the lower pole. I would recommend a circumareolar lift with areolar reduction, release of the constricted breast tissue and breast augmentation. You will do great. Good luck.
Breast Augmentation and Lift
I think that most plastic surgeons would recommend a breast augmentation and lift in your situation. However, you appear to be sitting down in the pictures. I would recommend taking pictures standing up, arms at sides, and shoulders relaxed to allow for the best advice to be given. Kenneth Hughes, MD Los Angeles, CA
Sorry, some surgeons use tuberous but it really is tubular as in the breasts look more like tubes. Anyway, you have a very distant form of this. It appears that you have a little bit of constricture of the inner corners of the breasts only. The solution. You'll need areolar reduction because if you don't the areolas will widen even more with the implants. Next, you'll need release of the constrictures, subpectoral implants and finally a periareolar breast lift. Without the breast lift you will have a very unacceptable cosmetic result. Go see a few other surgeons and get a few more opinions.
Tuberous Breast Surgery and Concerns?
Thank you for the question and pictures.
I would suggest that you share your concerns with your plastic surgeon. I would also suggest that you discuss the position of the nipple/areola complexes on your chest wall; I would be concerned that you may not be happy with the outcome of the plan procedure if breast lifting is not performed.
Again, do not hesitate to ask for additional time with your plastic surgeon to discuss your questions/concerns.
Saggy breasts and areola size change with implants
You need an asymmetric breast lift with an evening out of the breast tissue at the same time. The implants can be placed through these incisions under the muscle (in my opinion) and the areolas adjusted as needed.
You and your ps need to decide on the size of the areolas but equal areolas are important to the final symmetric result.
Good luck with your surgery.
Tuberous breasts and big areolas
go hand in hand. You need to really think about your goals and expectations because there are so many options for you. If you want smaller areola (they will stretch slightly with implants) you need an areola reduction and even possible left mastopexy/reduction if you desire similar sizes. Once you know for sure what you want and what scars you are willing to accept, you must let your surgeon know so the right plan can be formulated for you. And under the muscle is fine as long as the 'dual plane' technique is employed.
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.