Great question!! So there are several ways that you can fix this problem and you have nailed both of them here in your question. Some patients are able to go right to implants and some really do need expanders. The reason for the expanders is that the lower breast skin is very tight and can vary amongst patients in how tight it is. If you have a particularly tight lower breast area then expansion can be a wonderful way to stretch the skin out and give you good long term shape. We use expanders in breast reconstruction all the time to stretch skin after a mastectomy so it can then accommodate an implant. This is similar to what you would have done but obviously no mastectomy. The expander would be placed beneath the pectoralis muscle and sometimes above it and then used to stretch the skin out. Good that you ask these questions. Make sure you do your homework and choose a surgeon who has experience with this type of breast issue.
Tissue expanders are not required for tubular
breasts. I recommend a new technique
called The Mini Ultimate Breast LiftTM. Using only a circumareola incision it is
possible to reshape your breast tissue creating upper pole fullness, elevate
them higher on the chest wall and more medial to increase your cleavage. At the same time, implants can be placed if
you desire increased size. This
technique avoids the ugly vertical scars of the traditional technique,
maintains nipple sensation and the ability to breast feed.
Gary Horndeski, M.D.
Thank you for the question.
To best help you, a physical examination or pictures evaluation is required in order to determine which procedures and techniques would be best for your case.
Tissue expanders are certainly reasonable for treatment. I would consider a couple of factors here. You will need at least 2 operations with this method. You will also require a series of sessions in which the expander is filled over a sometimes very long period of time. There is also a risk of infection and deflation with the tissue expander. I have not used a tissue expander on tuberous, tubular, constricted breasts, or Poland's syndrome, and I have had excellent results. Having said all of this, tissue expanders remain a perfectly reasonable mode of treatment.
board certified plastic surgeon who performs hundreds of breast
augmentations each year. Then look at the plastic surgeon's website
after photo galleries to get a sense of who can deliver the results.
Kenneth Hughes, MD
Los Angeles, CA
With tubular breasts, the lower pole tissue is generally constricted. A tissue expander will expand this area so that it is less constricted.
tubular breasts and breast augmentation requires special techniques. The technique required is individualized based on the severity of the condition and the size implant that you desire. Tissue expansion is only one of the techniques to help with tubular breasts.
Tubular breasts come in all different shapes and sizes. There are typically certain features of the breast that suggest they are tubular. It sounds like your surgeon has already diagnosed you with tubular breasts. How old are you? Many times tissue expanders may be used in women who have breasts that are still growing. Other times the tissue expander can stretch a tight breast pocket in order to allow for a larger implant to be placed. The "magic" in correcting the tubular breast shape does not lie in the expander itself, but what your surgeon does to prepare the breast tissue for the expander and, later, the implant. It sounds like you are on the road to a good correction.
The diagnosis of tuberous breast disease includes a wide variety of deformities. All tuberous breasts, by definition have a tight and constricted lower breast pole.
For mild cases, surgical release through radial scoring of the tight tissue may allow an implant to expand this tight inferior pole in one surgery.
For the more severe cases, expansion of the lower pole may be easier (and produce a better result) by placing a tissue expander first. This will allow greater expansion and better control of the implant position.
You should definitely see a board certified plastic surgeon if you wish to be evaluated for this (or any) cosmetic breast surgery.
Thank you for this question. Sometimes tubular breasts do have staged corrective procedures with expanders. This largely depends on the plastic surgeon's evaluation of each patient's specific anatomy and what area(s) may be tight. Many patients are able to have correction in one operation. An in-person exam with a board certified PS is the best way to go. I encourage second opinions if you are still not sure. Good luck
Good question, classically staging the surgery into two does give better results as the expander will slowly stretching your tissue especially in the bottom of your breasts, this will help round out your breasts in a way that one stage may not do as well