What would be the appropriate approach to tuberous breasts like mine if I want an aesthetic shape of breast and areola? (photos)

Hello! Thank you for your question. Apart from tuberous breasts, I can also see that your areolas are wide, and your breasts are sagging. In your case, to achieve an aesthetic shape I would advise reduction of subareolar area and implant insertion via subglandular plane with mastopexy to solve your breasts sagginess problem. Parenchymal scoring might also be necessary.

Unfortunately, surgeons have created the term tuberous breasts, a fact which causes unnecessary concerns for women. Many women just have different sizes and shapes and in my opinion shouldn't be labeled. I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Your breasts are not tuberous. The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Good morning,
I would recommend a donut mastopexy and submuscular augmentation with saline or silicone implants, depending on your preference. We would figure out the exact size and profile when I measure your chest, we review photos together, and you have an opportunity to try on the implant sizers here in the office.

Dear lmw2473,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.The type of surgery best for you will depend on the severity of your condition.My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Have a nice day! Here’s Dr. Jose Suarez hoping to answer all your doubts. The best option is a breast implant

Your breasts are not tubular, but you do have sagging. a lift with an augmentation would work well for you.

From your photos it appears you would have a nice result from breast augmentation with implants and a crescent mastopexy which would slightly raise the position of the nipple/areola. See a board certified plastic surgeon near you for a consultation to learn more.

Hello lmw2473.
Based on the pictures you have provided I would consider inframammary fold incision, subglandulatr prepectoral position of an implant, radial glandular scoring (internal deep breast incisions) based on the appearance with a sizer. If breast tissue is prolapsing through areolas, an areola reduction with a suture to stabilize diameter and shape may be suggested. There is a wide space between breasts. If a tighter cleavage is desired, preferentially medial (closer to the center of a chest) dissection may allow to decrease separation between left and right reasts.
Best,
A. Shteynberg, M.D., F.A.C.S.Diplomate, American Board of Plastic SurgeryNew York, NY.

Hi and welcome to our forum!
From your photos, I note that the anterior view is somewhat distorted as one arm is elevated and the other is down. I cannot ascertain symmetry. There is minimal sag (as the nipples still reside above the level of the fold at the bottom of the breasts).
Tubular (tuberous) breasts demonstrate large puffy areolae, wide spacing between the breasts, minimal breast tissue, sagging, higher than normal fold beneath the breasts, and a narrow breast base.
You don't fit this picture in its entirety. Your breast configuration is quite common after significant weight loss. You would represent an excellent candidate for breast augmentation with a lollipop lift.
I recommend consultation with a board certified plastic surgeon.
Best wishes...