What would be the best approach to fix my tubular breasts? (photo)

For your type of deformity, combination of peri-areolar breast lift (to reduce size of areola and reshape lower, narrow pole of the breast) and augmentation with sub-muscular implant would be good approach. Good luck.

Unfortunately, without better pictures and more information, it is impossible to say what will work best for you. With Tuberous breasts it is not uncommon to need an areola reduction and/ or actual lift along with implants. The best thing to do is to go for a few consultations with board certified for plastic surgeons and see what the consensus is. I hope this helps.