Do I have tuberous breasts? Would a fat graft provide optimal results? (Photos)

I'm 29 and have never known whether I had tuberous breasts until stumbling upon this forum. I'm interested in breast augmentation because I've never felt confident in how my breasts looked. One side is definitely smaller and when not constricted, the areolas are quite puffy. I honestly hate the way they look but am more interested in fat grafts as a first option. Will it be possible to achieve more a fuller base of the breasts as well as the size increase from the fat grafts?

Doctor Answers 9

Tuberous Breasts/Constricted Breasts/Breast Implants/Breast Augmentation/Breast Lift

I appreciate your question.

From your photos, you appear to have characteristics of tuberous breasts.

Constricted or tubular breasts tend to be too narrow with a breast crease that is too high. Tight ring-like bands of tissue around the areolae and nipples may create the appearance of protruding or puffy areolae. A higher than normal breast crease may make your nipples appear to be too low or down pointing. Constricted breast features can be very mild or severe. In fact, mild variations are relatively common. To summarize, the features can include:
  • Inframammary fold (breast crease) too high
  • Inframammary fold misshapen
  • Breasts too narrow (disproportionately narrow base width)
  • Insufficient breast skin
  • Constricted or tubular shape, resulting from tight bands of tissue within breasts
  • Protruding or bulging appearance of areolae (pigmented area around nipples)
Improvement is possible and generally includes a breast augmentation, sometimes combined with a lift (mastopexy). The lift is usually limited to an incision around the areolae. During the procedure, I release the tight, constricting bands from the inside, allowing the skin to expand properly. I also lower the inframammary fold to a more ideal position and improve its shape. Breast implants help create the right amount of volume and improve breast contours, resulting in a more rounded or tear drop shape.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.

Best of luck!

Dr. Schwartz
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute
#RealSelf100Surgeon


Degrees of Tuberous Breasts

Tuberous breasts (a.k.a. tubular breasts, constricted breasts) can be classified in three grades, based on the location of constriction. Grade 1 is a breast that is constricted in the inferomedial quadrant. This makes the inside half of the breast fold look flattened. Grade 2 is a breast that is constricted in the lower half. This makes the breast look flat across the bottom and the breast can look like it is sitting on an invisible shelf. Grade 3 is when the whole breast is constricted, giving it a cone shape like the breast is being strangled and the tissues are bulging out the areola. Grade 3 is what many of my colleagues have described.
While more photos at different angles and at profile would be helpful, it appears that you have a mild grade 1, at least on the left breast. To round out the bottom half of your breasts and obtain the more fuller base you desire, your best option is to have breast implants placed. It is much more reliable than transferring fat to achieve the breast shape you describe.
Definitely see a qualified plastic surgeon who is experienced in both options to help you further. Best of luck!

Tuberous Breasts

While I don't think you have tuberous breasts per se, you do have some constriction of the central or medial aspects of your breasts.  I can understand your feelings, though what you have is a common and normal finding.  A breast augmentation, done with the intention of rounding out the lower portion of your breast, can create a smoother, more symmetric shape if that is what you would like.  Your nipples are also a normal finding, but nipples can be made smaller in surgery if that is your preference.  As far as your asymmetry, this is also common and can be improved.
In short, you are no different than many other women who seek breast enhancement- look for similar patients on my or other Board Certified plastic surgeon's websites, and find someone that you are comfortable talking to about this.
Best wishes, 
Dr. L

Fat versus implant for breast deformities

The definition of a tuberous breast has three components: a constricted lower pole with a higher than normal inferior fold, a widened areola with a fibrous ring around it, and breast tissue herniating through that ring.  You do not appear to have a frankly tuberous breast, but you do appear to have a mild deformity and some asymmetry: the inferior part of your breast appears a little underdeveloped, and the areola appear mildly puffy.  Correcting this with fat alone would be difficult if not impossible.  Fat is good for simply replenishing lost volume.  The "envelope" of your breasts - is too small.  Fat doesn't do well in tight spaces.  As well, the boundaries of your breast need to be re-established and possibly the areolae reduced with a periareolar mastopexy.  The best way to do this is with a trans-areolar breast augmentation with possible glandular scoring.  If there are any fibrous structures that are constricting your breast, they can be released and the fullness of the lower pole enhanced. My best advice is that you be fully examined by a board certified plastic surgeon.  She or he should listen carefully to your expectations and counsel you as to the risks and benefits of their proposed plan.  Best of luck for a fabulous result!

Whitney A. Burrell, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 6 reviews

Tuberous breasts

In my opinion, you do not have tuberous breasts, but as you say, they are asymmetric.  Fat grafts can augment the size of the breasts, but fat injections are not always predictable, and it takes multiple fat harvestings and then injections over a period of months. 

Breast Augmentation Options

Hello,

Thank you  for your question and photos. You appear to have just some mild constriction. In order to release this and round out the lower breast poles, typically some surgical release of constriction could be done through an incision around the areola which could also be used to correct the puffy nipples. I recommend that you meet with a board certified Plastic Surgeon in person to discuss your concerns. They will examine you and present options which address your goals.

All the best

Tuberous breasts

I do not believe you have tuberous breasts and will have a very nice result from a breast augmentation.  Be sure to get multiple consults from board certified plastic surgeons and good luck!!

You will enjoy the results!

Dr. Luong

Jacqueline Anne Luong, MD, FACS
Edina Plastic Surgeon
5.0 out of 5 stars 8 reviews

Do I have tuberous breasts? Would a fat graft provide optimal results?

Fortunately you do not have tuberous breasts.   You should be able to achieve a very nice result with breast augmentation.

Please be aware that you do have an asymmetry.  A lift of the right breast and bilateral implants may be her best option to achieve symmetry.  For more on breast asymmetry please read below:

Tubular breasts

There are different degrees of tubular breast and without a profile view, it is hard to tell for sure. But the bottom of the breast on your left side seems straight, rather than curved... which is seen in mild tubular breast.  I would go with an implant and not fat grafting. The implant will help shape the bottom of your breast into a more rounded appearance.

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 52 reviews

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.