Breast Augmentation - Best Type? (photo)

Hey. What type of surgery would you recommend? I'm 20 and have fairly small breasts. I've had a consult before and he said my breasts are slightly tuberous. I don't like how flat they are on the top and underneath and how the Areola covers the breast. I don't like how I gather fat under the arms, which then is flat until you reach my breast but I gained weight to have bigger breasts (from an A cup). What type of implant / surgery would you recommend? I want something natural like pictured! thanks!

Doctor Answers 11

Breast implants an shape.

Your pictures give some clues to recommending treatment, but it is difficult to recommend a specific treatment unless I examined you. You have a mild tuberous condition from what I can tell. I sometimes see patients like you and am able to treat them with internal shaping of the breast gland at its base and avoid the full circumareolar scar. If possible, I try to avoid this even if the areola is large as a scar is a scar. Sometimes, the patient is adamant about having a smaller areola or this is the only option. Your breasts are wide so I don't think that they are ideal for a form stable implant. My patients have been very  happy with the results of internal breast shaping with breast implants and I also use it in those patients with very pointy breasts. I would likely use a moderate-plus implant of the appropriate width and size for your body type.  

Bellevue Plastic Surgeon
4.1 out of 5 stars 13 reviews

Breast Augmentation for Tuberous Breast

I agree with your assessment that you have slightly tuberous breasts and it looks like you want a natural looking round full breast.  You actually have common complaints from many women I see.  I recommend that you have an implant placed under the muscle and use the scar around your areola (the dark part around your nipple) because you can lift and reduce the size of your areola at the same time.  I think you can get fantastic results!  Good luck!

K. Roxanne Grawe, MD
Columbus Plastic Surgeon
4.9 out of 5 stars 137 reviews

Breast Augmentation with Mini Ultimate Breast Lift

Unfortunately, you have not told us your bra size.  If you are size 32 or 34 each 100 cc of implant will correspond to 1 cup size change.  If you are size 36 or 38 each 200 cc of implant will correspond to 1 cup size change.  From this, you can determine what size implant that would be best for you.  Since you are under 22, you can only have saline implants.  I recommend retro-pectoral position because it look and feels more natural.  At the time of breast augmentation, I recommend a new lift technique called The Mini Ultimate Breast Lift.  Using a circumareola incision it is possible to elevate your breast tissue higher on the chest wall to increase upper pole fullness and displace you breast more medial to increase cleavage.  This approach also allows placement of the implant.  Aligning the areola, breast tissue and implant high on the chest wall over the bony prominence will give you the maximum projection with a minimal size implant.  The smaller the implant the less complications and more long term stability.  You may be an excellent candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift. 

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

Tuberous Breasts

I agree with the diagnosis of tuberous breasts. In my opinion you should choose between both rounded or anatomic implants. The difference between them is the transition on the upper pole (smoother on an anatomical implant) specially if you are a skinny person. On the other hand, there's a current wave on plastic surgeons doing fat transfer on tuberous breast at the same time. I agree with this and I am doing it myself these days. It helps a lot to round the breast, deal with the breast crease and get a more "normalized" pattern.


Thank you,


Dr. Gustavo Sordo, MD.


Gustavo Sordo, MD
Spain Plastic Surgeon

Tuberous breasts

 There are a number of features that define a tuberous breast:

•Wide and puffy areolae
•widely spaced breasts
•high breast fold
•constricted lower pole (deficient tissue in lower half of the breast
•minimal breast tissue
•high breast fold
•narrow base of the breast

Several of these are apparent on your photos, but not the ones that most interfere with standard surgical methods. 

I think you would do well with submuscular implants, of a size chosen at consultation, accompanied by a circumareolar (donut) lift which will reduce the size of the areolas, and properly position the nipples and areolas. I believe you should expect a fine result. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Breast Augmentation - Best Type?

The picture is no good enough, but you have big areola , to correct that is necessary more scar, all around it, and for more volume.


Spanish translation provided by doctor:

Si bien la foto, no es suficientemente buena, las areolas son grandes, pera corregirla se necesita de un incision periareolar, que dejara mas cicatriz, para el volumen implantes. 

Maria Cristina Picon, MD
Argentina Plastic Surgeon

Breast Augmentation and Circumareolar Lift

   You would be a good candidate for breast augmentation and circumareolar lift performed concurrently to address the areola size concerns and give about 2 cm of lift.  As far as size, based upon the pictures you provided, a 300 cc implant or so, would be a good starting point.  I would recommend trying on the breast implant sizers to get a better idea of volume needs.  Saline or silicone would be fine.  Find the plastic surgeon with ELITE credentials who performs hundreds of breast augmentations a year.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Breast Augmentation

Your appearance is very common but not entirely straightforward.  You are a wonderful candidate for augmentation, but due to your age only with saline implants.  Choose a surgeon who specializes in cosmetic breast surgery and ask to see pictures of similar patients.  This is as much art as science, you need to happy with the work and results of your surgeon.  You can achieve a very pretty, natural result in the right hands. Good Luck!

Brian K. Reedy, MD
Reading Plastic Surgeon
4.9 out of 5 stars 144 reviews

Breast shaping surgery decisions


Thank you for the question and the photos.  Deciding on breast shaping surgery such as breast augmentation or breast lift can become overwhelming with all of the information that is available out there.  I would first decide on the cup size that you want to achieve.  Based on your current cup size and your desired cup size your plastic surgeon can give you a range of implant sizes for your breast width that will accomplish your goal.  You can try on these implants in your plastic surgeons office or try one of the 3D imaging systems to visualize what you would look like.  I recommend silicone implants either under the muscle or in a sub-fascial position.  Your areola can be re-shaped either at the same time or at a second surgery.  A purse-string areolasplasty is what you will need and can be safely done at the same time as your surgery.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Breast Augmentation - Best Type?

Thank you for your question.  It is always difficult for patients to determine what size or type of breast implant would look best on them.  Until recently, we did not have the technology to provide our patients a preview of what is possible.  In my practice, I use the Vectra X3 3D camera system to show our patients what the different size implants would look like on their body prior to performing the surgery.  Although the software can not predict the final outcome 100%, our patients have been very pleased with the results and the high accuracy of the preoperative images.  I use the 3D camera system with every patient that is interested in breast augmentation.  As to the type of breast implant (silicone vs. saline), that decision is made by the patient after I have explained the difference between the two implants in detail and allow them to see and feel the implants.  I hope this helps.  Best wishes!

William J. Vinyard, MD, FACS
Palm Beach Plastic Surgeon
5.0 out of 5 stars 32 reviews

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