Breast Lift for Tuberous Breasts

Question

I have been diagnosed with tuberous breasts and it was recommended I get a lift on one side, because one of my nipples hangs lower than the other. Like most ladies with this condition, when it's cold, my tuberous breasts actually look normal and my nipples actually even out. Would I have the opposite problem after getting a lift done? What would happen when I'm cold?

Michael Law, MD · Answer

Tubular breast is a condition where one or both breasts do not develop normally or completely, remaining narrow at the base and projecting in a conical or tubular fashion from the chest wall. Tubular breasts are usually somewhat small and droopy, and they tend to have overly projecting or bulging areolas. The inframammary folds are generally higher than normal, and the breasts often appear to be unnaturally far apart on the chest wall. The condition is thought to result from an early restriction of normal breast development at the time of puberty, and is present to some degree in as many as 3 to 5 per cent of patients seeking breast augmentation.

Most of the patients that I have treated for tubular breasts have described how uncomfortable and self-conscious they have always been about their breast appearance, and how it has affected all aspects of their life. Many have not known in advance of the consultation appointment that their breast problem actually has a name, and that the problem is in reality a fairly common one. The correction of tubular breasts is deeply rewarding as a plastic surgeon, as patients report that their lives are truly transformed by their improved (and more ‘normal’) breast appearance.

The appearance of tubular breasts can in most cases be dramatically enhanced, but it is very important to understand that the surgery is not as simple as merely adding a breast implant. The surgical procedure often involves elements of a breast reduction, a breast lift, and a breast augmentation – all in a single operation.

Most patients with tubular breast have severe underdevelopment of the lower pole of the breast, and the surgeon must essentially ‘create’ a lower pole by expanding the existing tissues in such a way that those tissues will accept the volume of a breast implant in a manner that appears natural. It is thus critical that patients with tubular breasts be evaluated and treated by a board-certified plastic surgeon with experience in correcting this complex abnormality, as failure to address all of the abnormalities that contribute to the tubular breast appearance will result in a poor surgical outcome and an even unhappier patient.

The surgical techniques I use to improve tubular breasts include reduction of the prominent areola, elevation of the areola to a more superior position on the breast mound, lowering of the inframammary fold, and radial and circumferential scoring of the constricted breast tissue in order to allow it to expand and accommodate the additional volume of a breast implant. In many cases the breasts are asymmetrical and this issue must also be addressed. The surgical techniques used for each individual patient are carefully selected based on preoperative evaluation.

Because so many complex issues must be addressed when correcting tubular breasts, the surgery takes longer than routine breast augmentation, and as one might expect there is a higher need for surgical revisions. However, with careful attention to detail and highly individualized surgical treatment many patients can achieve an aesthetically desirable breast appearance in a single operation.

Larry S. Nichter, MD, MS, FACS · Answer

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.  See the below link on some suggestions on finding the most qualified Plastic Surgeon for a Breast Augmentation.  Always insist on a board certified plastic surgeon.

Lewis Albert Andres, MD · Answer

Thank you for your question!  The standard procedure would be placement of an implant (or tissue expander, depending on the lower pole of your breast) as well as a circumareolar breast lift.  These modalities would correct the issues with tuberous breast: constricted breast at the inferior pole, via breast prosthetic; scoring of the tissue to release the bands; lowering the inframammary fold; correcting the herniation of breast tissue into the areolae; and decreasing the overall size of the areolae.  These are the hallmarks of tuberous breasts.  Consult with a plastic surgeon well-versed in breast surgery and discuss your goals and expectations.  S/he will then be able to examine and discuss the various options and assist you in deciding which decision os the right one for you, given your desires.  Hope that this helps!  Best wishes for a wonderful result!

Rod J. Rohrich, MD · Answer

A true tuberous breast correction procedure can be quite difficult and challenging for a surgeon. The breast has a constricted base with a protruding nipple and most often has a small amount of breast volume. This varies from patient to patient and requires a variety of procedures from a small radial release with breast augmentation and/or release or reduction of the areolar. Sometimes this will also require a staged surgery to be done over two sessions with or without tissue expanders. It varies widely depending on the patient and the extent of the deformity.

Scott C. Sattler, MD, FACS · Answer

There are several aesthetic problems to be dealt with in the tuberous breast patient.

	1. the base of the breast is narrow and constricted vertically and horizontally

	2. the breasts are often spaced far apart

	3. the areola are often dilated

	4. there is usually significant asymmetry between the breasts

	Correction requires breaking the breast down internally and distributing it over an implant using some specialized implantation techniques (Dual Plane etc), lowering the infra-mammary fold, disrupting the fibrous constricting bands that narrow the breast, and reducing and lifting the areolar position.

	As you can see, there are a lot of 'moving parts' in this operation. Seek out a board certified plastic surgeon that has treated other tuberous breast patients.

Otto Joseph Placik, MD · Answer

Oneof the features of a tuberous breasts is a large areola. A lift will elevate and reduce the areola to make it appear lifted. This can be done on both sides.

Shahram Salemy, MD, FACS · Answer

Tuberous breasts can be quite a challenge, so it's important to speak with a Board-Certified Plastic Surgeon who understands the anatomy and can offer you the best option for your surgical correction.  This usually involves a breast augmentation combined with some form of mastopexy, and this is usually performed on both breasts.
I have not heard patients complain of an unusual reaction to the cold with this procedure in the past, so I would not focus your attention and energy on this question.  Instead, find a surgeon who can outline a carefully thought-out plan for you, including realistic expectations for your final result-- this will give you the best chance at acheiving your goals.
Good luck,
 
Dr. Salemy

David Shafer, MD, FACS · Answer

Tuberous breasts require complex surgery. If you provide a picture, we may be able to give you more specific advice. However, a simple "lift" is likely not all you need. Just make sure that you are seeing an experienced surgeon. Also, in most cases, both breasts are operated on at the same time to achieve the best symmetry. Good luck.

Tom J. Pousti, MD · Answer

Tuberous breasts have a very narrow base, short distance from areola to inframammary fold, tight (constricted) lower pole of the breasts, relatively wide space between the breasts, "puffy" and areola and some degree of ptosis (drooping).
	Generally, the procedure involves breast augmentation with areola reduction / mastopexy procedure. The distance from the inframammary fold is increased (to create a more rounded out appearance). Proper implant positioning improves the distance (cleavage) between the breasts. The areola reduction helps to treat the pointed and "puffy" appearance of the areola.

	In the most severe cases of tuberous breast, a more complete breast lift may also be necessary.  In many cases however, a lift is not necessary. The patient should be aware that the final result will take months to see and that they will need to be patient and that revisionary surgery is more likely than in patients who do not present with tuberous (constricted) breasts.

	Discuss your specific concerns with your surgeon and they will most likely put your mind at ease re: your concerns.
	Best wishes.

Olivia Hutchinson, MD · Answer

There are several aspects to a tuberous breast, and different degrees of the deformity. Appropriate technique selection depends on an accurate physical examination and diagnosis of the parts of the breast that need to be corrected. Breast lift using a periareolar incision will allow repositioning of the nipple to correct asymmetry.

Breast Lift for Tuberous Breasts

Answers (19)

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