What Procedures Would I Have to Do in Order to Have my Breasts Look Like my Wish Pictures? (photo)

I had an areola reduction but it did not correct the "puffiness" of my areolas because it is actually my breast pushing forward into my areolas. My areolas are large and puffy. I would like more of a natural crease at the bottom of my breasts, smaller flatter areolas and nice cleavage with full round breasts. I think implants alone wont help it will just make my breasts look like large cones. Please help. Thank you.

Doctor Answers 13

Explanation what you have, and what you can do!

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You have more breast tissue above your nipple than below and you have enlarged areolas. This is a minor variant of what my colleagues already mentioned: constricted or tuberous breasts. 

Your first "wish breasts" have the opposite, more volume under the nipple than above (thanks to the implants) and small areolas. The second are more realistic but have small areolas.


  • Your breast skin is tight and not enough stretched 
  • Your areola skin is loose and stretched even after the attempt to narrow it.
  • You miss volume all together
  • You miss volume more in the bottom half


  • expansion of your lower pole
  • narrowing of the areola

As you can understand this is not easy cause the one works against the other. So you have to adjust your expectations or else risk to be disappointed again....

If you were my patient i would advise a moderate breast augmentation via de crease under the breast, i would incise the bottom half of the breast from the inside so that it can expand more, and use anatomical gel implants to increase the volume. 

Secondly you need an areola reduction and you might want to postpone that till the lower pole is stretched since you already have had an attempt that did not work.

Hope this helps, good luck 

Belgium Plastic Surgeon

Breast Augmentation with Mini Ultimate Breast Lift to achieve wish pictures

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You will need a breast augmentation to increase the volume of your breasts to the desired volume in the photographs.  Through a circumareola approach your areola will be reduced in size, elevated on your chest wall and the shape of your breasts can be changed to provide more upper pole fullness and increase cleavage.  All this can be done without a vertical scar leaving only an incision around the areola.  I recommedn Breast Augmentation with Mini Ultimate Breast Lift using silicone gel implants placed retro-pectoral to achieve your desired result.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Tuberous Breasts #breastimplants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You exhibit the qualities of what we would call Tuberous Breasts. The three main features are 1. High riding inframammary fold, 2. Herniated tissue into the areola with large areola, and 3. Narrow lower poles of the breasts. These cases can be extremely challenging at best. I would caution you against wanting a specific look of someone else because breasts are all so different. There are qualities of the wish boobs that I do not think you can get. I do not think you can ever get the lower pole expansion that she has. Also the small areola she has might be very difficult to build on your breast mound. Being that said you can have a wonderful result. If you truly want to be that large you may have to have tissue expansion first to make room for a larger implant. Then you will need to have the areola reduced and the tissue modified to that the areola are less puffy. Seek a board certified Plastic Surgeon who does many of these operations because this is a tough one. 

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews

Puffy nipples, areolar reduction and breast implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You have a  breast shape that occurs when your lower half of your breast failed to expand when your breasts started to grow. Consequently, your gland stretched out your areolas. So reducing the areolas will not correct this problem. Larger breasts (implants) will improve the lower half of your breasts but not the tissue that protrudes out that way. So you need to make room for that gland or remove part of it. Then the areolas can be made smaller. So to get a better looking breast you have to address all of the problems. ..The chances of you looking like your dream pictures are not going to be realistic, but you can get much better looking breasts!

How to correct tuberous breast shapes

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The appearance that you have is for your breasts to show a tuberous breast shape bilaterally.  This will not look like the  example of the breasts that you are comparing yourself to, but you certainly will see improvements in your shape if you have bilateral doughnut mastopexies performed bilaterally. You will need a more effective areolar doughnut reduction  I don't believe that a breast augmentation by itself will give the results that you will want without the lift.  Please follow the  advice of your Plastic Surgeon, and if you have any other thoughts about the recommendations given, seek another opinion.


Frank Rieger M.D.  Tampa Plastic Surgeon

Recommendations for breast surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

First, I don't think that your breasts will ever look like you "wish" photos. You are simply not built that way. On the other hand I think that further periareolar mastopexy and a small to modest sized breast implant would improve your shape and proportions. Take your time and get several consultations if necessary until you find the surgeon who seems right to you. Good luck.

Tubular breasts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your posted photos show asymmetric nipple position (the left is higher and further from the midline than the right), enlarged puffy areolae and a deficit of skin between the nipples and the inframammary folds. Although surgery can improve things there is no way to get from where you are to the photos you posted as what you wish for you. You need some major adjustments of the skin envelope and there is no lift procedure on earth that will increase the amount of skin between the nipple and fold. Lift procedures remove excess skin and alter nipple position. To get more skin where you need it you have to either expand it with a tissue expander or lower the folds. I am not so sure from the photos that lowering the folds is a good idea. Your best option may be a staged procedure to first address the skin envelope and then address the breast volume.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Breast issues and wish list

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Certainly an implant can be placed and the areola reduced.  Achieving the "wish breasts" is unlikely but you can have a very nice result.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast surgery wish list

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is important for you to understand that we can wave our magic wands, or scalpels, and change the breasts you have into someone else's. Unfortunately, tuberous breast deformity is a difficult problem to correct.

Tuberous Breasts and Wish Lists

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Ladyred514,

Thank you for your question and the photos.  Your breasts have the shape and appearance of a tuberous breast deformity.  Unfortunately, no matter what techniques or implants you may use, you will never be able to have the exact shape, look, and positioning of the breasts you list on your wish list.  That being said, you can still achieve a very beautiful and aesthetic breast appearance.

The procedures required are a nipple/areola reduction with an internal suture to control the herniation of the breast tissue through the N/A.  This will decrease the size and puffiness of the N/A complex.  You will need an implant to both increase your breast volume and also to provide shape to the breast-if possible, a cohesive implant such as a Style 410 implant.  Lastly, you will need the fold under your breast lowered and re-positioned. Please consult with a board certified plastic surgeon who help you achieve the best results possible.  It will be worth it!

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon
4.7 out of 5 stars 88 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.