Are my breasts tuberous and what would be the optimal placement of an implant?

Implant selection is truly something that is based not only on your objective measurements obtained from bio dimensional analysis, but also your subjective goals regarding the aesthetics of your breasts. It is impossible to tell you what implant you should get strictly based on your measurements alone. The projection of the implant dictates a lot about your ultimate aesthetic outcome, for instance are you looking for an extremely natural look or do you want to look like a stripper. You have a mildly tuberous breast defect, and, in my practice, I treat these exclusively with subfascial augmentation plus lower pole support with Galaflex. Additionally, a circumareolar mastopexy is almost always used in order to create a proportionate looking and appropriately position nipple areolar complex. In some instances, sometimes even an inverted T mastopexy is utilized.

Your breasts are not tuberous but asymmetrical and ptotic. The lift technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Unfortunately, surgeons have created the term tuberous breasts, a fact which causes unnecessary concerns for women. Many women just have different sizes and shapes and in my opinion shouldn't be labeled. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA