How to improve the shape of hypoplastic breasts? (photos)

Question

Hello, I previously had submuscular inframammory implants for 12 years to improve the size and shape of my hypoplastic breasts. However, I was never happy with them because they were larger and more prominent than I wanted. Now, I've had them removed for 2 years and they are even more deformed after removal but I don't know the best way to proceed. I want to improve the shape, more rounded and less pointed. I am thinking fat transfer or maybe anatomical implants?

Joel Patrick Maier, MD · Answer

Anatomical implants have a textured surface to keep them in the correct position, and we now are seeing occurrences of a rare cancer due to the chronic interaction/in-growth of the breast tissue with the implant so this is not the best option unless you are willing to accept the risk. However, fat transfer is a very good option with minimal long term concern since there is no foreign objects. The challenge with you may be finding enough donor fat, but I bet we could get enough to meet your expectation. Thank you.

Brian Bassiri-Tehrani, MD · Answer

This is a good question. The answer depends largely what your goals are. For example, if you didn't mind having implants, but just didn't like the size and projection of your previous implants, you can consider having a smaller sized implant with less projection placed to help with a rounder shape and modest improvement in size. This can be anatomic or round. If you want a very subtle increase in size, fat grafting can be an option for you, however, depending on your desired size, you may need to have multiple surgeries to achieve the volume and look you want. There are pros and cons to each option, that is why it is important to talk through all the benefits and drawbacks of each with your plastic surgeon. Hope this helps!

John Michael Thomassen, MD · Answer

Your inframammary fold is very close to your nipple and therefore you are at risk for a double bubble deformity.  The fold can be dissected, released and placed lower but sometimes will not release adequately.  Was this the problem with your prior implants?  Would you be able to show photos of how the implants looked?

Daniel Barrett, MD · Answer

Dear Celebrated6724,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.The type of surgery best for you will depend on the severity of your condition.My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Alan Gonzalez, MD, FACS · Answer

Hello @Celebrated6724, thank you for your question. It depends on what you want to achieve.  If you removed your implants for health issues then implants are out of the question. If there is not much breast tissue you could have a breast fat transfer with an experience surgeon that can create with you a surgical plan to improve the shape of the breast.  For  more information and recommendations, it is best to consult one or more board-certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS.   If you are considering to improve volume, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results.  Best wishes! Alan Gonzalez MD, FACS.  American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Gary M. Horndeski, MD · Answer

Your breasts are low and lateral on the chest wall and you have poor cleavage. The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Urias, MD · Answer

Celebrated6724 you’re on the right track. Besides an implant and fat grafting, it will be a good idea for you to research a mastopexy. You’ll require expansion of your breast circumference and lower pole skin. Trying to use the implant alone to achieve this may not be enough as it will result in the unnatural look you had. This is where the mastopexy comes in to play. Fat grafting then can be used to give more volume and further shape your breast. In addition can help reduce the size of the implant. Now remember an in person consult is always required especially for your situation.

Connie Hiers, MD, FACS · Answer

Since you have very little actual breast tissue, implants behind the muscle would be best. The muscle can help hide the implants and avoid the ball look. Fat is placed in actual breast tissue and you have very limited tissue to hold fat.

Hilton Becker, MD · Answer

If you have excess fat, fat grafting may be a good option
It usually requires small volumes in  2-3 stages

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment on the outcome of a plastic surgery procedure we generally need to see proper before and after pictures. If you’ve had more than one operation, then it would be helpful to see before and after pictures of each procedure. If you don’t have before and after pictures then ask your surgeon to forward the pictures they took.
It sounds like a better option would’ve been to decrease your implant size rather than removing the implants. Fat transfer can increase breast size by approximately 1/2 cup. The procedure does little to change breast shape, and it’s not going to increase the diameter of your breast.
Anatomic implants may or may not have advantages. Choosing the correct size implant, especially taking consideration into one profile, and how profile affects projection are very important decisions to differentiate quality outcomes from those which may not be desirable. 
Best,
Mats Hagstrom, MD

How to improve the shape of hypoplastic breasts? (photos)

Answers (11)

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