What would be the best way to correct my tuberous breasts? (photos)

I have been told my right breast is a “stage 3” tuberous breast and my left is a “stage 2”. I am 18 and 5’3 and weigh 135 lbs. My areolas (especially my right side) are very enlarged and need to be reduced – what is the best way to do this? Is a 2 stage procedure recommended here? The first to remove herniated tissue and reduce areola and second to insert implants? Silicone or saline? Under the gland or under the muscle? Any advice greatly appreciated.

Doctor Answers 4

Treatment of Tuberous Breasts

You are one of the few examples I have seen on this site of a true tuberous breast. I would do this in one procedure. I would use the area around the areola where the esees skin is removed to access the sub glandular space and insert the implant. The implant needs to be placed sub glandular as you need to access the whole of the area under the breast to release the breast tissue and splay it out on top of the implant. I would use a textured silicone implant in this space as it will give a more natural result. You will need different size implants because of the difference in the 2 sides. You will need good preoperative  and intraoperative antibiotic coverage since you are incising into the breast tissue. A 2 stage procedure would only minimally reduce the risk of implant bacterial contamination. Make sure you see a plastic surgeon experienced with this type problem. 

Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Tuberous deformity

You have a more difficult issue on the right side ( left in picture) than the right. It might be wise to stage the areola reduction on the right first and then add implants at a later time. I might be difficult to do the areola reduction on the right at the same time due to the two working against each other.  Reducing and stretching at the same time.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Tubular breasts

Dear TBD,   Thanks for submitting your pictures.   From observing your pictures, your left breast is a typical tubular breast that can be easily converted to a beautiful breast  by using breast implant with mini lift (donut, Benneli ) procedure.   Your right breast is an extreme case of tubular breast. The corrective surgery is still the same - breast implant and mini lift, however the outcome depends on stretch ability  of the band under the areola. So, you have to be willing to accept the fact that even though your breast will improve dramatically with the above mentioned procedures,  it might not be as nice as the left side due to the stiffness of the band. If the band will stretch, you breasts will be more symmetrical.   Not all results are the same, because experience, skills ans aesthetic eye are critical for good outcome. So do your due diligence and choose wisely.   Always, consult with experienced board certified plastic surgeons who do lots of breasts augmentation with mini lift in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking.                            Best of luck,                                                      Dr Widder

Shlomo Widder, MD
McLean Plastic Surgeon
4.8 out of 5 stars 124 reviews

What would be the best way to correct my tuberous breasts?

Thank you for the question and pictures. 
I think your breast photos do demonstrate most of the characteristics seen with tubular (constricted) breasts. For example, the distance from the areola to inframammary folds seems to be tight and relatively short. Your inframammary folds seem to be widely spaced from the midline of your chest. The areola do demonstrate some features associated with tubular breast such as an increased width and “puffiness”.

Generally, correction of tuberous breast anomalies 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 your case, if the appearance/shape/size of the breasts are a concern, you may be an excellent candidate for corrective surgery. In my practice, I would certainly recommend the use of silicone gel breast implants placed in the sub muscular (dual plane) position.  Sometimes, based on careful physical examination and careful communication of goals, I find a two-staged approach helps minimize  risks of complications and improve final aesthetic outcomes.

When you are ready, please make sure you consult with well experienced board-certified plastic surgeons who have significant (demonstrable) experience with this type of surgery. There are a lot of factors to consider when making recommendations; for example your life circumstances ( planned pregnancies, psychosocial situation…) and tolerance for scars are factors that should be taken into consideration by you and your plastic surgeon.
 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. 

The good news:  in our practice, some of our happiest patients have been patients who have started out with constricted/tuberous breasts.
I hope this, and the attached link (dedicated to corrective surgery for patients with tuberous/constricted breasts) helps. You will find a separate page, on the same website ("cases of the week"  demonstrating relevant/recent cases. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 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.