Fat grafting or breast lift slightly tuberous breast? (photos)

Hello! I have tuberous breasts and hate how conical and constricted they look. I have read about fat grafting and breast lifts which sound like what I'm looking for. Pretty much would like to just not get implants, any suggestions? Thank you .

Doctor Answers 11

Fat grafting or breast lift slightly tuberous breast?

In my opinion the best option in your case would be to have breast implants and release of the lower pole of the breast to expand the skin. It might take a few months for you to see the final result. I dont see where fat would be harvested for transfer. Many times atleast two sessions are necessary.

Bloomfield Hills Plastic Surgeon
5.0 out of 5 stars 19 reviews

Tuberous Breasts

Typically the most effective way to correct and reshape tuberous breasts is with a combination or implants and release of constricted tissue. I recommend that you meet with a Plastic Surgeon in person who can examine you and make recommendations specific to you and your goals. Be sure to seek a board certified Plastic Surgeon.
All the best

Fat grafting breast

Thank you for your question . Fat grafting is a possibility for you, but you will need multiple sessions to obtain the size and shape you are looking for. The reason for the multiple sessions is your skin can only stretch a certain amount per fat grafting session. Secondly your breast size will be limited by the amount of usable fat you have. I recommend finding a board certified plastic surgeon who is also a member of the American Society of Aesthetic Plastic Surgeons for a consult. Best of luck with your surgery.

Johnny Shea-Yuan Chung, MD, FACS
Allentown Plastic Surgeon
4.3 out of 5 stars 19 reviews

Tuberous Breasts/Breast Augmentation/Breast Implants/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision

I appreciate your question. Constricted or tubular breasts tend to be too narrow with a breast crease that is too high. Tight ring-like bands of tissue around the areolae and nipples may create the appearance of protruding or puffy areolae. A higher than normal breast crease may make your nipples appear to be too low or down pointing. Constricted breast features can be very mild or severe. In fact, mild variations are relatively common. To summarize, the features can include:
  •          Inframammary fold (breast crease) too high
  •          Inframammary fold misshapen
  •          Breasts too narrow (disproportionately narrow base width)
  •          Insufficient breast skin
  •          Constricted or tubular shape, resulting from tight bands of tissue within breasts
  •          Protruding or bulging appearance of areolae (pigmented area around nipples)
Improvement is possible and generally includes a breast augmentation, sometimes combined with a lift (mastopexy). The lift is usually limited to an incision around the areolae. During the procedure, I release the tight, constricting bands from the inside, allowing the skin to expand properly. I also lower the inframammary fold to a more ideal position and improve its shape. Breast implants help create the right amount of volume and improve breast contours, resulting in a more rounded or tear drop shape. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery. best of luck!Dr. Schwartz Board Certified Plastic Surgeon Director-Beverly Hills Breast and Body Institute #RealSelf100Surgeon #RealSelfCORESurgeon

Fat grafting versus implants

Fat grafting can increase breast size a small amount compared to implants. The best results are when you place an external expander on the breasts, known as the BRAVA system. The takes some dedication, since one needs to wear the device for at least 8 hours a day for about 3 weeks. You can do a search for this online.  Take your time and do the research to find out what is best for you.A lift can improve the shape. 

Paul W. Loewenstein, MD
Milwaukee Plastic Surgeon
4.8 out of 5 stars 26 reviews

Fixing tuberous breasts with fat injections and lift or fat and implants

Thank you for your question.

I am assuming that you prefer a natural option for breast augmentation using fat transfer.

It is true that fat can be used to expand, improve shape, and correct deformities in patients with tuberous breasts who have small, narrow and abnormal looking breasts, however, it cannot match the shape improvement brought on by breast implants.

There are somethings you should know about it though.

Fat transfer to the breast involves carefully harvesting fat using liposuction from areas in which you have excess, unwanted, and stubborn fat deposits such as the outer thighs and abdomen, flanks, hips, etc.,  and injecting it safely back into the breasts which may be lacking in aesthetics or volume. You must adequate fat to do this.

Once injected, the fats cells must form a new blood supply to be nourished and remain alive. What can hinder is the technique used to inject and process the fat. If fat is injected in large quantities in one sitting, then blood supply cannot be formed effectively, resulting in death of some fat cells and their removal by the body – this results in a decreased breast size over time. Furthermore, your harvested fat can have certain impurities and oils which increases fat reabsorption. Purifying it is essential. 2 effective techniques are centrifugation and filtration (using PureGraft system).

I use the Puregraft system and it has been shown to more effectively remove the oily, watery, and dead components from the fat harvest. It is also prevents contamination of the fat from air exposure, and can be used for breast augmentation, while centrifugation is most good for purifying small amounts of fat as used for the face.

If an expert, and board-certified surgeon purifies fat using the PureGraft system, and places fat in multiple directions and layers within your breast, then only will blood supply form around the transferred fat, and then only will your results be sustained over the long-term.

Below I describe the pros and cons of the fat-based breast augmentation.
  •  Pros
    • Fat is usually inexpensive, abundant, readily available and accessible, and can be harvested numerous times
    • Fat is your own tissue, and your body will not reject the transplanted tissue
    • There is no foreign tissue reaction as seen with implants – i.e., Capsular Contracture
    • Your body figure is improved by removal of fat while your breasts are enhanced
    • The procedure results in soft and natural breasts with long-lasting results
    • It is minimally invasive and your recovery will be quick
    • It can be used to enhance the cleavage area, improve symmetry, and change the shape of narrow based breasts
    • It is a scarless procedure
    • Fat transfer to the breast will also improve the skin quality overlying the breasts through a rejuvenation effect (i.e., repair sun damage)
  • Cons
    • There is a limit to the augmentation size possible with fat
    • Unlike implants where you can choose the size you want, you can only go up by a maximum of 1 cup (e.g., ½ - 1 cup increase in breast volume) – If you want to go for a C cup, only an implant can be used
    • You may require more than one procedure to get the desired effect for 2 reasons: 1) you can only put a limited amount of fat in the breasts at a time, 2) fat reabsorption can occur resulting in reduced volume
    • In case a retreatment is needed, it can only be done 3-6 months later to avoid death of fat tissue
    • Procedure is not possible if you do not have enough fat available for transfer from donor sites
    • It cannot change the shape of the breast, correct the nipple position, or correct sagging of breasts (ptosis)
    • It does not provide the upper pole fullness that can be achieved with an implant.
Please find a board-certified plastic surgeon who is an expert in fat transfer and share your goals with them.

Now, I am assuming that you are concerned over the safety of silicone implants.

The best way to make an informed decision is to know pros and cons about the option. I describe some below.

Silicone Implants (5th generation silicone breast implants)
  • Silicone as a filler will make the implant feel softer resembling the feel of the natural breast tissue due to its gel-like cohesiveness. This characteristic also makes the implants less detectable even by touch or feel.
  • Silicone implants are ideal for thin woman with small breasts
  • Silicone implants experience minimal rippling which is barely visible and may occur mostly when patients lie down on their breasts
  • Silicone’s cohesive gel allows more a greater variety of implants – i.e, shaped implants are only silicone-based and provide a natural look which is helpful in treating certain conditions related to the chest wall or breast development.
  • Silicone implants have a 1%/year chance of rupturing similar to saline implants (10% chance after 10 years), however, the rupture is silent which means that you will require an MRI test to diagnose the gel leakage/rupture unlike saline implants, which cause the breasts to deflate making you aware of the problem right away. For many women this is a minor inconvenience for the superior look and feel that silicone implants offer.
  • Unless they are small, silicone implants can more safely be introduced behind the breasts through the inframammary or peri-areolar approach compared to the transaxillary appraoch (scarless technique)
  • Silicone implants are more costly
  • Silicone implants appear in pre-filled form which means implant insertion requires a longer incision on the skin and thus the scar will be longer.
  • The volume of silicone implants cannot be manipulated.
  • There is often a concern over safety and monitoring, but silicone implants have a similar complication rate compared to saline implants, and several clinical trials have shown the safety and longevity of silicone implants that allowed them to be approved by the FDA since 2006. The concern over silicone implant safety originated in 1990s when it was speculated that silicone was associated with connective tissue diseases such as cancer, systemic lupus erythematosis, rheumatoid arthritis, scleroderma. This soon led to the ban of silicone implants worldwide. After over 100 clinical trials showed that silicone implants are not associated with connective tissue diseases, it was not until 1999 that an independent committee of 13 research scientists affiliated with National Academy of Science concluded that silicone breast implants do not cause any major diseases such as depression, lupus, or rheumatoid arthritis, etc. However, silicone was said to be responsible for localized problems such as hardening or scarring of breast tissue. After structural re-engineering of silicone implants, FDA approved them in 2006.
  • Please note that today's 5th generation silicone cohesive gel implants have been proven to be very durable and safe. In fact, they have lower rates of capsular contracture and silicone gel diffusion. Silicone gel diffusion which can lead to an inflammatory response was a major concern with previous silicone implants along with capsular contracture. This was the case in the 1970s, and this problem cannot be applied in the contemporary context because the more cohesive silicone gel and the higher number of shells prevent silicone’s movement, diffusion, leakage, and exposure to the surrounding breast tissue. In fact, even in the case of an implant rupture, the silicone gel remains restricted inside the shell because of its thickness – this is referred to as “gummy bear silicone”. The new silicone implants have thicker shells, wider variety of surface textures, and implant shapes, giving patients more options to meet their desired looks.
  • Final Verdict: Silicone implants are very safe and durable.
  • If your major concern is safety, and you also prefer a natural look, then the new Ideal Implants may the right choice for you. Ideal implants have been created to provide the natural look and feel but with saline as a filler rather than silicone. The unique structure of the Ideal Implants allows for a similar look and feel as silicone with the safety of saline. Ask a board-ceritied plastic surgeon about IDEAL implant.

In the end, a surgery to release the constrictions coupled with a combination of a small implant and fat grafting may be best for you.

Hope this helps, Best of Luck!

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 414 reviews

Mastopexia /lollipop scar/implants

Thanks for your photos and question. 

You have  tuberous breasts and an asymmetry.  Based on them you will benefit from a Mastopexia with implants and a lollipop scar. It will give you the result that you desire. Your surgeon should enhance your breasts with implants (round and moderate profile implants) to help with asymmetries. 

Please consult with a board certified plastic surgeon. Good luck...

Ozge Ergun, MD
Turkey Plastic Surgeon
5.0 out of 5 stars 10 reviews

Breast lifting and fat graft enlargement

Thank you for asking about your breast lift and augmentation with fat.
  • I agree with you that you have a moderate form of tuberous breast shape.
  • Surgery can be done to lift them, release the constriction and reduction the projection.
  • There are pros and cons to breast implants and to fat injections.
  • Fat injections can be placed anywhere in the breast to reshape them.
  • But implants by their size and weight can keep the breast expanded after release of constriction.
  • If is possible that a combination of a small implant and fat injections may be what is best for you.
  • I suggest you have a consultation with one or more plastic surgeons to understand the pros and cons of both and to find the surgeon in whose advice you have confidence.
Always consult a Board Certified Plastic Surgeon.  Best wishes. Elizabeth Morgan MD PHD FACS

Fat Grafting vs Implants

It really depends on how much, if any, increase in size/volume you may want as well. If all you are looking for at this point in your life is better shape, you can accomplish this through an incision around the areola. A small increase is possible with fat grafting but implants are probably better if you want more than very modest enlargement.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.5 out of 5 stars 69 reviews

Fat grafting or breast lift slightly tuberous breast?

Hello dear, thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but  also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissue… Breast augmentation surgery increases or restores breast size using silicone gel implants, saline implants or in some cases, fat transfer. One of the most popular and frequently performed aesthetic surgery procedures, breast augmentation has a long and successful track record in satisfying women who wish to enhance, regain or restore balance to their figures.

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 329 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.