Follow-up Question - Improving breast shape, no implants. Suggestions? (photos)

Some surgeons have suggested I have a mild form of tuberous breast, others have said I simply have small breast, and others have said they are indeed small but seem constricted. I don't want implants, is there a natural way to enhance my breast? I don't mind small breast. The shape is what bothers me, I wish they were rounder, and not so spaced apart. Can i achieve any of this without implants or anything permanently inserted in my body?

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Doctor Answers 11

Follow-up Question - Improving breast shape, no implants. Suggestions?

Thank you for your question and photo:

  1. You do not have tuberous breast fortunately but you do have a constricted breast.
  2. The inferior pole of your breast, below the nipple areola is tight and that is preventing a rounded shape
  3. Some type of volume expansion is necessary to round out this portion of your breast.
  4. Since you do not want breast implants  in my opinion-year-old option would be fat transplantation to the breast.
  5. For more information please review the link below:

Tuberous or constricted?

Thanks for your question. This is a question that I think confuses many patients and even some doctors. A conical shaped breast with a short distance from the nipple to the fold is usually referred to as constricted. It looks pointy and tight.

A tuberous breast usually hangs down like a snoopy dogs nose and has a large and dilated areola. The fold of the breast is quite high.

The confusion is that some constricted breasts can gain laxity and look tuberous.

From your photos, I believe that you are constricted.  A constricted breast tends to hold onto its conical shape even when implants are placed underneath which can give the appearance of a breast sitting on top of an implant. This is know as double bubble.

In a constricted breast the tissues require more release so the the shape of your breast takes on the shape of the underlying implant. Tightening of the skin around the areola can also help to flatten the natural breast mound and make your breast shape better as well.

You will have to see a PS who can guide you through  this and and give you realistic expectations about width as well. You may achieve a better shape with lift alone, but I think you would need implants to give a better, wider appearance.

Hope this has helped.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 90 reviews

Follow-up Question - Improving breast shape, no implants. Suggestions?

Other than implants, which you don't want, fat transfer from your own body is the only option to enhance your breasts. See link below for examples. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 63 reviews

Dr Kayser

Thank you for your question. You have many of the conditions that you've already described. Your breasts are small, they have a constriction deformity and are slightly tuberous. These all fall within the spectrum of the variations in development of the breast. It is certainly reasonable to not want an implant as these are man-made devices that occupy a single pocket and will, at some point in a patient's life, have to be removed. 

An alternative would be the placement of fat. This allows the transfer of fat from one part of the body to the breasts. The limitation of fat is that, because it is living tissue, has to be introduced properly in order to allow its maximal survival. This is analogous to a farmer planting seeds whereby the distribution has to be even so that the seeds have the best opportunity to germinate and grow. Placing all the seeds in one location will compromise their growth. These same circumstances are applicable to fat transfer. Because of this you would be limited to the amount of fat that can be placed in any one session unless expansion is first provided. This has been traditionally used with what is referred to as a Brava expansion. However, the company no longer manufactures the domes that are necessary for this procedure. Alternative domes are on the market but thes are not approved in the US for use. Please see the attached videos below and also the link to the web page which explains in detail the concepts of fat transfer on my website. In any case I would recommend a consultation with a board certified plastic surgeon who is experienced in the many aspects of fat transfer. I hope this helps and have a wonderful day. Dr. Kayser - Detroit

Melek Kayser, MD
Detroit Plastic Surgeon
4.9 out of 5 stars 31 reviews

Constricted Breasts

LindaRose.   Your photos indicate mildly constricted breasts with tight inframammary folds. I am afraid that your best option by far, is augmentation with silicone implants and release of the folds. Be sure to consult with a board certified plastic surgeon. Good luck!

Robert M. Tornambe, MD
New York Plastic Surgeon
5.0 out of 5 stars 23 reviews

Fat grafting

If you are interested in having one cup enlargement and symmetry, fat grafting would an option. This will give you more cleavage. Please see the link

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 110 reviews

Improving Breast Shape

So many women are told they have tubular breasts when they do not. You have a prominent conical shape to your nipple areolar complex but this does not mean that they are tubular. You have nice breast shape and I think you would look very natural with round implants, particularly placed over the muscle. I do not know of a better alternative to change your breast shape without implants. Fat transfers could be considered but I think that would throw the natural shape of your breasts off.


I do not think you have  tuberous breasts.  I also do not believe there is a way to permanently change the shape of your breasts without surgery.

Hope this helps.

Dr. Ali Mosharrafa

Ali Mosharrafa, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 10 reviews

Follow-up Question - Improving breast shape, no implants. Suggestions?

You can have a modest improvement, but it is somewhat unpredictable, with fat transfer to the breasts and it may be worth trying. Just be sure you pick a surgeon with extensive experience in that operation. Otherwise it would require implants to get the best results.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Improve breast shape without implants?

Thank you for your question and pictures. Your breasts are small and somewhat constricted.  In addition they are widely spaced. You could increase the size a little bit and improve the shape with fat grafting. Prior to doing so you would need an external expander, which is a suction device.  But you can't increase the size like you could with implants.

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