Do I have tuberous breasts or breast ptosis? (Photo)

Hi, I am turning 21 in a few months and am looking into getting my breasts fixed. I'm not sure if I have tuberous breasts or breast ptosis, or if it's something else entirely. What would the procedure be in my case? Additionally, is 21 too young of an age to get a procedure like this done? Are there any cons/pros in waiting until later? Or is now a good of a time as any? Thank you in advance (I apologize in advance if the images are not right side up, I didn't know how to fix it)

Doctor Answers 19

What to do if I have tuberous breasts?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hello Chasao and thanks for your question. I don't believe I see any signs of a tuberous breast in your photos. However, photos don't always tell the whole story and there might be some constriction on examination. 

These are the classic components of a tuberous breast:

1) Puffy or herniated areola.
2) Widely spaced breasts.
3) High breast fold.
4) Constricted lower pole or deficient tissue in lower part of the breast.
5) Minimal breast tissue.
6) Narrow base or small "footprint" of the breast.

Again, except for the large areola, I don't see much consistent with tuberosity. You do have significant sagging and one breast is smaller than the other. If sagging can be confirmed,then you might need a breast lift, but this can only be confirmed on examination.  In the photo, you appear to be a grade 2 or 3 level of sagging of your breast tissue. In my office, patients with similar findings will be recommended a vertical or anchor breast lift and implants combination if they want the sagging to be reduced, lift the nipples to a more ideal location, and have better long term results.

Based solely on your pics, I would say you're a good candidate at 21 years old for breast lift and breast augmentation with silicone breast implants. Breast implants will usually give bigger cups, with better fullness up at the top of the breasts. You might need a slightly bigger implant on your smaller left breast. Please see a surgeon certified by the American Board of Plastic Surgery.

Best wishes, Dr. ALDO

Scottsdale Plastic Surgeon
4.9 out of 5 stars 211 reviews

Tuberous breasts?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thanks for your inquiry and excellent pictures.  I believe you have breast ptosis (drooping) and asymmetry with posssible slightly constricted lower pole which may be asssocited with a tuberous breast.  You should seek an in person exam by a board certified plastic surgeon to discuss breast lift, breast augmentation options.  

Tuberous breasts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for the very thoughtful and intelligent question.  From your photos I do see some degree of constriction of the lower pole of the breasts, especially toward the middle of the chest.  Tuberous breasts are not an all-or-none phenomenon.  There are different degrees of the problem, and yours appear to be mildly to moderately constricted.  The breasts are also ptotic (droopy).  I recommend a breast lift with or without an implant (with an implant if fuller breasts are desired).  Best of luck!  

Paul Fortes, MD
Houston Plastic Surgeon
4.0 out of 5 stars 16 reviews

Breast ptosis

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
You dont look like having tuberous breast but in order to rule out this you need a examination in person, it looks like your breast are sagging so you need to see a certified plastic surgeon in order to see what are the best options for your case  (breast lift or breast lift with implants). Best Wishes!

Australia Fragoso-Baez, MD
Dominican Republic Plastic Surgeon
4.5 out of 5 stars 431 reviews

Do I have tuberous breasts or breast ptosis?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for the question and pictures.  Your pictures demonstrate asymmetric breast ptosis. There may be some elements of breast constriction as well. Keep in mind that the presence of breast ptosis  and breast constriction are not  mutually exclusive.

You will  likely benefit from breast augmentation/lifting surgery; you will likely benefit from different breast lift “patterns” to improve the breast symmetry. Some variety of vertical mastopexy and/or full mastopexy surgery will likely be necessary.  

 Generally speaking, breast augmentation/lifting surgery is more complicated than either one of the procedures done separately. On the one hand, breast augmentation surgery is expanding the breast skin “envelope” while breast lifting is (by definition) tightening up the breast skin envelope. These 2 forces are counteracting each other. Therefore, it becomes important to remove the appropriate amount of breast skin and to use the appropriate size/profile of breast implants to balance these 2 forces appropriately and to allow for achievement of the patient's goals while minimizing risks of complications. Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications.

Also, generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts. Patients should be aware of the complexity of this combination procedure, achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only.

For example, some patients who wish to maintain long-term superior pole volume/"roundness" may find that this result is not achieved after the initial breast augmentation/lifting operation. An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness). It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation. The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery, Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia, lateral displacement etc).

Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues to causing skin or tissue necrosis. Poor scarring, pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc. Patients may also be dissatisfied with breast size, shape, and/or how the breast implants and overlying breast tissues “interface” with one another. Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least. Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved.
Given the complexity of the combination breast augmentation/lifting operation and the greater risk of revisionary breast surgery needed, there are good plastic surgeons who will insist on doing the procedures separately.

For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure in one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks are greater with a 1 stage procedure and the patient does have a higher likelihood of needing revisionary surgery.

Having discussed some of the downsides and potential risks/complications associated with breast augmentation/lifting surgery, most patients (If properly selected and who are doing the operations at the right time of their lives psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry.

I hope that this summary of SOME of the issues surrounding breast augmentation/lifting surgery is helpful to you and other women considering this procedure in the future. Also, given your young age, I would suggest that you TIME the procedures carefully in relation to your life circumstances ( such as relationships, pregnancies…).
Obviously, much to consider… The attached link may also be helpful.  You will find a separate page devoted to tuberous/constricted breast surgery concerns on the same website.
Best wishes.

Do I have tuberous breasts or breast ptosis?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hi chasao,

You do have very irregular, underdeveloped breasts, and there is evidence of tuberosity. Ptosis refers to sagging, so you do present with ptosis of the breasts. I believe you would require an in depth assessment to weigh up your options. I believe you may require a bilateral mastopexy (breast lift), and a unilateral reduction on the right, with simultaneous bilateral breast implants.

This would require meticulous, precise planning and measurement to achieve a pleasing result. I would recommend seeing a highly experienced plastic surgeon.

All the best,

Craig Rubinstein, MBBS
Melbourne Plastic Surgeon
5.0 out of 5 stars 42 reviews

You have breast sagging with tuberous elements but not tuberous breast

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
You do not have a typical full blown tuberous deformity of your breasts.  You have sagging.  Breast lift will certainly be required.  Use of implants is optional. Discuss pros and cons when you are ready to proceed with your surgery.
Age is right.

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 24 reviews

Breast ptosis with asymmetry, not tuberous breasts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question and photographs. I do not see evidence of constricted or tuberous breasts in your photographs.  You have evidence of breast asymmetry and breast ptosis.  Your condition could be improved with a breast lift to elevate the breasts, improve symmetry and reduce the size of the areola.  Be sure to see and experienced, board certified plastic surgeon.

James McMahan, MD
Columbus Plastic Surgeon
4.7 out of 5 stars 41 reviews

Tuberous breasts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hello, based on the photos you do not appear to have the typical features of tuberous breasts.  Options to improve breast appearance include a breast lift, or breast lift with implants.

Tuberous breasts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
You certainly have components of a tuberous breast.  If you want improvement of them, you may opt for a lift and possible implants.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.