Tubular with ptosis breasts, what do you recommend? (Photo)

Your large areolas will be problematic for breast lift, and it is possible that some areolar skin will need to remain along the vertical scar as fully removing the excess areolar skin in one surgery will create too much tension. This also means that adding an implant will compound the problem of excess tension. Safest would be to do a lift, leave some areola, and then do an augmentation later and perhaps excise excess areola that remains at that time.

Dear Thriving462160,
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

1) You have very little breast tissue to camouflage the implants. Submuscular is likely best
2) Large areolas and sagging skin. A circumvertical with no lower horizontal limb will likely do the trick.
3) Implant type. Most surgeons are steering clear of the anatomic shaped textured implants due little benefit in final shape, and there is a small but real risk of Anablastic Large Cell Lymphoma (cancer) associated with textured implants. Best wishes with your surgical journey!

I recommend 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. The areolas can be reduced to the size you desire and moved higher. At the same time, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Good Morning ! Doing a breast lift with implants will help with your dislikes of your breasts along with changing the size of your areolas at the same time. Depending on the size of your implant you select and the surgeon you select will depend on the style of lift performed. Smooth implants are sought to be the safest implants. My preference in my practice is subfasical placement, it looks the best and feels more like natural breasts. Good luck with your journey !

I would suggest going in for consultation and measurements. there you can try on a range of sizes to see what you like. I prefer the smooth round implants placed behind the muscle and the vertical lift for you.

This is one of my favorite procedures! Because of the shape of your chest/ sternum and rib cage and how thin you are, you would need a vertical mastopexy with total submuscular gummy bear implants (Natrelle cohesive).
I do not recommend a textured/ shaped implant for you.