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

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.

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

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.