Do I have tubular breasts and will over the muscle placement help correct their appearance?

Question

I am a 29 y/o female and I suspect I have tuberous breasts but my PS did not confirm. The plan is for him to do a sub-glandular over the muscle placement, using 340cc Natrelle SCX implants with an Ultra High Profile. My question is - will this alone make my breasts look better?. My PS never recommended anything about a lift but he did say that going under the muscle would create a "double bubble" situation.

Brian K. Reedy, MD · Answer

Thanks for your question! Your breasts do appear to be tuberous (but mildly so). I do think a subglandular or submuscular augmentation would be an option for you. I might advise against the extra full profile but that is just personal preference. Plus, it would be nice to see some "wish pics". If you aren't feeling confident, you can always seek a second opinion. Good luck!

Gary M. Horndeski, MD · Answer

You do not have tuberous breasts. You have small breasts with very little breast tissue above the nipple-areola complex. I recommend an inframammary approach to place submuscular implants with a circumareola lift.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ramin Behmand, MD, FACS · Answer

Based on the photos, you do have some components of tuberous breast deformity, but not all. Tuberous breast deformity, also known as tubular breasts, is a condition characterized by several distinct anatomical features. These features can vary in severity from one individual to another, often affecting one or both breasts.  The general components of tuberous breasts are:

1. Constricted Breast Base: One of the hallmark features of tuberous breast deformity is a constricted or narrow base of the breast. This constriction prevents the breast from developing normally and expanding horizontally and vertically, leading to a more cylindrical or tube-like shape.

2. Herniation of Breast Tissue: Breast tissue can herniate or protrude into the areola, which leads to puffiness or enlargement of the areolar region. This occurs due to the constricting ring at the base of the breast, which pushes the tissue forward into the areola.

3. Large or Puffy Areolas: As a result of the herniation of the breast tissue, the areolas often appear enlarged and puffy. This is a common and noticeable feature of tuberous breasts.

4. High Breast Fold: The inframammary fold, where the breast meets the chest wall, is often higher than normal. This unusual positioning contributes to the shortened appearance of the breast height and can make the lower pole of the breast appear tight or constricted.

5. Asymmetry: It is common for tuberous breast deformity to cause asymmetry between the breasts. One breast may be more affected than the other, leading to differences in size, shape, and position.

6. Lack of Breast Fullness: Especially in the lower poles (the lower half of the breasts), there is often a lack of fullness due to the restricted development and expansion of the breast tissue.

You have a constricted breast base, and a high lower breast fold, with less breast tissue in the lower poles.  However, you don't have the hallmark enlarged & puffy areolas. A breast lift (usually a donut lift, also called circumareolar) is done to deal with this very specific problem, which you do not have.

The implant position would be best to be partially under the muscle, or what we call dual plane, because there is better tissue coverage over the implant, and less risk of capsular contracture.  The double bubble deformity is most often the result of trying to place an implant that is too large for a non-expanding breast base.  The ultrahigh profile implant has a narrower base, and less chance of a double bubble deformity. However, it may still be necessary to go to a smaller implant size to avoid a double bubble deformity. Ultra-high profile implants also have a drawback in that they will make more noticeable any asymmetry in the position of the nipple areolar complexes.

Dr. B.

Connie Hiers, MD, FACS · Answer

Yes, you have some degree of tubular breasts. Yes, placing the implants behind the breast will help give you the best shape. No, you do not need a lift. For you, placing the implants behind the breast will be more stable in creating the shape and roundness you want.

Do I have tubular breasts and will over the muscle placement help correct their appearance?

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