Tubular breast correction without implants?

There are a variety of different treatments for tuberous breast deformity. The right procedure for you will depend on the severity and your aesthetic goals. Mild cases can be treated with release of the bands and fat grafting alone (without an implant). In some cases, treatment with fat grafting without an implant will require more than one session of fat grafting to achieve the desired aesthetic results. Fat for transfer can be harvested from anywhere. The abdomen is one of the most common sites because it does not require any intra-operative position changes for the harvest portion of the procedure. In cases where there is a limited amount of abdominal fat, other areas (flanks, back, thighs, arms, etc) can be added to maximize the amount available for transfer.

Hi, thanks for your question. There are a variety of techniques that can be used to correct tuberous breasts, including fat grafting, nipple areolar complex reduction, mastopexy (uplift), release of constrictions within the breast itself, and breast augmentation with implants. A consultation is required to determine which would be best for you based on the characteristics of your breasts and what you hope to achieve by having surgery.

It is possible to release the constricted tissue, reduce nipple puffiness and perform a lift at the same time to give your breasts a rounder shape without implants or fat transfer. Breast augmentation is only recommended if you’d like to increase your breast size.

The best way to improve the tubular breasts it’s with implants, not fat, you need support to disrupt the rings, just cutting and fat with time it will be the same

Unfortunately, you have not provided photographs or told us your bra size. However, I correct tuberous breasts routinely without implants. The disadvantage of the scoring technique is that the under surface of the breast is undermined an scoring the breast results in cutting the nerves to the nipple resulting in decreasing nipple sensation. The technique I recommend is 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. At the same time, fat transfers or small implants can be place totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Tuberous breast deformity has a wide degree of severities, but generally is associated with a lack of volume in the breast, especially at the bottom, and enlarged areolas. For this reason, the usual surgical plan would be adding volume, whether that is with an implant or fat grafting, and decreasing the size of the areola. If you were interested in fat grafting, fat can be obtained from anywhere from the body, such as the tummy, flanks, back, and thighs, depending on where you had the most excess. Without seeing a photograph, it is difficult to offer more specific recommendations.

Dear Elcrippo,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

It is not possible to give you specific advice without pictures or an examination. There are many degrees of severity with tuberous breasts. In severe cases, there is a lack of breast tissue and volume needs to be added to correct the problem. There is often a short distance between the nipple and the natural crease in the breast which needs to be expanded. The only effective way to do that is with a breast implant. Even fat grafting is not good at expanding and stretching skin. In very mild cases where there is breast volume but the areola seems to be somewhat herniated, it might be possible to do a lift without anything else. Those cases are more rare however. Seek several opinions from board-certified plastic surgeons if you are not comfortable with the advice you’ve been given. Best wishes.

If you actually have tubular breasts and not just sagging breasts, implants are usually needed to control the shape once the restricted areas are released. Fat usually does not do well with controlling the new shape. If only the release is done, your breast will quickly go back to its original shape. The base needs to be expanded and held in that shape with implants or expanders.

Typically implants are used along with a lift to correct shape from tuberous breasts. There are varying degrees to this condition so what is recommended for you may be different. If you were unhappy with your first consultation I encourage you to visit a few other board certified plastic surgeons in your area to hear opinions. Just be sure that you listen and evaluate each opinion and don't simply 'shop" for the opinion that matches yours.