Breast Lift with Augmentation or Without To Correct Congenital Ptosis and Asymmetry? (photo)

Okay, I am a 23 year old female. I have never had volume in my breasts. I was recently told that I have congenital breast ptosis with marked dialated areola along with SEVERE ASYMMETRY. What surgery would fix this with minimum scarring? Yes, I know there will be scarring no matter what the surgery, but what would be the safest with the best results. I also want to increase my bust size to a DDD, would I be able to do a lift/correction/augmention ALL in ONE surgery?

Doctor Answers 5

Sagging Breast or Congenital Breast Ptosis Requires Breast Lift and Augmentation

When the Breast is sagging or has Congenital Breast Ptosis a Dermal Mastopexy is required to improve the shape of the Breast.

Since you want to be bigger as well a Breast Augmentation with a Breast Implant will also be necessary.

There are limits to the size of Breast Implant that can be placed during a Breast Augmentation. From your photos I doubt if you can be enlarged to a DDD.

Discuss with your surgeon the possibility of Soft Tissue Expansion. There are expandable Saline implants that can be used to gradually increase your size and improve the shape of the breast

Congenital tuberous or tubular breasts

You must be VERY careful in choosing your surgeon.  You have a congenital condition that is refered to as tuberous breast deformity by doctors and sometimes called tubular breast by laypeople.  Make sure that your surgeon recognizes this and has some sort of surgical strategy to address it or you will be extremely high risk for an unacceptable result!


To answer your questions, yes you can have everything done in one surgery but tuberous breast deformity requires special considerations and techniques.  For the morphology of your breasts I would use a technique I call the FEMMA-S with or without an implant.  In this way the scars can be hidden, limited to aroung the nipple and underneath the breast, and your tissue can be reshaped into an aesthetic breast shape without throwing away any tissue.  I you really do want the size you mention, I would add a silicone gel implant in the SUBFASCIAL plane to give you the most natural looking results.  I use a technique called 'cold-subfascial augmentation' that allows the shaping and support of the implant and creation of a tear drop form.  I hope this helps!


All the best,


Rian A. Maercks M.D.

Rian A. Maercks, MD
Miami Physician
4.9 out of 5 stars 75 reviews

Breast lift without implants for constricted bases and congenital asymmetry

Thank you for your question and the photo. Yes, you will likely benefit from a lift with or without implants. At 23 years old, you may consider the lift now and implants later after children. When you see your surgeon, ask about the location of the incisions and the risks, benefits, and potential compllications of surgery.

I do not recommend that you get large implants as this will set you up for problems down the road.

If you get surgery done when you are young, there is a very high likelihood of getting things redone as you get older, have children, and your weight changes up or down.  This is part of it. Your breasts will change throughout your lifetime.

To be sure what is specifically best for you, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.  I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 183 reviews

Breast Lift with Augmentation or Without To Correct Congenital Ptosis and Asymmetry? (photo)

Thanks for the photo posted. I recommend to see in person a few boarded PSs in your are. But I see that you may need 2 to 3 staged surgeries. The 1st is a full lift with anchor scar. Second after at least 3 to 6 months healing, insertion of large implant. Than 3rd revision of scars if needed and areolar position. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Breast Ptosis and Asymmetry

Based on your photos, you will need a lift with implants to achieve your desired goals, although your desired size to DDD could create problems.  In my opinion, you will need a T-scar type pattern incision due to the amount of ptosis present.  I believe this will give you the longest lasting result.  I would recommend that you consult with a board-certified plastic surgeon to discuss the options and most importantly to discuss your desired size.  Trying to go too large in breast size with your issues, can lead to more complications.

Don W. Griffin, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 73 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.