I have tubular breast, should I go under or over the muscle? (Photos)

The treatment of a tubular breast deformity usually involves release of the gland tissue as well as reduction of the areola and placement of a purse-string suture. Implant placement position is the surgeons choice and I think that most surgeons these days would place the implant beneath the muscle if possible. I hope this has helped.

For correction of tubular breasts, I prefer to place the implant beneath the muscle. Remember that subpectoral placement only places the upper portion of the implant below the muscle, the lower part is not covered by muscle so it is in the same position as it would be for a subglandular placement. It is important to choose an implant size that fits your chest dimensions and not try to go too large as this can lead to all kinds of problems with the shape and look of your breasts. It is also important to release the constricting bands of tissue in the lower breast to allow the skin to stretch over the implant and not cause a crease or double bubble. Again, staying with a reasonable size implant helps with this as well. Many patients benefit from doing a periareolar or circumvertical mastopexy to elevate and diminish the size of the nipple-areola complex and improve the pointed shape of the breasts.

Hello and thank you for your question. You do have tuberous breasts.  You are a great candidate
for a breast augmentation with release of lower pole constrictions bands.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  There are several
advantages and disadvantages to over vs under the muscle.  Under the
muscle has the advantage of lower capsular contracture rates, less risk
of rippling, and better visualization with future mammograms.  Most
patients say that under the muscle also has a more natural look and
feel.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon