I have tuberous breasts , would over or under muscle implants deliver better results? Should I consider a lift?

You need a lift with implants. The lollipop lift is perfect in your situation. Implants under the muscle. I know some surgeon like adding fat around the implants. I think that is useless. Find a surgeon in your area that specializes in lifts with implants. And avoid the temptation to get a donut lift . They don’t work and they look terrible

Thank you for your question and photos. An examination in person would be required to properly evaluate your breasts, but with that said, based on your photos it would appear that you almost certainly require a breast lift (mastopexy) to properly reduce the excess skin envelope and elevate the position of your nipple/areolae. This can be accompanied with a properly sized implant. In my practice I usually place the implant subfascial (above the muscle) to avoid animation deformity (unwanted movement of the breast with activation of the pectoral muscles).

Please consult with an experienced board certified plastic surgeon whose aesthetics seem to align with your own. Best of luck to you.

Your breasts are small, deflated, and ptotic[sagging] but not tuberous. Fortunately for you your breasts are easier to fix than most tuberous breasts. You definitely need a lift to reshape your breast and get the nipple centered. I would also recommend implants to fill out your breasts [to reflate the deflated] which could be placed at the same time. Good luck.

Implants will not solve your problem. Your breasts are not tuberous but low on the chest wall and widely separated. You will need a lift. The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Dear Margomargor,
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

Dear Margomargor,
As with many topics in plastic surgery, if you ask 10 opinions on how to correct something, you might receive 10 different answers. There are many variables involved with tuberous breast correction and augmentation; type of lift, type of breast implant, above muscle/below muscle and a great number of variables computes to a great number of possible combinations to get to a solution. The advantages and disadvantages of breast implant type (anatomic vs round), above or below muscle, and type of breast lift can be found in this forum in many prior question submissions. I would suggest reading each of those and then getting a third opinion from an American Board of Plastic Surgery certified plastic surgeon. Good luck!

Based on 2 posted photos appears as deflated 3rd degree ptosis of breasts. I recommend 2 rounds of surgeries. Round 1: Full lift with areolar reduction. Wait 3-6 months then Implants in dual plane position around 450 cc High Profile. Fees en toto $15,000. Best to virtual consult with...