Tuberous breast, not a lot of natural breast tissue on one side. Best implant choice? (Photo)

200 5,7.. He told me not to loose sleep over saline, silicone or gummy bear. Now that im researching i am nervous bc i have heard rippling or feeling the implant more in gummy bear implant in smaller breast. My boobs are about 75cc different, my surgeon thinks 400cc would be good size for me as i want natural. Question -what implants should i get? Im nervous about silicone migrating and killing me , is that rational idk can it really happen idk that either. -what is a good cc for my physic

Doctor Answers 9

Tuberous breast treatment

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Hello, I most often treat tuberous breasts with teardrop anatomic implants but in some cases the round implants work well.  Your PS will be the best source of advice regarding implant size and type because they have done a proper examination and breast measurements.

Tuberous breast, not a lot of natural breast tissue on one side. Best implant choice?

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Thank you for your photograph and question. However, your photo wearing a bra does not allow adequate assessment of your breasts. If you truly do have a tuberous breast, to look natural would require a mastopexy as well. To determine the need for this with any accuracy will require an examination by an experienced plastic surgeon.

My preference for breast implants is silicone gel, although saline implants are quite good. The gel implants feel and look more natural, and they are much less likely to wrinkle. Also if the saline implants leak, which the occasionally do, they deflate and go flat. However, the saline implants are less expensive.

Do not worry about the silicone gel migrating. This would be extremely unlikely with the new Memory Gel implants. If they did leak, they would not affect your general health.

Thanks again for your question, and I wish you the best of luck.

Silicone implants, some advices:

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Thanks for the question. 

In my practice I recommend you Cohesive Gel - Silicone Breast Implants with textured cover ("gummy bear implants") They are quite safe and aesthetically best as they give a firmer consistency, better projection and natural appearance.

Kind regards 

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 372 reviews

Implant selection

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Best to be seen in person to decide which implant would be best for you.  Silicone implants are very safe.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Implant selection

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Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.   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.   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.  

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 174 reviews

Tuberous breast

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Thanks for your questions. In cases like your I recommend silicone implants, i never use saline, only in the US doctor still use saline because years a go silicone was not approve but this has change and now days its been proved that silicon implants are safe. Silicone will give you a more natural looking. If your have tuberous breast a will recommend to to go dual plain and to use Natural shape implants to fill out the inferior pole of the breast, this way you will have a more natural look. Concerning to the size, this has to be decided during the personal consultation. Good luck.

Ricardo Ventura, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 50 reviews

Tuberous breast plus implants

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I would for sur ego wiht silicone and another good thing to consider is to augment/equalize your two sides with some of your own fat.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 70 reviews

Tuberous breast, not a lot of natural breast tissue on one side. Best implant choice?

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 Thank you for the question.

Despite your good description of goals, online consultants will not be able to provide you with specific enough advice to be truly helpful. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging)  as well as careful measurements (dimensional planning) will be critical.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, 

I have found that the use of words such as “natural” or "C or D cup” etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.

Generally, correction of tuberous breast anomalies involves breast augmentation with areola reduction/mastopexy procedure. The distance from the inframammary fold is increased (to create a more rounded out appearance). Proper implant positioning improves the distance (cleavage) between the breasts. The areola reduction helps to treat the pointed and "puffy" appearance of the areola.

Generally, patients who start out with constricted/tuberous breasts may need to be more patient when it comes to viewing their final outcomes (after breast augmentation surgery) compared to patients who do not start out with these anatomic findings.  Because the breast implants take time to "settle" into the relatively tight tissues of the lower breast poles, it may take several months (six months or even longer) before the final outcome of the procedure is achieved. In other words, patients undergoing this type of surgery should be aware of the need for patience and time before the lower breast poles "round out".  Also, generally speaking, as the breast implants "settle" into their positions, the nipple/areola complexes seem higher on each breast mound ("perkier").

Both types of breast implants are very “safe” and have been studied extensively. Each may have its “indications” and pros/cons; certain patients may do better (when it comes to achieving their goals and avoiding complications) with one type of breast implant as opposed to another. For example, if a patient has very minimal breast or soft tissue present, I would likely recommend the use of silicone gel breast implant which tends to have fewer problems along the lines of rippling/palpability, compared to saline breast implants.

In my practice, I tend to use  smooth round silicone gel breast implants for patients undergoing corrective surgery for tuberous/constricted breasts.   Again, however, I think that careful selection of plastic surgeon will ultimately be much more important than the shape or surface characteristics of the breast implants utilized.

 You may find the attached link/video helpful to you as you learn more. Best wishes.

Tuberous breast, not a lot of natural breast tissue on one side. Best implant choice?

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Thank you for your question and photograph.  Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. It is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome.  It sounds as if it may be wise for you to "try on" several of the implants so that you can have a better visual representation as to what each size would look like. Silicone implants are now used three times more frequently than saline implants and have less risk of rippling than saline.  Feeling the implant will depend more on the size of implant selected relative to the amount of natural breast tissue you have and this would affect both saline and silicone placement.  As far as safety, there have never been any confirmed links between silicone implants and an increased risk of health problems. Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 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.