I have pointed areolas and pointy breast. Would implants alone fix this? (photo)

Thank you for your question.
You have tuberous breasts and in addition to implants you will need release of infra mammary fold and re-draping of the parenchyma. It is difficult to say what size of implants would look best without an actual examination but slightly bigger implants seem to work better in this situation. You may also need a small breast lift, based on your examination. Please find an experienced Board Certified Plastic Surgeon who can examine you and help you with all your concerns. All The Best !

Hello and thank you for the question and sharing your photos.  I do believe you have elements of tuberous breasts, including high inframammary crease, constricted lower pole and herniation of breast tissue into areola. You area a great candidate for breast augmentation. When doing breast augmentation for tuberous breasts, it is often recommended to do scoring of the lower pole for better expansion. I would consult with a board-certified plastic surgeon for a formal evaluation. Best,
Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon

Implants alone will not solve your problem.  Your breasts are too low on the chest wall.  You would benefit from a breast lift using the no vertical scar technique.  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 can be performed if additional volume is desired.  Implants are not lifetime devices.  6% fail within the first year and 30% fail within six years.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

Hello! Thank you for your question- I receive a lot of questions like this in my office. For the best result, you would benefit from breast implants placed under the muscle with a mastopexy (breast lift) at the same time. If you were to only have breast implants, your breast shape would be slightly more rounded, but your nipples would likely still protrude and point downwards. After a lift, the implant sizing between a moderate profile and high profile is really just a preference for how full of a breast you are seeking. Both profiles of implants can help with stretching the short distance between the nipple and inframammary crease. Please feel free to view before and after photos of patients with breast implants and mastopexy at the same time. 

Your nipples point downward especially on your right side. I think the best option is to have a lift and implant. You are ideal for a lollipop type of lift. It will improve symmetry and place your nipples where they should be in addition to giving a more desirable shape.

Dear Alibee1986,
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.
Tuberous breasts can rarely be corrected without implants or at least a small one. The breast needs to be scored radially from the inside to expand it. If you don't place an implant behind the radial scoring it will fall back to its original state. You could theoretically remove the implant at a later day and graft with fat but that would be a separate surgery.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  You appear to have areolar herniation consistent with tuberous breasts.   Based on your photographs, the best shape and contour could be achieved with an implant and a periareolar mastopexy.  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.  FACS

Harvard-trained plastic surgeon
 

Based on your pictures, it appears that you could use a lift as well as a breast augmentation.  The lift will help elevate the nipple areola on the implant and provide better overall proportion to the breasts.  As you can see by your computer simulations, an augmentation alone will not change the position of your nipples.  As far as implants, without measurements it is impossible to say what would be best for you.  The best thing to do is to have a few consultations with board certified plastic surgeons and see what they recommend.  I hope this helps.

Tuberous breast is not, technically speaking, a "yes" or "no" question. There can be different points on the continuum. The typical hallmarks include a high, tight fold with "puffy" or distended areola, minimal breast tissue and potentially herniation of the breast tissue through a tightened ring thus the "tuberous" label. It is a congenital deformity which usually manifests at puberty. To what degree it manifests will vary from one patient to the next.
Treatment of tuberous breasts varies depending on the degree of the breast architectural distortion. Surgical correction typically involves:
-areolar reduction
-submuscular augmentation
-release of constricted breast tissue
All of these techniques work in concert to correct the tuberous deformation of the breast.Based on your photos, you demonstrate some features of a classically "tuberous" breast. You would benefit from the techniques described above. These can be challenging cases and nipple position is function of much more than simply implant profile choice. 
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Verified Member
RealSelf Top 100
RealSelf Hall of Fame

Thanks for your inquiry and excellent pictures, I believe you have some features of a tubular breast you would benefit from a periareolar lift and radial scoring to free the lower pole. Please discuss with your surgeon and best of luck.