Can tuberous breasts ever look "normal" after breast augmentation?

After several years of online research the only procedure I've seen done to FULLY correct tuberous breasts is Dr. Alejandro Noguerria's (of spain) 4 flaps technique as seen on YouTube. Why do most tuberous breast patients still after surgery have a constricted looking lower pole and herniated nipple protrusion? A lot of after photos of women with this deformity still have the snoppy nose look just bigger with an implant. Educate me please doctors (no sarcasm)

Doctor Answers 9

Tuberous Breasts

The short answer to your question is yes - tuberous breasts can be significantly improve.   The exact treatment plan will depend on your baseline anatomy.  A formal physical exam is really needed to give you any meaningful advice.  Basic principles in the treatment of tuberous breasts include a internal radial release of the constriction bands that contribute to the conical shape of the breast.  In addition, a periareolar mastopexy is required to reshape the breast and address areolar size.   In some very severe cases, a two step approach is required with a tissue expander implant to help stretch the skin envelope.  Please see a board certified plastic surgeon with extensive experience with the management of tuberous breasts to learn more about your options.  Best wishes,

Dr. Basu
Houston, TX

Houston Plastic Surgeon
4.7 out of 5 stars 211 reviews

Tuberous breasts.

Tuberous breast is a congenital abnormality that occurs during puberty breast development. It can be classified by a combination of reduced breast diameter, underdevelopment of the breasts, areolar overgrowth, protrusion of the nipple areola complex, breast sagging, and breast asymmetry.

What you must realize is that breast tissue grows in between the skin and chest muscles. When there is a stronger than normal adherence between the muscles and the skin overlying the breast tissue, it makes breasts grow out of the area where there is least resistance. The result, the developing breast tissue herniates into the narrow opening of the areola resulting in the tubular appearance.

We call this a constriction ring in the bottom and sides of the breast.

Now that you know why this happens, please know that you are not alone in experiencing this, and this can be fixed.

Correction of tuberous breasts requires total personalization, surgical planning, technical skill and finesse, anatomical understanding, and an aesthetic vision to achieve the most beautiful, balanced, and natural results.

As cases of tuberous breasts present a surgical challenge, you must seek the help of board-certified plastic surgeon who is knowledgeable and skillful in the task.

The surgery may involve releasing the constricted base of the breast where the overlying skin is strongly attached to the chest wall while fixing the areolar herniation. The breast tissue’s distribution will be rearranged to cover the previously constricted areas. The breast sagging will be fixed using a breast lift, and the inframammary fold (breast fold) will be defined and restored. The size of the areola will also be fixed, and the breast volume may have to be augmented to fix underlying breast asymmetry using the anatomic gummy bear implants and fat. These procedures may either be done in 1 or 2 different surgeries.

The technique used will have to be tailored to your breast's anatomical problems. You mentioned the 4-flap technique, but other techniques may include the Puckett's or Ribeiro's technique. You can search these online, and they work wonderfully in releasing the lower pole and creating the natural looking curvature that you might expect after surgery. In the end, it depends on how well your surgeon made attempts to score and release the constricted lower pole.

Hope this helps.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 469 reviews

Can tuberous breasts ever look "normal" after breast augmentation?

Thank you for the good question.  Based on your question, I think that you have a good understanding of the anatomic features associated with constricted or tuberous breasts. I think that the outcome achieved with breast surgery for patients who start out with tuberous breasts depends on how well the "constricted looking lower pole and herniated nipple protrusion" are addressed by the surgeon.  Achieving a "normal" or close to normal look does require significant surgeon experience and may also be dependent, to some degree, on how severe a patient's constricted breasts are (more challenging  anatomic starting point).

 I hope this, and the attached link, helps. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Tuberous Breast Correction

Thank you very much for your question. Many women with tuberous breasts will see a dramatic improvement after a breast augmentation. Achieving optimal results, however, will depend on several factors, including the severity of constriction and the experience/skill of the surgeon. I recommend scheduling a consultation with a board certified plastic surgeon, highly experienced in the correction of tuberous breasts, who can then explain all of your surgical options. At this appointment, the surgeon will perform a physical examination to determine the best technique(s) for your situation. He/she should show you photographs of their recent tuberous breast patients, helping you to achieve realistic expectations for your own potential results.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 109 reviews

Can tuberous breasts ever look "normal" after breast augmentation?

There is a range of anatomies represented by this entity, and there are many different alternatives to create a much improved appearance.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Tuberous breast and BA

You have clearly done a lot of research on this subject.  "Tuberous breasts" are not all the same. There is a great variety in the severity of the inferior pole contracture, nipple and areolar herniation, and other abnormalities from patient to patient, and even from breast to breast. 

In my experience, the vast majority of patients can be treated in a single surgery, with release of the scarred tissues and placement of an implant. However, this is not a run-of-the-mill breast augmentation. Often a patient has pre-existing breast asymmetry that requires different size or profile breast implants placed on the right and left, as well as different surgical techniques. I recommend you choose your surgeon carefully.

Good luck!

Jon Ver Halen, MD
Southlake Plastic Surgeon
5.0 out of 5 stars 27 reviews

Tuberous breasts

You would have to be seen in person to determine what would be best. Within the category of tuberous breasts, there are many different options based upon the anatomy.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Tuberous breast gone

This is a great question.  Of course, there are grades, or varying severities, of tuberous breast deformity.  The more constricted and elevated the IMF, the more difficult to correct.  I tell some patients that it may not ever be completely normal, but of course that is the goal.  Depending on the severity, the most conservative way to deal with this is to do it in 2 stages, with the first one releasing the constriction band and placing a tissue expander to help push out and release the IMF, which will hopefully push out and prevent the double bubble deformity if the IMF needs lowered.  

Cain R. Linville, MD
Houston Plastic Surgeon
5.0 out of 5 stars 33 reviews

Tuberous breast surgery

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  The key is to release the lower pole constriction bands for an improved shape.  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.   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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 131 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.