Am I limited on size breast implant with a tuberous breast and very bulky pectoral muscle? (Photo)

I had 300cc silicone subglandular implants and am unhappy with the size outcome I wanted to go with 400cc. I spoke to my nurse post op and she explained I wasn't offered them likely because I was limited on pocket space in my tuberous breast and couldn't go under the muscle for a natural look due to the bulky muscle, I'd this true? I can't see my surgeon for 3 months to ask? I wondered If she was just trying to 'keep me happy' thanks in advance for any advice

Doctor Answers 19

Am I limited on size breast implant with a tuberous breast and very bulky pectoral muscle?

Considering her preop breast shape you have a very nice in fact excellent result.  Patients with constricted breast very often need multiple procedures to achieve the final desired result.  I am certain with time he can have a larger implant but it looks to me based on your postop photos that you had exactly the correct operation for your first stage.You really do look excellent and give your self more time. The expansion of your breast that you have achieved will allow a larger implant in the future if you so desire.

Do tuberous breasts limit size of implant?

The width of the skin envelope is relatively narrow in a tuberous breast, and there are constraints with the implant that can be used. Breast shape can also impact whether an implant looks better above or below the muscle. In some instances it may be possible to put in larger implants after the skin envelopes have stretched. The best person to guide you is your surgeon. She can go over the specific constraints in your specific situation, and you can ask her if increasing the implant size would be possible after the skin envelopes have stretched. 

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All the best.

Heather J. Furnas, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 30 reviews

Am I limited on size breast implant with a tuberous breast and very bulky pectoral muscle?

In most my tuberous patients I need 2 to 3 separate operations to achieve the desired goals. This was not offer to you as it appears to me. Seek second opinions to have a series of surgical options presented...

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Am I limited on size breast implant with a tuberous breast and very bulky pectoral muscle?

Thank you for sharing  your question and photograph.   At times a patient's physical anatomy limits a surgeon's ability to place an implant of a particular size.  Tuberous breasts are one of these more common instances. I would voice your concerns to your surgeon so that they can  discuss with you your current outcomes and the necessity of the 300cc implants.  Once your skin and tissues have stretched it is possible to replace the implants with a larger size.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 68 reviews

Tuberous breasts

You have a nice result as other surgeons have said and going with a smaller implant at first is a safer, more predictable way to go. If you decide you want to be larger then proceeding with a breast implant exchange at least 6 months after your surgery would be the next step. Some surgeons may offer this at a discounted rate if they preformed the first surgery. It does seem odd that you cannot see your surgeon though.

Josh Olson, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 90 reviews

You look very good

Your surgeon did a very good job.  Your folds were asymmetrical before surgery and he help to improve your IMF. Your shape is quite nice.

What are you not happy about?

Dr. Goldberg

David S. Goldberg, MD
Monterey Plastic Surgeon
4.8 out of 5 stars 4 reviews

Implant size

Hello and thank you for your question.  From what I see in the picture, you seem to have a very nice result.  The size 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.  If you are unable to see your surgeon in person for three months, perhaps consider at least speaking on the phone with your surgeon and sharing your concerns.

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

Breast Augmentation - Size Selection

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Steven J. Rottman, MD, FACS
Baltimore Plastic Surgeon
4.9 out of 5 stars 81 reviews

Breast result

Thanks for your inquiry and you have a very nice result.  Patients with tuberous breast often require skin removed in a peri-areolar fashion and also have less stretch in their breast tissues due to underdevelopment of the lower pole.  That being said, implant choices in general are dictated by tissue stretch, need for a lift, and physical dimensions like your breast width.  As for the implant position, many surgeons prefer the submuscular position regardless of the muscle thickness while others primarily place implants above the muscle routinely.  

Vishnu Rumalla, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 200 reviews

Am I limited on size breast implant with a tuberous breast and very bulky pectoral muscle?


Thank you for your question. You have a very nice result. I would not increase the size of your implants. Consider that with time your implants will settle further down your chest. The heavier the implant the sooner you might need revisionary surgery to re-position the implants. Larger implants can also cause other complications such as chronic pain, nipple numbness, skin stretch deformities, capsular contractures, irreversible soft tissue damage, skin stretch deformities, malposition, etc. Also, as with most women, breasts increase in size with weight gain, pregnancy, etc. I suggest you wear supportive bras to help keep the implants in place for years to come and minimize your chances of revisionary surgery caused by their weight. I hope this helps. Best wishes and kind regards, 

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 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.