Age 18 - Is There Any Hope for Me?

I'm 18 and I've had this problem since my boobs started growing in 5th or 6th grade. Very little has changed since then, other than the areolas are much more puffy and ive sprouted a little more breast tissue. I want to get them fixed. Can i do this without implants? and if so, about how much would this cost?

Doctor Answers 26

Snoopy Nose, Tubular Breast or Tuberous Breasts

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Dear Bambi369 in Castro Valley, CA:

You have tuberous breasts with a small amount of breast tissue, Unfortunately, most your breast tissue is "herniating" into your areolae (the pigmented skin around the nipple). It can be corrected without an implant, and the result will be fairly flat. Since tubular breast are often associated with small breast, it is common to use breast implants to increase the bust size at the time of surgery. Fat grafting to the breast was abandoned, with good reason, in the past. More work is being done currently in this area, but it still should be approached as experimental  procedure that is best performed under appropriate research protocol.

Walnut Creek Plastic Surgeon
4.5 out of 5 stars 17 reviews

Tubular Breasts

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Breasts come in all shapes and sizes and significant variations in breast contour are common amongst women. One of the more commonly seen breast variants is the tubular breast deformity. This is also frequently referred to as a constricted breast deformity.

This condition occurs because of constriction of the skin at the base of the breast. This often results in herniation of the breast tissue through the areola which creates a unique breast shape. The vast majority of constricted breast deformities are relatively mild and treatment may not be necessary. Severe cases of this condition occasionally occur and do require treatment because of the magnitude of the breast deformity. A variety of approaches can be used to correct this problem. Treatment should be individualized based on the specifics of the anatomic deformity and the aesthetic goals of the patient.

Your pictures and history suggests a severe tubular breast deformity. Correction of this problem will require a mastopexy with or without a breast augmentation. Correction will require consultation with a board certified plastic surgeon. This surgeon should be able to formulate a treatment plan that addresses your concerns. 

Tuberous breasts

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You have a severe case of tuberous breasts as you already most likely know. The surgery will require careful reduction of the tissue herniated into the nipple complex and scoring of the base of this tissue to open it up. You could put in breast implants at the same operation. If you want fat grafting instead of implants you cannot do the grafting at the same time as the tuberous breast surgery because that will diminish the ability of the grafted fat to survive. Since you will need more than one grafting session to achieve a desireable result I think it will end up costing you much more for all those procedures than a single tuberous breast correction and breast implants. Given the severity of your current condition there is no guarantee that one operation is all you need though it should be in good surgical hands.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Good news, there is definitely hope

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thanks for posting your photos, I know it takes a lot of courage just to ask for help.  you have a severe case of tuberous breasts or constriction. implants with or without expansion has been the standard along with "parenchymal scoring".  recently, vacuum expansion (BRAVA, look it up on the net) with fat grafting has shown promise for augmentation if you want to try to avoid implants.  speak to a board certified plastic surgeon and start considering options. remember there is no rush. take your time and make a decision you feel comfortable with. good luck, it may be a bit of a bumpy road but I know it can be well worth it.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

There is certainly hope for tuberous breast deformity

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Your photos show fairly severe tuberous breasts.  The surgical goals include reducing the size and prominence of your areolae, and getting some volume to provide breast shape.  This is typically done with implants, and plastic surgeons will usually need to do some internal release of some of the fibrous breast tissue that is causing your current constricted shape below your areolae.  Fat injection may be an option, or as an adjunct to implants.  I would be concerned that the BRAVA would stretch your already puffy and stretched areola tissue more than the surrounding tight breast tissue and skin.  I don't use that device, so if you are considering that procedure, obviously seek out someone who uses it and make sure they have experience using it on breasts like yours.

Hope for a tuberous breast shape

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We hear many questions about a tuberous breast, though your breast is the truest example. The good news is that your breast will work as any other, and even breast feeding is possible if that is on your future list. You can have just the nipple herniation reduced or corrected though we would suggest an implant as well to stretch the skin envelope and give better shape and projection to the breast. If you are not in favor of an implant structural fat grafts can be helpful for more modest breast shaping. Be very careful about which surgeon you select as correction such as yours may be out of the ordinary for some cosmetic surgeons.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Tuberous Breasts, You Would Need a Modified Breast Augmentation

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Thank you for your question. You appear to have tuberous breasts. Breast development can continue into your early twenties, so the appearance of your breasts could improve a bit until that time. To improve the aesthetic appearance of your breasts overall though, you would need to undergo a modified breast augmentation, where the surgeon would perform radial scoring of the breast glandular tissue and would lower the inframammary fold in addition to placing the implants. You may also need a tissue expander before implants would be able to be placed. Please see a board-certified plastic surgeon for an in-office consultation to determine the best course for you.

Tuberous breasts and puffy nipple correction

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The surgery must address all of the anatomical problems including: breast fold malposition, constricted or narrow breast base. Surgical procedures may include the following:

  • implant alone,
  • type and shape of implant
  • one or more stages
  • the use of tissue expansion and implants
  • pocket placement
  • placement of incisions
  • breast lift and type
  • correction of the breast base and breast fold,
  • correction of the areola.
  • the use of fat grafting or natural breast enhancement to help shape the breast with or without implants

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Hope for tuberous breasts

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Absolutely there is hope but you need a plastic surgeon with experience in correcting tuberous breasts
You have a severe case of tuberous breasts.The surgery will require careful reduction of the tissue herniated into the nipple complex and scoring of the base of this tissue to open it up and in addition a breast implant 

Breast Augmentation in Women with Tubular Breasts

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This is a great question and more common than you might think to vary degrees. Typically a patient with breasts such as yours are treated with a periareolar mastopexy augmentation. This is where the size and shape of the nipple is corrected while placing a breast implant to help improve the overall shape of the breast. Patients do extremely well with the procedure and tend to be very happy!

It is important to discuss your options with a board certified plastic surgeon that performs a lot of breast surgery.

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.