Need advice regarding flexion deformity after breast aug on tuberous breasts (Photo)

I am 5'11, very athletic and 155 lbs. I was very self conscious about my small, tuberous "pointy" breasts. My doctor said he would release the constricted tissue, lower the breast pocket and place 235cc silicone unders to give me the teardrop shape I desired. What I have ended up with is slightly larger "pointy breasts", without lower pole fullness, and a flexion deformity. It can be seen perfectly though my sports bra and tank top. My surgeon won't offer revision until a year postop. Advice?

Doctor Answers 7

Flexion deformity after breast augmentation on tuberous breasts

Thank you for your question and for including pictures. Your concerns are important and definitely need to be addressed. One of the most challenging issues with tuberous breasts is draping a narrow breast over a round implant and then potentially not having a lot of skin in the lower portion of the breast. The final concern a lot of times is also herniated tissue from the nipple/areola complex. If you are having a flexion deformity (animation deformity) then I recommend changing the pocket from under the muscle to over and also scoring the breast tissue so it falls better over the implant. The "pointy" aspect of the breast can also be improved with an areola reduction. Finally, some fat grafting may also improve any contour abnormalities that may so up. I do not think you need to wait a year for this, but would recommend at least 6 months. I would also seek out other opinions from board certified surgeons with experience with tuberous breast. Best of luck and feel free to ask any more questions. 


Jacksonville Plastic Surgeon
5.0 out of 5 stars 78 reviews

A revision

A revision to tighten your inframammary fold as well as release parenchyma/muscle attachments can help smooth out your lower pole.  You do not need to wait a full year for this.  

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 49 reviews

Flexion deformity

It also looks like you have a constricted breast in the lower pole creating a snoopy look to the breast. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 25 reviews

How to correct my augmented tuberous breast shape to my breasts

Thanks for the question, and please be aware that this has been a problem that some patients and their Plastic Surgeons may have faced in the past, and may continue to experience. The initial thinking of the Plastic Surgeon may have been very correct, and yet the final result is not what both of you hoped for.  On occasion, going on top of the muscle may be a consideration, as well as to perform a donut mastopexy surrounding both areolar to tighten up and reduce the size.  There is also a newer style of implant that's many of us have had good success with on occasion to stretch out the skin below the breast, and the implant style is called the teardrop, form stable, true gummy bear implant.  You may want to ask your Plastic Surgeon about this, and there is never any worry about getting another opinion if you have any unanswered questions.


Good luck to you.


Frank Rieger M.D.  Tampa Plastic Surgeon

Flexion or animation deformity with tuberous breasts

I am sorry you did not receive the results you are desiring. When things do not turn out the way you expected, it can be disheartening. Most times as plastic surgeons we try to put implants behind the pectoralis major muscle. This protects against many potential complications. However it can lead to issues like this, many times this is unknown until it happens. The best way to move forward would be to find a plastic surgeon who understands the issue. You do not need to make your breasts just bigger, but you need to change the shape of your breasts as well. I believe if you swithch out the location of the implants, change the shape and texture or the implants as well, and potentially add a little fat grafting to the lower pole of your breasts you can achieve a nice result. Obviously you need an examination and to know the type and size of the previous implant.


Good Luck

Eric Weiss MD 

Eric Weiss, MD, FACS
Orange Park Plastic Surgeon
4.8 out of 5 stars 32 reviews

Need advice regarding flexion deformity after breast aug on tuberous breasts.

Thank you for sharing your question and photographs.  I see your area of concern.  Without preoperative photographs it is difficult to offer definite advice but tuberous correction often requires release of the constricted breast fold and breast tissue to ensure appropriate spreading of a patient's natural breast tissue.  If appropriate muscle release and mastotomy incisions was performed your results should improve over the first six months from surgery.  If it has been longer than this you will likely need a revision procedure.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 50 reviews

Tuberous under muscle pointy self conscious

Sorry for you.

Total under muscle implants will not give your breasts the shape you desire. In order to change your shape, the implant has to be in the breast. 

If plan A doesn't work, don't do plan A again. As you say, your "pointy" breasts are simply sitting on a mound.

I suggest that you seen a second opinion from  a Plastic Surgeon who understands the benefit of implants on top of the muscle, especially in a situation such as yours.

Good luck

Richard Sadove, MD
Gainesville Plastic Surgeon
4.9 out of 5 stars 21 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.