Constricted breasts; need opinion on implant type, size and incision location. (photos)
Doctor Answers 5
Tuberous Breasts and Shaped vs Round Breast Implants
In my own practice, I augment nearly all of my tuberous breast patients with round breast implants. More studies are coming out about rotation of anatomic implants. I have also had satisfactory results with shaped implants, but the results don't appear to be superior to those achieved with round implants in my experience. There is no good implant or bad implant. The most important is the ones your surgeon has the most experience achieving good results. Look at before and after photos. Choose the surgeon, not the implants. Discuss size with your surgeon as well.
To see a breast augmentation of a tuberous breast patient with round implants, click on the link below.
All the best.
Hello and thank you for your question. You are a great candidate for a breast
augmentation. You do appear to have lower pole constriction, which will require release of constriction bands during your surgery. This can be done through a periareolar or inframammary incision. The size, shape, and profile 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. Anatomic or tear shaped implants can rotate after being placed in your breast pocket and can have problems for that reason. Smooth silicone moderate profile plus may another good option for you. This entire surgery can be performed with a
small incision technique. 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.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon
Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery
I appreciate your question.
Constricted or tubular breasts tend to be too narrow with a breast crease that is too high. Tight ring-like bands of tissue around the areolae and nipples may create the appearance of protruding or puffy areolae. A higher than normal breast crease may make your nipples appear to be too low or down pointing. Constricted breast features can be very mild or severe. In fact, mild variations are relatively common. To summarize, the features can include:
- Inframammary fold (breast crease) too high
- Inframammary fold misshapen
- Breasts too narrow (disproportionately narrow base width)
- Insufficient breast skin
- Constricted or tubular shape, resulting from tight bands of tissue within breasts
- Protruding or bulging appearance of areolae (pigmented area around nipples)
Improvement is possible and generally includes a breast augmentation, sometimes combined with a lift (mastopexy). The lift is usually limited to an incision around the areolae. During the procedure, I release the tight, constricting bands from the inside, allowing the skin to expand properly. I also lower the inframammary fold to a more ideal position and improve its shape. Breast implants help create the right amount of volume and improve breast contours, resulting in a more rounded or tear drop shape.
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 and restorative plastic surgery.
best of luck!
Board Certified Plastic Surgeon
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Hello, a proper assessment in-person is more valuable than advice in this forum because a proper assessment involves direct measurement of breast dimensions and other characteristics. I think you would receive better advice by choosing one of the 9 doctors you have seen who is experienced and aligned with your own goals, and they can provide specific advice.
Constricted breasts; need opinion on implant type, size and incision location.
Thank you for the question. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.
These days there are a variety of breast implants available; the variety of breast implant available raise a lot of questions from women considering breast augmentation surgery. Personally, I think that for most patients considering breast augmentation surgery, careful selection of plastic surgeon and careful communication of goals, far outweigh the specific type of breast implant utilized (when it comes to the success of the breast augmentation procedure).
Anatomical breast implants were designed to better simulate the natural breast shape; the problem with these implants is that if they shift or rotate, the entire breast will change shape as well. This change in breast shape may require further surgery to correct. Round implants, under the hand, can shift or rotate without changing the shape of the breasts. Overall, I find that beautiful outcomes can be achieved with the use of round saline or silicone gel breast implants for the vast majority of patients.
Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "normal" or "C or D cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.
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.