Do I have constricted breasts? Tuberous breasts? Or relatively "normal" breast shape? How would you approach my case? (photo)

I have very little asymmetry and find the majority of the similarities I share with constricted breasts are from the puffy areola when my nipples are relaxed. There may be a small herniation behind the nipple as the puffiness goes away when my nipples harden. I'm interested in TUBA or transaxillary for scar placement but have concerns if this will work in my case - even if I think it's minor. I'm willing to travel to get the best results possible. VS says I'm 34C. But I think closer to 34B. TY!

Doctor Answers 5

BBA

You have tuberous breasts, although the degree of tuberosity is mild. Regardless, the distance from the nipple to the fold is short, and there is centralization of the breast tissue behind the areola. Given the appearance of your breasts, you are not a candidate for TUBA or a trans axillary augmentation. The fold needs to be lowered and the breast "capsule" released. I'd recommend crease or nipple approach.


Vancouver Plastic Surgeon
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Do I have constricted breasts? Tuberous breasts? Or relatively "normal" breast shape? How would you approach my case?

Thank you for the question.

You do have some characteristics of a constricted or tuberous breast. There is a shortened distance between the nipple and the crease, with some constriction of the lower pole of your breast. There is some "puffiness" of your areola. Overall, your anatomy represents a mild form of tuberous breasts.

My recommendation would be breast augmentation performed through an incision in the crease below your breast. This gives excellent access to the pocket where the implant is placed, and allows lowering of your inframammary fold (if needed), constricting bands in the lower aspect of your breast can be divided. Dividing these bands allows the lower pole of your breast to expand and become more rounded.

Do I have constricted breasts? Tuberous breasts?

You do have some characteristics of a constricted or tuberous breast, though on the milder end of the spectrum. You do have a tight lower pole with a shorter distance from nipple to inframammary crease, and your best result would be from an approach that allows proper release of the lower pole...dividing any constricting bands, radial scoring of the breast parenchyma if needed, lowering of the inframammary fold if needed (based on measurements with the lower pole on stretch). I would not recommend the TUBA or transaxillary approach, nor the periareolar approach (though it provides better access for lower pole alteration than the first two), but instead the inframammary approach which allows the best access, the lowest risk of capsular contracture, ability to directly fix the new inframammary crease if it needs to be lowered (to reduce the risk of implant dropout), and the scar is hidden under the breast.

Analysis of breast shape

Hi.  You only have a few of the classic characteristics of the tuberous breast.  For example, your distance from nipple to crease looks a little short, and the nipple position is slightly low.  I would advise a peri-areolar approach to do a lift, and perhaps some radial scoring of the lower breast tissue, internally.  An implant could be placed to give you more volume.  

I would personally advise against a TUBA or transaxillary approach.  Although they have less scarring on the breast, they are also less effective in dealing with the issues you have.

All the best,

Do I have constricted breasts? Tuberous breasts?

Thank you for the question and pictures.
I think your breast photos do demonstrate some of the characteristics seen with tubular (constricted) his breast. For example, the distance from the areola to inframammary folds seems to be tight and relatively short. Your inframammary folds seem to be widely spaced from the midline of your chest. The areola do demonstrate some features associated with tubular breast such as an increased width and “puffiness”.

You will benefit from an in-person consultation with well experienced board-certified plastic surgeons. This consultation will allow for accurate advice that is best provided after a thorough history, physical examination, and detailed discussion of your goals. There are a lot of factors to consider when making recommendations; for example your life circumstances ( planned pregnancies, psychosocial situation…) and tolerance for scars are factors that should be taken into consideration by you and your plastic surgeon.

Based on your photographs and description of concerns, it is likely that you will benefit from breast augmentation plus/minus areola reduction surgery (to improve the "puffy" areola concerns).
 
I hope this, and the attached link (dedicated to corrective surgery for patients with tuberous/constricted breasts) helps. Best wishes.

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.