Slightly tuberous breasts - Will a straight forward BA with implants give me a good result? (Photos)

Tuberous breast is not, technically speaking, a "yes" or "no" question. There can be different points on the continuum. The typical hallmarks include a high, tight fold with "puffy" or distended areola, minimal breast tissue and potentially herniation of the breast tissue through a tightened ring thus the "tuberous" label. It is a congenital deformity which usually manifests at puberty. To what degree it manifests will vary from one patient to the next.

Treatment of tuberous breasts varies depending on the degree of the breast architectural distortion. Surgical correction typically involves:

-areolar reduction

-submuscular augmentation

-release of constricted breast tissue

All of these techniques work in concert to correct the tuberous deformation of the breast.

Based on your photos, you demonstrate some very mild features of a classically "tuberous" breast. You would benefit from some of the techniques described above.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Donovan Rosas MD

Board Certified by the American Board of Plastic Surgery

Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons

RealSelf Verified Member

RealSelf Top 100

RealSelf Hall of Fame

Dear Maree93,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.
The type of surgery best for you will depend on the severity of your condition.
My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.
That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.



Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

That’s a very insightful question, and it’s great that you’ve done your research before consulting with a surgeon. What you’re describing/showing is a mild or moderate tuberous breast shape, which means the breast base is slightly constricted and the tissue doesn’t expand fully in the lower pole (the “under boob” area).
In these cases, implants alone may improve fullness, but they often can’t completely release that tight, narrow shape on their own. To achieve a round, natural breast with soft lower fullness, your surgeon may recommend tissue scoring (release) or IMF. These small refinements help the breast tissue expand over the implant evenly, creating a natural slope and defined undercurve, something that’s difficult to achieve with implants alone if the tissue is tight.
The good news is, with a conservative and precise approach, these techniques don’t have to be extensive or create visible additional scarring. The key is gentle internal reshaping, not overcorrection, to maintain softness and a natural contour.
During your consultation, ask your surgeon to explain how they would approach expanding the lower pole and whether a round or anatomical implant would best match your goals. Achieving a natural shape is very possible with careful planning, even if it requires minor tissue release.
Warm regards,Dr. Sibel Atalay, MDBoard-Certified Plastic Surgeon

Hello, I’ve reviewed your photos and question carefully.In mild tuberous breast anatomy, the main issue is not the size of the breast but the way the lower pole is restricted. When the tissue is tight or the fold is positioned too high, an implant alone may not fully expand that area to create a natural under-breast curve.
If the constriction is subtle, a dual plane placement with careful pocket release can often achieve a soft and natural shape without major modification. When the tissue is more resistant, a limited internal scoring or gentle lowering of the fold helps the implant settle properly and prevents a dome-like look.
These adjustments are small but make a visible difference in shaping the lower breast. Avoiding them entirely may limit the improvement, even with the right implant.
A detailed consultation and measurements will clarify how flexible your tissue is and whether minimal release will be enough for the balanced contour you want.
I hope this helps you understand how careful technique and pocket planning can turn a mild tuberous shape into a natural, well-proportioned result.Güray Yeşiladalı, MD

Click the link below to read about a one stage simplified augment approach for a nice result without scoring or lowering the IMF. In my published study I found;
Correction of tuberous breast deformity (TBD) is traditionally done with a 1-stage breast
augmentation with radial scoring of the constricted breast tissue and/or the lowering of the
IMF. An alternative 2-stage approach first uses a tissue expander to correct the deformity; the
expander is later replaced with a permanent breast implant. Sixteen patients are presented in
which a 1-stage correction of TBD was successfully accomplished with saline implants acting as
tissue expanders. In all cases, the expansion remedied the deformity without the need for
radial scoring of the breast tissue or lowering of the IMF. This approach has not been reported
in the literature.
Sixteen women (32 breasts) were treated, with TBD ranging from mild to severe. All patients
had a breast augmentation with round, smooth saline implants placed through an IMF incision
in the dual plane (partially subpectoral and partially submammary). Implants ranged in size
from 225 cc to 675 cc. The IMF was never lowered and the breast parenchyma was never
radially scored. Three patients had asymmetry requiring breast implants of different sizes, and
one had a circumareolar mastopexy to repair a herniated areolar complex.
Representative case examples are provided. The average follow-up time was 9 months. All
deformities were corrected, and the patients expressed satisfaction with their results. There
were no occurrences of hematoma, infection, capsular contracture, or malposition.
Conclusion: This review has shown that saline breast implants alone, with their inherent
expansion capability, can correct TBD without the increased morbidity associated with radial
scoring and lowering the IMF. For patients who choose saline implants, this single-stage, less
invasive surgical approach can provide a good aesthetic result. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Thanks for your question.For mildly tuberous breasts, implants alone can sometimes give good results, but often a small amount of tissue release or IMF adjustment is needed to achieve a natural lower curve.Without this, the breast may stay slightly tight or high.An in-person consultation is best to assess your tissue and plan the most natural outcome.