Will implants alone correct my tuberous breasts? (photos)

Question

I've been to see a surgeon about my tuberous breasts. They felt that I had a mild case and would probably achieve a good result from implants and some scoring as the skin would stretch over time. They said that later down the line I could get a second surgery to correct the nipples if they didn't improve. However I'm concerned about the herniation of my nipples and feel that an implant may make them more pronounced. Do I need to get a second opinion and see if another surgeon would do a lift?

Benjamin Baker, BMBS MBA FRCS(Plast) · Answer

Hi, thanks for your question. Based on your photos, you have significantly tuberous breasts with both a constructed lower pole and herniation of the nipple areola complex. I would recommend addressing both of these simultaneously with surgery, likely with a combination of a breast implant and periareolar correction of the nipple areola complex (this is not a 'lift' as such - your nipples are not sitting low, the problem is that the lower part of your breast is underdeveloped and so lifting the nipples would not help in your situation, but the herniation does need correction). I would recommend a face to face consultation with a plastic surgeon with specialist expertise in aesthetic breast surgery.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry, if you were my patient I would like to address the tuberous breast shape at the same time as the augmentation with a periareolar mastopexy and radial scoring of the lower pole.  Hypothetically, you could stage this, but I am unsure why.

Marc Pacifico, MD, FRCS(Plast) · Answer

Dear Hayleyj22Many thanks for your question and your photographs.From what I can see in your photographs, I am concerned that implants alone will actually accentuate the puffiness of your nipples, due to the pressure they exert on the breast from within.In my experience, breasts such as yours really need surgery on the areolae too, in order to contain the breast tissue that "pseudo-herniates" through the areola.Personally, I would recommend having another discussion with your surgeon, and if you are not comfortable with the advice, then a second opinion is always a good idea.Good luck

James Murphy, FRCS(Plast) · Answer

I don't think your surgeon is completely wrong in the advice that hes given to you but it may take several months or even years for the problem to be corrected by implants alone. it depends on the size of the implant and the natural qualities of your tissue. You may feel that a circular, or doughnut, mastopexy might be a price worth paying to get the result that you need sooner.

Suzette Miranda, MD · Answer

Thank you for questions and pictures. From your pictures, it does appear that you have tuberous breasts and there are numerous procedures available to help with the treatment of this condition. There are certain treatment goals and different options that can be done. Some of these include expanding your breast circumference and the skin envelope of the lower part of your breast, reducing the areolar size and correcting the location of your nipple if you have some sagging, and increasing breast volume if appropriate. Treatment is guided by the individual needs but can include a breast lift, some scoring to help release constriction and permanent implants (or expandable permanent implants) to help with volume. I recommend you see your Plastic Surgeon again to go over your concerns and questions so that you two can evaluate your anatomy and navigate (with you) the the different possibilities to achieve your goals. Good luck! 
Best wishes, 
Dr. Suzette Miranda

Kim Taylor, FRACS · Answer

I agree with your concern, as I feel that it is likely that your nipples will get worse or at best remain the same if you were to get implants only.  If the nipple appearance does not currently bother you then it would be reasonable to wait & see how the appearance is after an augmentation & glandular scoring.  If they bother you now then you should definitely have a combined procedure to reduce the herniation.All the best.

Jon Ver Halen, MD, FACS (license suspended) · Answer

Hello and thank you for your excellent question. You are a great candidate for a breast augmentation.  The size, profile, shape, texture, and type of implant (e.g., saline, silicone gel, “gummy bear”) is based on your desired versus existing breast size and shape, your chest wall measurements, and soft tissue quality. If you are concerned about the short and long term appearance of the nipples, I suggest that you have an immediate nipple reduction at the time of your surgery. Of course, you will need an in-person consultation to evaluate you for this procedure. Preoperative visualization and surgical simulation with the Crisalix system may help with your decision. Any treatment plan should be based on a detailed discussion with equal input from both you and your surgeon.    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. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck!
 
 Best,
  
Jon Ver Halen, MD FACS

Harvard educated plastic surgeon

Will implants alone correct my tuberous breasts? (photos)

Answers (7)

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