Treatment for tubular breasts & puffy nipples? (Photo)

Question

I have what I believe to be tubular breasts. I really don't like the shape, or the look of my nipples. Would breast implants and a Areola reduction be the only way to get a normal breast shape? Thanks.

Jimmy S. Firouz, MD, FACS · Answer

Yes it appears you do have tuberous breasts. Tuberous breast correction is a very meticulous and specialized procedure and should only be performed by a board-certified plastic surgeon with extensive experience in this area. I prefer using a breast implant in conjunction with a periareolar incision for reconstructive tubular breast surgery as it provides the highest degree of control and accuracy when placing the implant. This surgical technique results in a natural, symmetrical, and full breast appearance. In order to restore a more ideal and rounded breast shape, you may also recommend a breast lift along with the augmentation. Each patient with tuberous breasts is unique, and so is their surgery. I would need to consult with you in person to determine the best tuberous breast correction surgery approach.

Paul Vitenas, Jr., MD · Answer

Thank you very much for your question and photographs. From looking at your pictures, it does appear that you are dealing with tuberous breasts. Your breasts show constriction at the base, take off lower on the chest, and exhibit puffy areolae/nipples. There are excellent surgical options available today that can provide superb results for tuberous breasts. This will often include a breast augmentation, and in some situations, a breast lift. Once the constricted bands of tissue have been released, the breast skin can naturally expand. Implants will then create a full, sculpted shape for the breast. Finally, the nipple/areola can be reconstructed and repositioned for a pleasing, proportionate appearance. I suggest that you see a board certified plastic surgeon for an in-person exam, and to further discuss the best treatment option for your personal situation.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

From your photos, you appear to demonstrate characteristics of tuberous breasts.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!

Dr. Schwartz

Board Certified Plastic Surgeon

Director-Beverly Hills Breast and Body Institute

#RealSelf100Surgeon

Gerald Minniti, MD, FACS · Answer

Hello,Other than breast implants, fat grafting after vacuum expansion is also an option to achieve volume and shape improvement. A periareolar lift will also help to improve nipple position and symmetry. Go visit a few ABPS certified/ASAPS member surgeons.Best of luck!

Vishnu Rumalla, MD · Answer

Thanks for your inquiry.  You could also consider just a peri-areolar mastopexy without an implant if you did not want to increase your size.  An implant would increase size, fullness, and also give the breast a rounder shape.  Please seek the in person consultation of a board certified plastic surgeon.

Stuart A. Linder, MD, FACS · Answer

A breast implant under the muscle with a removal of retro areolas tissue and ateolar skin reduction will be useful

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.

I think your breast photos do demonstrate some of the characteristics seen with tubular (constricted) breasts. 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”.

Generally, correction of tuberous breast anomalies involves breast augmentation with areola reduction / mastopexy procedure. The distance from the inframammary fold is increased (to create a more rounded out appearance). Proper implant positioning improves the distance (cleavage) between the breasts. The areola reduction helps to treat the pointed and "puffy" appearance of the areola.

In the most severe cases of tuberous breast, a more complete breast lift may also be necessary. In many cases however, a lift is not necessary. The patient should be aware that the final result will take months to see and that they will need to be patient and that revisionary surgery is more likely than in patients who do not present with tuberous (constricted) breasts.

In your case, if the appearance/shape/size of the breasts are a concern, you may be an excellent candidate for corrective surgery.

When you are ready, please make sure you consult with well experienced board-certified plastic surgeons who have significant (demonstrable) experience with this type of surgery. 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.

I hope this, and the attached link (dedicated to corrective surgery for patients with tuberous/constricted breasts) helps. Best wishes.

Vasdev Rai, MD · Answer

There are more than one option available to you. It is possible that implant alone will fix your concern. All depends on your goal. It is best that seek advice in person so that  yoursurgeon can discuss all aspects of your available options.

Owen Reid, MD · Answer

Although there are breast re-shaping techniques designed to correct a tubular breast, in my experience, patients similar to you benefit most from a procedure that includes:- release and lowering of the infra-mammary fold- placement of a breast implant- areolar reduction with or without a liftDuring a consultation, a plastic surgeon will be able to present the available treatment options along with the relative advantages and disadvantages so that you are better able to make an informed choice. Good luck.

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