What is the best incision method to correct tuberous breast deformities? (photos)

You have significant areolar herniation and a very constricted lower pole.  The periareolar approach in which the areolar herniation is corrected along with a textured shaped implant is the best approach but due to your tight skin envelope, you may only obtain a modest size improvement.  If you would like a larger breast, you may need to consider an expander to stretch the skin before the final implant is placed. 

An incision in the inframammary fold allows access to release the breast tissue and areolae. It also allows for dual plane insertion of implants.An exam and full discussion with a plastic surgeon is recommended to answer all of your questions.

I agree that Fat augmentation is a great choice and should be investigated. It can give very natural and permanent results. A period of breast  expansion (BRAVA) would be needed beforehand. Best of luck. 

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
highInframammary fold misshapenBreasts too narrow (disproportionately
narrow base width)Insufficient breast skinConstricted or tubular shape, resulting
from tight bands of tissue within breastsProtruding 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

Thank you very much for sharing your concerns with us.After having analyzed all the information and photos provided to us, i can identify that you have a underveloped and mild tubular Breast. I recommend you perform a Tubular Breasts Correction with Breast Augmentation using silicon implants, at the same surgical time.There is a surgical technique for Tuberous Breasts correction, by which it is arranged the tuberous areolar ring from inside, without requiring areolar reduction. In this technique we also need silicon implants, to get a better Breast volume and projection.Therefore it is very important that the plastic surgeon who will perform the surgery, has the skills and vast experience in this type of procedure.Respectfully,Dr. Emmanuel Mallol Cotes.-

Thank you for the question and the photos. I agree that the periareolar incision is the preferred one in this case for access to the areolas and to minimize scars on your breasts. However for correction of tuberous deformities I place the implants on top of the muscle provided you have more than 2 cm of tissue for coverage. Best of luck Dr. Khutha

LilyYour question is certainly legitimate, but definitive answer requires physical exam. There are advantages to both approaches. Incisions around the areolas may allow correction of the puffiness, but incision under the fold allows better exposure to address all aspects of your constricted breasts. Also Gummy bear implants may not be for you, as they can feel quite firm. Seek out a board certified plastic surgeon with lots of experience with this type of surgery, as this surgery is not straight forward. Good luck!

Tuberous breast treatment is highly individualized, so there's no such thing as a best incision.  The options depends on shape and need for release of the tuberous tissue. Based on what I see on your photos, in my opinion the incision around the areola is going to be the option that I might use for a patient in your situation. 

Hi... thank you for the question and photos... A tuberous breast could not be treated like a simple breast augmentation. In order to correct puffy areola and  breast constriction some procedures have to be done. I suggest for this a periareolar incision.  

One of the most noticeable characteristics of tubular breasts is areolar herniation. An augmentation can address breast size but an implant alone can make the areolar "puffiness" even more prominent. Many surgeons would recommend a "doughnut" or circumareolar mastopexy to tighten and flatten the areolar skin as well.The Breast implants can be placed using the mastopexy incision. A consultation with aboard certified plastic surgeon will more accurately determine your options and which would be appropriate for you.