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

I am 20 years old and looking to correct my moderate tuberous breasts. So far, the advice I have gotten from doctors and the internet point to doing a gummy bear implant under the muscle, but I'm unsure if I should go with a periareolar incision or an incision under the breast fold. I don't see how an incision under the fold would do anything to correct the puffiness of my areolas, which is something I am looking for. Thoughts?

Doctor Answers 19

Best incision for tubular breasts?

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.

Lexington Plastic Surgeon
4.1 out of 5 stars 12 reviews

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

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 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

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 91 reviews


Hello and thanks for the question. A periareolar incision would be the most appropriate approach for your surgery. Your areola and constricted breast tissue can then be effectively addressed. Good luck. 

Dr. B

Carlos Burnett, MD, FACS
Westfield Plastic Surgeon
4.9 out of 5 stars 37 reviews

Breast development and breast implants


Thanks for posting your question. I am happy to try and help you.

Tuberous breasts or constricted breasts have a great deal tightness in the lower half of the breast. So much so that the breasts will not develop in the lower half. When the breast does start to develop, it will actually grow and extend into the nipple area and make the areolas dilate and protrude. The best result would involve a treatment to release the tight bands of tissue in the lower half of your breasts, and place breast implants. There may be some degree of lifting. This would be dependent on the size implants and your natural tissue tightness. The breast crease is the inframammary fold.

The article below will show you pictures of developmentally different breasts.

These can be corrected using either incision.

Best wishes,

Dr. Michael J. Brown
Northern Virginia Breast Augmentation

Michael J. Brown, MD
Ashburn Plastic Surgeon
4.8 out of 5 stars 33 reviews

Tuberous breast correction, some advices:

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.

Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 256 reviews

Incision for tuberous breasts

If your areola has some herniated tissue then I usually use a circumareola incision to reduce the herniated tissue.   Some will use an inframammary. Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Tubular Breasts

In my experience, a peri-areolar approach with a purse string mastopexy and a gel implant in the dual plane with lowering of the fold is necessary to correct this deformity. I would find it difficult to gain access to the bottom portion of the breast and lower the fold through a inframammary crease incision. Because a mastopexy will change the shape from pointy to round it will necessitate using some of the overlying skin thereby decreasing the size of implant that can be placed. You may want to consider an expandable saline implant in that case. Try to find a board-certified plastic surgeon in your area with experience in tubular breast. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Tubular breasts

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. 

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 49 reviews

Tuberous breast deformity

Thank you for your question and for including photos.

Tuberous breasts are indeed difficult cosmetic surgeries.  There are several ways to perform the augmentation as you see in the varied answers from my colleagues.  I use the periareolar(through the armpit) approach and many times place the implant on top of the muscle.  The need for a second surgery is common, so be prepared for this even if not discussed in you consultation.

Best of luck.

Dr. T

Douglas Taranow, DO, FACOS
New York Plastic Surgeon
4.8 out of 5 stars 56 reviews

Tuberous breast

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.

Harry T. Haramis, MD, FACS
Montclair Plastic Surgeon
3.7 out of 5 stars 19 reviews

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.