I'm interested in fixing my tuberous breasts, but am not comfortable with implants, is it possible to do without?

Hello dear,
Thank you for your question. Based in your question and the pictures you showed, you are a great candidate for a breast augmentation, I totally recommend you implants since you`re really skinny and you dont have enough fat to make the transfer. Tuberous breasts are one of the most challenging breast shapes to correct. The implant size and shape can be determined by breast measurements during consultation. As you mentioned, you do need releasing cuts under your breast tissue to open up the breast to become less coney shape. There is a good possibility that your areola need to be downsized which also provides the lift. Consult a board certified plastic surgeon. Best of lucks :)
Dr. Luis Mejia. 

HiIt really depends on the size and look that you are trying to achieve.  You are very slim and dont have much fat for fat grafting so this would only give you a very modest increase in size.  You would get a very nice result from an implant.  The best results from an areolar reduction are if it is done after the augmentation however it is commonly done at the same time.RegardsDamien