Shaped implant or round implant for tuberous breast?

Teardrop shaped implants have been nothing but trouble. It’s hard to believe anyone still uses them. Stick with round

Breast implant shape is not the first thing to consider when patients have tuberous breasts. To create a less tuberous breast shape. the constricted tissue surrounding the nipples must first be released. If the areolae are puffy, this can be corrected as well. A lift may be necessary if there is sagging. Then, if the patient would like larger breasts, implants can be used. The shape of the implant can be selected based on the goals of the patient.

Thank you for your question. I might disagree slightly with some others on here. And I am going to answer several of your questions together....

Shaped vs. round implant - this is up for debate, the honest answer is that either will work and some surgeons might have a preference for one or another. I actually prefer a shaped implant for these cases, especially if the patient has a severely deformed breast or very little glandular tissue. You want to make sure you choose a highly-cohesive gel implant, and now these come in both round and shaped, so there are options, but the highly-cohesive gel will help shape the breast over time, so whichever shape you choose, the shape of the final outcome will look more like the implant you choose (especially if you are small breasted to start out with). My preferred approach to a tuberous breast with enlargement of the nipple/areola is an incision around the nipple to place the implant (under the muscle usually, but this really depends on soft tissue/breast coverage thickness), scoring of the gland restriction in the lower pole, and then a periareolar mastopexy on the way out! But this same approach can be done with a shaped or round device.

Which implant type bounces/jiggles more softer? - my advice here is to choose a highly-cohesive gel implant, which is firmer but also ripples less and will do a better job at shaping the breast. If you choose a "softer" or less cohesive gel implant, the implant will be more likely to be shaped and formed by the breast than the other way around and this can be a problem when there is baseline shape deformity in the breast (tuberous breast).

Tubular breasts, saggy, tight, constricted. Over or under the muscle implant? - see above, in general the answer is under the muscle, but the implant can be placed over the muscle if you have enough natural soft tissue thickness and breast tissue to adequately cover the implant. If you do go in front of the muscle, I usually suggest using a textured implant (all shaped implants are textured) as the risk of capsular contracture is less with a textured implant than a smooth implant when placed in front of the muscle. This would need to be determined by an exam to find out what is best for you.

Hope this helps!

Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Dear Hepburnn,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

For tuberous breasts, what is more important than the shape of implant is the lift technique. I recommend a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Hello @Hepburnn thank you for your question. It is vital to make an assessment to consider other factors that also need to be considered when deciding the location of the implant so that they can be determined in a personal and accurate manner, not only the location, but also the volume and type of implant. Best wishes! Alan Gonzalez MD, FACS

You need a consultation to be certain. However, round implants typically manage the constricted base and tubular breast better than anatomical shaped implants.

There are different options for augmenting and adding volume to your breasts. These options include fat grafting or use of an implants. As teardrop shaped implants have a risk of rotating and being misplaced, you would benefit from use of round implants. A Skype or FaceTime consultation with a breast augmentation specialist will help you get an accurate recommendation and pricing.

Respectfully,
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee