I have tubular breasts with a pretty significant size difference. What would be the best solution? (photos)

I prefer a lift and a decrease on the aeroloa on the larger breast without implants. My fear is that the asymmetry too significant for fat transfer? Thoughts?

Doctor Answers 9

Tuberous & Assymetrical Breasts May Benefit from a Mastopexy

Those with #TuberousBreasts are ideal candidates for #BreastLifts. Also, women with asymmetric or enlarged nipples or areolae (pigmented areas around nipples) also may be candidates for a breast lift or a modification of a lift. #Asymmetric breast can be adjusted by adding or removing volume. One side can be tightened more or less than another. In addition #BreastImplants commonly complement a Breast Lift (#Mastopexy) . Such is called #AugmentationMastopexy.
Tuberous Breasts or #tuberous breast deformity are breasts with an unusual shape. They may be very narrow at the base on the chest, or the whole breast can be very narrow in shape. There are different variations of #TuberousBreasts but is a growth and development problem which may create a great deal of angst for a young woman.
Without the Breast Lift, the breasts may appear larger and more droopy with solely implants. They will sag more and sooner, due to the sudden and excess weight. It's also possible for a “Snoopy” breast or double bubble to develop as a result. The implant with lift can also re-position the nipples which may have been affected by ptosis or drooping. One of the primary intentions of a Breast Lift (#Mastopexy) is to improve the shape and position of the breast without reducing their size. It is used especially for breasts which sag or droop (#ptosis). Both procedures are commonly done together, in the same surgery to correct the effects sagging and turberous breasts.

Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

A vertical lift can help you achieve symmetry

A vertical lift can help you achieve the symmetry that you want to make your breast more attractive. If you don’t want your breast to get bigger, then the implant will be unnecessary. Decide what you really want to achieve and discuss all the possible options with your surgeon.

Norman G. Morrison, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 39 reviews

Breast Asymmetry

You should be able to achieve better symmetry with a unilateral lift and fat grafting to make up the difference. You may require more than one surgery to achieve the degree of symmetry you would like, but some improvement is certainly possible.

Clark Schierle, MD, PhD, FACS
Chicago Plastic Surgeon
5.0 out of 5 stars 23 reviews

I have tubular breasts with a pretty significant size difference. What would be the best solution? (photos)

You have not only a shape asymmetry and a nipple position asymmetry, but also a volume asymmetry.  This cannot be corrected by augmentation alone or by breast lift alone.  You would need placement of a moderate to large implant on the right and perhaps a lift (depending on the implant size--if large enough you might not need a lift).  On the left you would need placement of a smaller implant (to balance out the now larger volume on the right--but remember the left side was larger to begin with) and definitely a lift as well.  Fat transfer probably has no role in the initial procvedure but might be helpful to touch up the end result.

William A. Terranova, MD
Charleston Plastic Surgeon
5.0 out of 5 stars 9 reviews

I have tubular breasts with a pretty significant size difference. What would be the best solution?

A breast lift would be the simplest option if you don't want a size increase. The breasts would be more balanced and the areola a similar size. 

If you also want larger breast, fat transfer or implants can be do at the same time. 

See link below for examples. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 68 reviews

Tuberous breast deformity

You do have a moderate degree of asymmetry and some component of tuberous breasts which will include a large areola with loose breast tissue protruding through, a short distance from the nipple to the infra-mammar fold and a higher fold as well. There are several surgical menuevers a plastic surgeon uses to help correct this breast shape. While fat transfer can definitely help even out the asymmetry regarding volume I would recommend implants instead as the shape of the implant will have a greater effect on the constricted lower pole of the breast and allow this portion of the breast to round out. See a consultation with a plastic surgeon who is certified by the American Board of Plastic Surgery and discuss your concerns and goals. Best of luck 

Josh Olson, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 89 reviews

Vertical lift

Would recommend a vertical lift to decrease the size of your areolas, raise your nipple position and to overall create a more aesthetically pleasing breast. Even easier if you do not desire a large implant to go up in size but a small implant would actually help give you a better shape. Best of luck.

Patrick W. Hsu, MD, FACS
Houston Plastic Surgeon
4.9 out of 5 stars 41 reviews

I have tubular breasts with a pretty significant size difference. What would be the best solution?

Thank you for the question and picture. You certainly have a significant degree of breast asymmetry; whether or not the lower breast demonstrates features of tuberous/constricted breasts are somewhat difficult to ascertain based on the photographs. Generally speaking, some of the characteristics seen with tuberous breasts include a very narrow base, short distance from areola to inframammary fold, tight (constricted) lower poles of the breasts, relatively wide space between the breasts, "puffy" and wide areola and some degree of ptosis (drooping). Regardless of the semantics utilized, if the degree of breast asymmetry is of concern to you, breast surgery well certainly be helpful. Breast lifting plus/minus breast augmentation (if you wish to increase breast size) will likely be options discussed. When the time is right, seek consultation with board certified plastic surgeons who can demonstrate significant experience helping patients achieve the types of outcomes you would be pleased with. Then, it will be important for you to communicate your goals carefully as well. Make sure that you also learn about the pros/cons/risks/complications associated with each surgical option discussed. You may find the attached link, dedicated to breast asymmetry concerns, helpful to you as you learn more. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Tuberous Breast

Thank you for your questions and photos. Tuberous Breast is a specific diagnosis with a range of manifestations from mild to severe. It is difficult from the photos to determine whether or not you actually have 'tuberous Breast.' Regardless, you will likely need some combination of Breast lift and augmentation. Given the complexity of your case I definitely recommend setting up a form consultation so your goals can be discussed, an exam can be performed, and a treatment plan be created. 

I I hope this helps - good luck!

Bryan Correa, MD
Houston Plastic Surgeon
5.0 out of 5 stars 15 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.