32 years old, mom from Montreal with severe tuberous breasts. (Photo)

Hello and thank you for your question. You are a great candidate
for a breast augmentation with an areolar reduction to treat your tuberous breasts.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  I cannot comment much on potential RAMQ coverage.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Thank you for this question on tuberous breasts. Your case looks pretty severe and will likely require two or three operations to give you the best results. It's smart to go through your insurance providers in Canada. I am sure a plastic surgery office can help with this or at least point you in the right direction to find a good surgeon accepting your plan. Best of luck to you!Dr. ALDO 

Thank you for sharing the photos.  I would not be able to comment on any type of coverage.  However, in the United States, despite the severity, there may not be any coverage for the correction as it is not life threatening or related to an injury or cancer.  Tuberous breast correction can be very challenging and I would say in your case to be prepared to have multiple operations.  Best wishes. 

Thank you for the question and picture.
You are correct: your breasts do demonstrate the qualities seen with tuberous (constricted) breasts; there is a wide range when it comes to tuberous/constricted breast presentation.
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 pole of the breasts, relatively wide space between the breasts, "puffy” areola and some degree of ptosis (drooping). 
Generally, correction of tuberous breast anomalies involves breast augmentation with areola reduction / mastopexy procedure. The distance from the inframammary fold is increased (to create a more rounded out appearance). Proper implant positioning improves the distance (cleavage) between the breasts. The areola reduction helps to treat the pointed and "puffy" appearance of the areola.
In the most severe cases of tuberous breast, a more complete breast lift may also be necessary. In many cases however, a lift is not necessary. The patient should be aware that the final result will take months to see and that they will need to be patient and that revisionary surgery is more likely than in patients who do not present with tuberous (constricted) breasts.
 When you are ready, please make sure you consult with well experienced board-certified plastic surgeons who have significant (demonstrable) experience with this type of surgery.  In other words, make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully, as discussed above. Working together you will come up with a good plan to achieve your goals.  
I hope this helps. Best wishes.