Bottoming out tuberous breasts. What are your opinions? (Photo)

Question

I have had 2 surgeries to correct my tuberous breasts this past year, two times donut mastopexy, two times scoring of the breast tissue and 2 different implants placed in. First time saline 450 cc user muscle and second time silicone 745cc under muscle. I love my size buy I still have problems with nipples spreading and staying puffy, muscle flex and I am now bottoming out. I am 25 years old 5'10 and weight 160. I have called a new PS and I am seeing him in September. What are your opinions?

Richard Baxter, MD · Answer

I see several issues, some of which are related. The muscle flexion distortion is called animation deformity. This can be corrected by converting to the split muscle plane, which will maintain the muscle coverage where it is needed but eliminate the pulling that you see. The bottoming out issue may require internal support with Strattice or Galaflex (available as Phasix in Canada), especially since your implants are rather large. Textured form-stable implants might also be worth considering, especially with your history of tuberous breasts. A final option would be a Strattice donut to prevent areolar widening. (I can send you a link to an article about that procedure.)

Steven Wallach, MD · Answer

It looks like the implants are too big. You are better off with smaller implants and adjustment of what may be the lower pole deficiency. Sometimes fat grafting can help as well.  The areola heights look different but that might be from your arm being raised. Tuberous breasts can be tough to deal with.

Robert Caridi, MD · Answer

I can tell you that what I "see" is a relatively small frame and very large implants. These large implants will simply overwhelm the ability of your skin and tissues to keep things where they are supposed to be. At this juncture you would do best to get a powerful bra to keep your implants and breasts "up and in" so they won't continue to fall down and off to the side.
I think your new surgeon will tell you to go smaller and that you may need some internal work and the use of acellular dermal matrix to support your new result.  Working around the areolas alone without a vertical incision may not keep the areolas from spreading. It's possible that if you choose smaller that you can continue to work around your areolas as there is less tension on the closure and your skin looks good.
I understand that you love the size but your body simply can't handle it.

Bottoming out tuberous breasts. What are your opinions? (Photo)

Answers (3)

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