Mother of 2 - Are these tubular breasts? Will a lift or areola reduction affect my milk ducts? (photos)

Question

Do you think I have tubular breasts, how severe just by looking at photos? I have a consult soon. I have breastfed 2. Do you think I need a Lift as well? I want an areola reduction. Will either the lift or areola reduction cut my milk ducts? Thank you.

Chul Hwan Seul, MD, PhD · Answer

Thank you for your question. Tubular breast is a serious case of tuberous breast, but in your case, I can see a regular tuberous breast case. In your case, breast lift (mastopexy), areolar reduction and implant augmentation should be performed for the best effect. After performing this surgery your milk ducts won’t be damaged and you can breastfeed again. However, you must take into consideration that after you breastfeed again, the shape can change, thus I would advise to undergo the surgery, after you won’t plan to give a birth again.

Leila Kasrai, MD, FRCSC · Answer

Your breasts don’t appear to have any constriction of tissue around the nipples, and you have a distinct breast fold. Rather, they appear to be sagging. A lift can be performed to make your breasts rounder and perkier, while an areola reduction can be performed at the same time. Any cosmetic breast surgery has associated risks related to breastfeeding. The procedure may negatively impact your ability to breastfeed, therefore you’ll need to consider whether the risks outweigh the benefits.

Justin Perez, MD · Answer

Thank you for your questions. You do have constricted breasts, meaning the lower part of the breast is somewhat shortened and your breast fold sits somewhat higher- so yes, I would say that you have constricted or what some call tubular breasts. That being said, the aesthetic treatment for a constricted breast is typically a breast augmentation with periareolar (around the nipple) lift/arolar reduction. This allows the implant to be placed such that the volume of the breast can be filled/rounded out, the fold of the breast can be lowered, the nipple can be repositioned, and the areola made smaller. So to answer your question, a lift and an areolar reduction are a good option in a patient with constricted breasts. Cutting some of the milk ducts can occur depending on what incision is used to place the implant (whether under the breast or around the nipple) -- this is best reviewed with the surgeon who would be performing your case. Hope this helps! Happy to assist in the future if needed. 
Have a beautiful weekend,Dr. Perez

Ted Eisenberg, DO, FACOS, FAACS · Answer

Unfortunately, surgeons have created the term tuberous breasts, a fact which causes unnecessary concerns for women. Many women just have different sizes and shapes and in my opinion shouldn't be labeled. I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Gary M. Horndeski, MD · Answer

Your breasts are not tuberous. The technique I recommend is a lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Donald R. Revis Jr, MD · Answer

Good afternoon,
Your breasts are not tuberous, they are just a little saggy and deflated- you do need a lift in addition to your augmentation, and when I perform this procedure I do not alter or cut the milk ducts in any way.

Daniel Barrett, MD · Answer

Dear Amaya01,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.The type of surgery best for you will depend on the severity of your condition.My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You have sagging but do not have tubular breasts. Any breast procedure can potentially affect breast feeding. If you are concerned about breast feeding, have all the children you want and then have surgery.

Camille Cash, MD · Answer

From your photos it does not appear that you have tuberous breasts.  A breast augmentation with a lift can help restore volume and raise the nipple position.  The areola can be downsized as part of the lifting procedure.  I've included a video I hope you find helpful that addresses how these procedures can potentially impact future breastfeeding.

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!From your photos, I note asymmetric small, laterally positioned breasts with large areolae, demonstrating significant sag. You may consider a full mastopexy to lift the nipple-areolar complexes into anatomic position, reduce areolar diameter, and conify the shape of the breasts. A breast augmentation may be added as well, if desired. Visit a board certified plastic surgeon for evaluation, examination, and discussion.Best wishes...

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