Why Do my Breasts Look Like This? (photo)

the nipple is flat and the areola is very large and puffy in its relaxed state. my breasts also take a sort of triangular shape in relaxed state, is there any way to fix this? also i'm wondering if a nipple piercing will make the actual nipple stick out, even when in relaxed state? or will it just be uncomfortable for me when the nipple is not erect? thank you.

Doctor Answers 17

Mini Ultimate Breast Lift for tubular breasts

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Your breasts look like this because you have tubular breasts.  If your cup size is adequate then you do not need implants.  If your cup size is inadequate then you need implants.  You are an excellent candidate for a new procedure called The Mini Ultimate Breast Lift.  This will reduce the size of the areolas, elevate the breast tissue higher on the chest wall and give the natural appearance that you desire, leaving only a scar at the areola-skin junction.  At the same time, implants can be placed if desired.

Best Wishes,

Gary Horndeski, M.D.

Why Do my Breasts Look Like This? (photo)

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Your breasts have large, "puffy" areolas, a narrow footprint and some droop, or ptosis.

Based on your photo (a physical exam and measurements would be essential if we were doing this for real) I recommend a breast lift with augmentation.

There are, as you know, different types of breast lift and implants.

You should see an experienced aesthetic breast surgeon to explore your options.

Good luck!

Unusual breast shapes

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I would agree with some of the responses that the term used to describe the shape of your breast is "tuberous". This comes in many varieties and degrees and can affect one breast more than the other. In your case you have bulging of breast tissue into the areola (not the nipple) with constriction of the breast tissue in the lower half of the breast.

Breast implants which are essentially a pillow of volume behind the breast are what can fill out the lower pole of the breast if it is not too ptotic (saggy), and the inframammary crease level can be lowered somewhat. Generally, the minimum size implant that would fit would increase the breast by about a cup size but would do nothing for the nipple-areola and the tissue behind it. This area would be treated by a peri-areolar mastopexy which is one of the few things a peri-areolar mastopexy is actually good for. I would not recommend doing the two procedures at the same time. If you are satisfied with the size of your breasts then just do the peri-areolar mastopexy. You could consider the implant later. If you do the implants first then you could consider the peri-areolar mastopexy later. 

The nipple is a separate issue and I doubt piercing it will do much more than it normally does including that it will not make the nipple stick out. 


Scott L. Replogle, MD
Boulder Plastic Surgeon

Tuberous breasts

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Thanks for the excellent picture, as my colleagues have already stated you have tuberous breasts.  I reccomend you see a plastic surgeon with alot of experience.

Constricted breast

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You have described  features that describe a "tuberous breast"

  • large puffy areolae
  • unusual, tirangular shape

Other features, some of which are apparent in your photo, include

  • widely spaced breasts
  • high breast folds with ptosis (sagging)
  • narrow breast base
  • diminished tissue, especially in the lower poles.

Yes this can be improved by surgery. A breast lift is the minimum, though this would be a more complex lift that the average one. If increased breast size is chosen as part of the correction or improvement, and implant or fat transfer would be in order.

Thanks for the question and for the photo. Do see a board certified plastic surgeon for a consultation.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Correction of tuberous breasts

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As stated below, you have tuberous breasts and possibly lower pole constriction.  Most cases like yours can be fixed with a peri-areolar mastopexy ("donut lift") and implants.  If the lower breast is constricted, then the fold under the breast may need to be lowered to improve the final appearance.   I have photos of a woman with a more severe deformity than yours on my website that may help you visualize what can be done to make your breasts fuller and more attractive.  Be sure to go to a plastic surgeon who is board-certified by the American Board of Plastic Surgery and has experience with your particular breast shape.  Hope it goes well.

You Have Tuberous Breasts

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The reason for your puffy nipples is that your breast tissue has herniated into the nipple.  The classical answer for why this happens is that your dermis, that area of skin below the surface, is weak and allows the breast tissue to herniate forward (technically, this is a pseudo hernia since it pushes all the dermis forward, not just at one point).  Your breasts started out looking like little thimbles, then looking like small potatoes sticking straight out (potatoes belong to a class called tubers), therefore this type of breast is referred to as a tuberous breast. 

Your areola are enlarged, and the technical way to push them back and decrease the puffy nipples at the same time would be to do a circumareolar or Benelli mastopexy using the dermal anchor technique.  This technique was first described by Mel Dinner, M.D. of Cleveland, Ohio.  It was later modified by me.  The technique and my video on the Benelli mastopexy can be found on YouTube.  The Benelli or circumareolar mastopexy will also lift your breasts at the same time. 

Tuberous breasts

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Your photo demonstrates a tuberous breast shape.  This is characterized by a constricted lower pole, large puffy areolas and a tight triangular shape.  You can improve this with surgery from a very experienced plastic surgeon but it is not an easy starting point.

Possibly Tuberous Breasts

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Thank you for your question. You exhibit some of the signs of tuberous breasts, which are: constricted breast base, high-riding inframammary fold, and herniation of the breast grandular tissue into the areolar ring. If you were to desire a somewhat larger, fuller breast with tuberous breasts, you would need to undergo a modified breast augmentation procedure. In addition to placing a breast implant, a plastic surgeon would need to perform radial scoring of the breast grandular tissue from the inside and to lower the inframammary fold.

Regarding nipple piercing, it won't be uncomfortable, but it is possible that it will make the nipple protrude more than you want even when the nipple is relaxed.

Tubular Breast Deformity

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Breasts come in all shapes and sizes and significant variations in breast contour are common amongst women. One of the more commonly seen breast variants is the tubular breast deformity. This is also frequently referred to as a constricted breast deformity. Your pictures suggest the presence of a moderate tubular breast deformity.

The condition occurs because of constriction of the skin at the base of the breast. This often results in herniation of the breast tissue through the areola which creates a unique breast shape. The vast majority of constricted breast deformities are relatively mild and treatment may not be necessary. Severe cases of this condition occasionally occur and do require treatment because of the magnitude of the breast deformity.

A variety of approaches can be used to correct this problem. In some cases, breast lift and breast augmentation may be necessary. Treatments should be individualized based on the specifics of the anatomic deformity and the aesthetic goals of the patient.

Based on your history and pictures, I believe you would benefit from combination breast augmentation/breast lift surgery. If you're considering correction of this problem, consultation with a board certified plastic surgeon is appropriate. This surgeon should be able to address both your unique anatomic findings and aesthetic concerns.

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.