I Have Tubular Breasts and Was Told by Doctor to go Over the Muscle, is this Best?

Height-5"7 Weight-120 Bra size currently-32/34b Want small D Getting high profile 500cc textured silicone

Doctor Answers 9

Tubular breasts and implants over muscle

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I can't say with certainty because I have no picture and no exam. In true cases of tuberous breasts, yes going above the muscle can have some good benefits compared to under the muscle.

The shell of the textured implants is thicker and can sometimes be felt...but textured implants may lower your chance of capsular contracture since the implants are going over the muscle.

I hope this helps. I wish you well.

Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Tubular breasts

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In my experience,to get the best looking breasts, I not only usually recommend going on top of the muscle but also do a modified uplift to try to achieve a more natural sloping breast.

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 28 reviews

Placement of large implants over the muscle never a good idea

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Correction of tuberous breasts can be challenging. Placing implants over the muscle can be a quick fix, but in the long run can do more harm than good. There are a number of techniques that could be used to correct this type of breast deformity. So It would be helpful if you could re-submit your question with photos. As every case is different, I find it best to narrow down the number of options best suited for you. Best regards, Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Tubular breasts and pocket for implants

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Without an exam, it is difficult to say what would benefit you in terms of pocket choice for your possibly tuberous/tubular breasts.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Subglandular implants for tubular breast

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Over the muscle is best for tubular breasts. If the implant is under the breast tissue, it will expand the tissue better and have more impact on breast shape.  It's hard to comment on the specifics: implant size, textured vs. smooth - without seeing photos. Best of luck!

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 57 reviews

Tubular or constriicted breast and augmentation

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It is difficult to give much advice without examining you or seeing photos. There are differing philosophies amongst plastic surgeons regards treatment of the tuberous breast. My approach is traditionally placing the implant partially under the muscle to provide better coverage of the upper inner implant looking for a more natural look. You may have ample tissue to cover the upper implant but the area of the breast primarily involved in a constricted breast is the lower part of the breast so this should not make much difference.

This is a discussion to have with the plastic surgeon you have chosen to perform your surgery. Ask this question as to why he/she thinks it is the best approach.

I wish you well.

Dr Edwards

Tuberous Breast, Augmentation

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The tuberous breast creates more of a challenge in getting a nice result and often requires the surgeon to be a bit creative. The deformity comes in a surprisingly large number of variations. It may be best in your case to go over the muscle if you have an adequate thickness to the breast tissues in the upper breast. It would be impossible to tell withou a good set of medical quality photos. In general, I find I get the best results with a subpectoral dual plane implant placement coupled with an areola reducing lift. Make sure your surgeon has a wide experience in this problem and see several sets of pictures of his work.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 28 reviews

Treatment of Tubular Breasts

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Thank you for the question.

Tuberous ( constricted) breasts are characterized by a wide spectrum of presentation including constriction of the breast base, glandular and skin hypoplasia (especially at the lower quadrants), mal-position of the infra-mammary fold, breast tissue herniation into the areola region and sometimes increased areola diameter. 

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.

Although every surgeon may have their own preference,  I would prefer to place the breast implants in the sub muscular (dual plane) position  if at all possible  to minimize risks associate with breast implants placed in the sub glandular position.

Probably more important than breast implant positioning,  is selection of a surgeon who has significant experience treating constricted/tuberous breasts. 

Best wishes.


Either above or below the muscle can work

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Tuberous or tubular breasts typically involve some degree of constriction of the breast tissue, a widened areola with some protrusion and a higher fold beneath the breast.  It is important that you and your surgeon recognize the condition preop to help with planning.

Important technical details include incising the tightened breast tissue, then expanding it internally at surgery and over time with the implant (if severe, a postoperatively adjustable implant can be considered).  Often reducing the areolar diameter is indicated as well as careful lowering of the inframammary fold.

The location of the implant, whether above or below the muscle has some bearing on the procedure details but it may be "best" to chose one or the other for different reasons such as ensuring adequate coverage of the implant, breast imaging and capsular contracture considerations.    

David J. Levens, MD
Coral Springs Plastic Surgeon
5.0 out of 5 stars 79 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.