Do I Have Tubular Breasts? Will 450cc Silicone Teardrop Implants Under the Muscle Fix my Pointed Nipples? (photo)

A cup to C. I have my BA surgery booked for 3 weeks from today. I am still questioning if sub muscular implants will address my pointed or "puffy" nipple concern. I hope for them to fill out or stretch and look natural. Thank You

Doctor Answers 11

Do I Have Tubular Breasts? Will 450cc Silicone Teardrop Implants Under the Muscle Fix my Pointed Nipples?

Dear Chelamels,

Thank you for your question/photos.  I do not believe you have tubular breasts.  However, you do have some issues that make your augmentation less than straight forward.  Your nipples are widely spaced, you have a very short distance between your nipple and breast crease, and you also have the potential for a gap in between your breasts.  These issues should all be taken into consideration during your surgery.  Your creases should be lowered, and your implants should be selected so that they fill your entire breast area from the edge of your chest to the sternum, and the pockets should be carefully dissected to make the implant fit like a glove.  Your nipples will always be widely spaced, and probably a little more so if not moved.  However, this will cause a scar around the nipples.  I do not think it is worth this scar to move them, however, this is something that can be done if desired.  Below is a case that is similiar to yours.  You have a much better starting point, but some of the same characteristics.

Best Wishes,

Pablo Prichard, MD

Phoenix Plastic Surgeon
5.0 out of 5 stars 46 reviews


It does not appear that you have Tubular Breasts.  Submuscular implants will not usually correct puffy nipples.  You need to make an incision completely around the areola to correct this concern.  You should discuss your concerns with your surgeon.

Todd B. Koch, MD
Buffalo Plastic Surgeon
4.7 out of 5 stars 35 reviews

Tubular Breast?

You do not have tubular breast, but may have a mild version of a constricted breast. A breast augmentation will improve your size, but I would caution about trying to go with such a large volume implant due to your size and tight tissue. A smaller implant will give you a more natural breast shape. I would recommend doing only the augmentation now, then deciding what, if anything, to do with the areola after 6 months. I don't think that you will need to do anything to them.

Don W. Griffin, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 72 reviews

Modest tubularity easily fixed by breast augmentation.

If you have any constriction of the base of the breast is quite mild. In any event if you want to have larger breasts you should get an excellent result for breast augmentation.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Do I Have Tubular Breasts?

These look like pretty normal breasts, although small. Because one arm is elevated in the frontal view, I can 't tell if they look even or not.  

I would proceed with the surgery as planned. You won't really be able to tell about changes to the areola and nipple until some months after surgery, and that would be the time to assess the possible need for surgery. to deal with the nipple and areola. My hunch is that nothing will be needed. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Puffy nipples, breast asymmetry and tubular breasts

Puffy nipples, breast asymmetry and tubular breastsTuberous Breasts have been labeled with a variety of names and conditions. These include the following: Tubular Breasts, Constricted Breasts, Puffy Nipples, Snoopy Breasts, and Conical Breasts What is a Tuberous Breast? This breast condition is a developmental problem of the breast. It may be characterized by a variety of appearances generally seen at the time of puberty. There may be breast underdevelopment of the breast with little or no breast tissue. There may be deficiency of breast skin. The breast may appear narrow, tubular, long, conical or droopy. These contours have resulted in the use of unattractive names such as Tubular Breasts, or Snoopy Breasts. Frequently, the areola (nipple) is often herniated forward creating a ‘Puffy Nipple’, or dome shape to the areola. The areola may be excessively large. Another unkind urban term is ‘Bologna Breast’, so called because the woman’s areolas are so large, that they take up almost the entire surface area of the woman’s breast. The color of the areola may be colored the same shade as bologna. Often, the lower part or lower pole of the breast is deficient (see severity) adding to Breast Asymmetry. The breasts are often widely displaced. The condition may be on one side (unilateral) or both (bilateral) and is often uneven between the two sides. Severity TBD may be divided into types depending on the severity: Type l affects the lower inner quadrant of the breast Type ll (grade 2) affects the lower breast , inner and outer

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 107 reviews

Breasts are not tubular

You do not have tubular (or tuberous) breasts. I agree that submuscular positioning of the implant is probably best in your case because you do not have a lot to tissue to camouflage the upper half of the implant. Going under the muscle provides a thicker layer of tissue. Because your tissues appear to be fairly tight I am not sure your breast will accommodate a 450 cc implant. Something a bit smaller might fit more comfortably. That can de determined at the time of surgery. Best of luck to you.

Neal Handel, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 33 reviews

Tubular or Tuberous breasts

Tubular breast augmentation patients are some of the happiest breast augmentation patients in my practice.  See link to my before and after breast augmentation page) They go from feeling extremely self-conscious about their breast appearance preoperatively, to feeling absolutely great about their breast appearance post-operatively. Now to get a full, beautiful, natural looking result in a patient who is starting with tubular breasts, it really requires thoughtful pre-operative assessment and planning, careful implant selection, and the utmost attention to detail in the operating room. There are a number of important things that need to be accomplished when transforming a tubular breast into an aesthetically beautiful breast. Number one, all of these patients require lowering of the inframammary folds. In concert with inframammary fold lowering is expansion of the lower pole so that the skin envelope will accommodate the volume of the breast implant in the lower pole. Implant selection is important, and so is radial scoring of the under surface of the breast so that natural breast tissue will expand over the breast implant in a natural way. Lastly, structural fat grafting really helps to provide missing contour in the lower pole, and helps to blend the transition from natural breast tissue to implant contour. A new implant that is available, is the shaped-form stable breast implant, just FDA approved in the last one to two years. These implants have a point of maximal projection that’s lower than a round implant. These will provide a beautiful really natural appearing lower pole in patients who are starting with a tubular breast. 

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 reviews

Avoid over implantation

Unfortunately, you have not told us your bra size just your cup size.  If you are a 32 or 34 each 100 cc's of implant corresponds to 1 cup size change.  If you are a 36 or 38 each 200 cc's of implant corresponds to 1 cup size change.  From this, you can compute the volume you need to change from an A to a C.  However, your breasts are asymmetrical, widely apart and too low.  You would benefit from a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to reshape your breast creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.  Through the same incision, an implant can be placed in the retro-pectoral position.  I recommend silicone gel implants since they look and feel more natural and are less likely to ripple.  Aligning the areola, breast tissue and implant over the bony prominence of the chest wall will give maximum anterior projection with a minimal size implant.  Smaller implants are more stable long term, less likely to descend and need revision.  450 cc implants would extrude inferiorly and laterally and require revisions.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 222 reviews

Normal Breasts

Be assured that you look perfectly normal!  Breasts come in different shapes; yours have prominent tissue beneath you nipples, but they do not appear tubular.  By the appearance of your photos I would guess that you have not had children as yet.  The appearance of your nipples and areola are sometimes referred to as "virginal" to reflect that your breasts have not yet gone through a cycle of pregnancy.  In my opinion I would not modify the puffiness by placing an incision around the areola.  What you will find is that immediately after surgery the pointy-ness of your nipples will increase.  This will continue for a few weeks or so, but will likely settle down.  Best of luck with your surgery!

James N. Romanelli, MD, FACS
Long Island Plastic Surgeon
4.6 out of 5 stars 22 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.