Asymetry, tuberous breasts, inverted nipples and a sunken chest..how can I fix all these? Also is my pectus bad? (Photos)

Doctor Answers 12

Asymetry, tuberous breasts, inverted nipples and a sunken chest..how can I fix all these? Also is my pectus bad?

Thank you for the question. In my experience, well-placed and appropriately selected breast implants tend to help “camouflage” the concavity associated with pectus excavatum,  making the cleavage area look deeper. Often times postoperatively is hard to know that the patient  initially presented with pectus excavatum.  I usually recommend under the muscle for longer term results as well as reduction in potential for rippling and palpability of the breast implants.   



Patients with pectus excavatum usually have medially sloped chest walls ( sloped towards the cleavage area);  care must be taken during the breast implant pocket dissection to avoid the implants coming together too close in the sternal area.



Also, patients with pectus excavatum may have their nipple/areola complexes relatively medially positioned on their breasts;  without intervention this inward  leaning appearance of the nipple/areola does not improve with breast augmentation surgery.



Generally speaking, the best online advice I can give to ladies with pectus excavatum who are considering breast augmentation surgery (regarding breast implant size/profile selection) is: 


1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. ***Ask to see lots of examples of his/her work, helping patients with pectus excavatum with breast surgery specifically.



2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.  him In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C or D cup” etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate.

 The use of computer imaging may also be very helpful during this communication process.


3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery after  careful measurements are made (dimensional planning).

I hope this, and the attached link (dedicated to pectus excavatum correction) helps. You will also find a separate page, on the same website, dedicated to breast asymmetry concerns.   Best wishes.

Silicone implants, some advices:

Thanks for the question.

In my practice for cases like yours I prefer using the Cohesive Gel - Silicone Breast Implants with textured cover ("gummy bear implants") They are quite safe and aesthetically best as they give a firmer consistency, better projection and natural appearance.

Kind regards

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 178 reviews

BA

Your best bet is probably an augmentation mammaplasty.  You do not have severe tuberous breasts.  The pectus excavatum is an issue but should be less noticeable with implants. 

Chest issue

You do not look like you have a tuberous breast or inverted nipples. It does look like your chest wall is a bit caved in.  You would have to see a thoracic surgeon if you want the chest wall corrected.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Fat grafting for symmetry

I would agree with other surgeon that you do not have tuberous breasts or inverted nipple based on the attached pictures. You do have asymmetry and mild pectus excavatum. I would recommend fat grafting for correcting the asymmetry. Please see the link

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 113 reviews

Breast Asymmetry

I agree that without a lateral view (side view) the diagnosis of pectus caranatum is difficult to assess.  There doesn't appear to be evidence of nipple inversion either. Your case can be nicely corrected with a breast implant with creation of a new lower fold. 

Gilbert Lee, MD
San Diego Plastic Surgeon
4.8 out of 5 stars 22 reviews

Breast augmentation

Thank you for the question and photos. I don't see a tuberous breast or inverted nipples. You appear to have a mild asymmetry of the breasts which can be corrected with breast implants. 

So really you are not as bad as you think. The majority of women have breast asymmetry. 

Consulting with a board certified plastic surgeon will help you determine the plan to achieve your goals. 

Good luck!

Dr. Khuthaila 

Dana Khuthaila, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 60 reviews

Breast shape

I see no tuberous deformity in your breasts. Also, without a lateral view it is hard to tell, but I do not see a pectus deformity either. There is a slight asymmetry between your breasts which can be corrected during surgery. Also, on the close up view, the left nipple does not appear inverted, which may be just dependent on the moment when the photo was taken. Overall, you appear to be an excellent candidate for breast augmentation and will probably benefit greatly from an in person consultation with a plastic surgeon. Good luck!

Asymmetry, tuberous breasts, inverted nipples and pectus - what to do?

Actually, you are in better shape than you realize. you have normal but small breasts. I do not see the signs of tuberous shape. If your nipples are inverted they can be corrected at the same time as a breast augmentation. Your asymmetry is well within the range of normal - none of us are symmetric but the slight size difference may be reduced with saline implants filled to different sizes at surgery At least in the photo. your pectus does not look severe. So have a plastic surgery consultation and plan your path to greater self-confidence and a pretty result.

Breast augmentation

Hello and thank you for your question. You are a great candidate for a breast augmentation and inverted nipple correction.  Breast asymmetry is very normal and can be improved with this procedure.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  This entire surgery can be performed with a small incision technique.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 80 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.