Advice on my tubular breast correction. (Photo)

I have been reading so many contradictions re subgland vs subpec/Dual, whether the constricted bands should be scored, incision location, use of expanders pre implants. Please see my images attached. It would be great to get some advice. I really want to avoid having high profile/obvious results, or to the 'double bubble'. I am willing to travel to find a surgeon who is confident and experienced in the correction of this deformity. Thanks!!!

Doctor Answers 11

Constricted breast deformity with breast augmentation

Dear klou22,
You do have elements of tuberous breast deformity including tight constricted breast folds with a short distance from fold to nipple and breast tissue pressing into the areolae.  There are many ways to approach the correction and augmentation of the deformity, several of which you have delineated above.  A plastic surgeon certified by the American Board of Plastic Surgery is well versed in all of the techniques.  There really is no contradiction because all of the techniques can be used effectively.  Your particular condition is relatively mild and would likely require less complicated measures.  Good luck!

Options for Tuberous Breasts

Good morning. Thanks for your questionTuberous (tubular) breast can be managed in a number of slightly different ways. I would agree with others that from your pictures you seem to have a constricted breast (without nipple herniation) rather than a true tuberous breast. With that in mind, it is likely your goals could be met with a dual plane, fold incision, shaped device in one step. Radial scoring of the tissue is likely. A firm, form stable implant with full projection will help stretch the lower breast tissue. A lower projection, softer device may not have the force needed for this lower pole effect. Take your time, find an experienced board certified plastic surgeon that you trust and take it from there. Best of luck. Dr Nodwell

Trefor Nodwell, MD
Ottawa Plastic Surgeon
4.4 out of 5 stars 10 reviews

Tuberous Breast Defomity

Yes you have TBD.  I would recommend a smooth round silicone implant placed in a dual plane fashion with radial scoring plus or minus areaola reduction.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with and who is a board-certified Plastic Surgeon certified by the American Board of Plastic Surgery. Best wishes! Dr. Desai
Harvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

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Breast Implants/Breast Reduction/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

I appreciate your question. From your photos, you do appear to have characteristics of tuberous breasts. Constricted or tubular breasts tend to be too narrow with a breast crease that is too high. Tight ring-like bands of tissue around the areolae and nipples may create the appearance of protruding or puffy areolae. A higher than normal breast crease may make your nipples appear to be too low or down pointing. Constricted breast features can be very mild or severe. In fact, mild variations are relatively common. To summarize, the features can include:
  •          Inframammary fold (breast crease) too high
  •          Inframammary fold misshapen
  •          Breasts too narrow (disproportionately narrow base width)
  •          Insufficient breast skin
  •          Constricted or tubular shape, resulting from tight bands of tissue within breasts
  •          Protruding or bulging appearance of areolae (pigmented area around nipples)
Improvement is possible and generally includes a breast augmentation, sometimes combined with a lift (mastopexy). The lift is usually limited to an incision around the areolae. During the procedure, I release the tight, constricting bands from the inside, allowing the skin to expand properly. I also lower the inframammary fold to a more ideal position and improve its shape. Breast implants help create the right amount of volume and improve breast contours, resulting in a more rounded or tear drop shape. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery. Best of luck!Dr. Schwartz Board Certified Plastic Surgeon Director-Beverly Hills Breast and Body Institute #RealSelf100Surgeon #RealSelfCORESurgeon

Tuberous breats

Thank you for your question.  You do have a mild tuberous breast in addition to limited native breast tissue, and you inframmamary fold is not well defined.  Traditionally,  a subglandular implant is recommended for tuberous breasts; however, you may be better suited for a dual plane augmentation to avoid visibility of the implant in the upper chest.  Most tuberous breasts need radial scoring to expand the skin of the lower breast to accommodate the implant and provide shape.  I would recommend a peri-areolar incision because your breast fold is not well-defined.  Also, a small peri-areolar mastopexy may be needed to control the size of the areola.  In rare cases where the skin of the lower breast is very tight, a tissue expander may be needed.  I don't suspect this in the case, but would only be able to tell by examining you in person.  Good luck!

Brian A. Pinsky, MD
Long Island Plastic Surgeon

Your breasts

Your breasts are not tubular, just small. You are a great candidate for an augmentation. At your consultation we would go over all that can be done and show photos of other patients who look like you and what you could expect. 

William B. Rosenblatt, MD
New York Plastic Surgeon
4.1 out of 5 stars 11 reviews

Breast augmentation

Hello and thank you for your question. You do have lower pole constriction of your breasts.  This is definitely fixable with the right techniques.  I recommend a dual plane approach with radial scoring of constriction bands.  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.  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 67 reviews

Tuberous Breast Options

Based on your photos you certainly have constricted breasts. The surgical approach is similar to that for a mild to moderate tuberous case. The lower pole is released through a periareolar incision and a dual plane augmentation performed. A small periareolar mastopexy may be required to properly place the NAC on the breast mound and help redirect it upwards but that would be better determined with an actual physical exam. I never place the implants totally subglandular since they do not look as natural over time. Best of luck.


You would definitely have to be seen in person to evaluate how tight the lower pole is and if tissue is herniated through the areola.  Sometimes I score the lower pole and sometimes I do not . I also often use a cirumareola suturing to adjust the areola size and fullness.   Best of luck.

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

Tubular breast deformity

You are a good candidate for dual plane breast implants with either moderate plus or high profile implants. Seek a specialist in tubular breast correction. Release of the lower pole required and excision of a limited amount of retro areolar tissue useful 

Stuart A. Linder, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 40 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.