Tubular breasts; what do I do? (Photos)
Doctor Answers 11
Tubular breasts; what do I do?
Thank you for the question and pictures.
I think your breast photos do demonstrate some of the characteristics seen with tubular (constricted) his breast. For example, the distance from the areola to inframammary folds seems to be tight and relatively short. Your inframammary folds seem to be widely spaced from the midline of your chest. The areola do demonstrate some features associated with tubular breast such as an increased width and “puffiness”.
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 your case, if the appearance/shape/size of the breasts are a concern, you may be an excellent candidate for corrective surgery. When you are ready, please make sure you consult with well experienced board-certified plastic surgeons who have significant (demonstrable) experience with this type of surgery. There are a lot of factors to consider when making recommendations; for example your life circumstances ( planned pregnancies, psychosocial situation…) and tolerance for scars are factors that should be taken into consideration by you and your plastic surgeon.
Generally speaking, the best online advice I can give to ladies 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 are looking for. ***Ask to see lots of examples of his/her work.
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.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example,
I have found that the use of words such as “natural” or "big B, small C 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. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
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 the use of temporary intraoperative sizers.
I hope this, and the attached link (dedicated to corrective surgery for patients with tuberous/constricted breasts) helps. Best wishes.
Tuberous breast correction advices:
Thank you very much for sharing your concerns with us.
After having analyzed all the information and photos provided to us, i can identify that you have a underveloped and mild tubular Breast.
I recommend you perform a Tubular Breasts Correction with Breast Augmentation using silicon implants, at the same surgical time.
There is a surgical technique for Tuberous Breasts correction, by which it is arranged the tuberous areolar ring from inside, without requiring areolar reduction. In this technique we also need silicon implants, to get a better Breast volume and projection.
I don't think your breasts are truly tubular. A well done breast augmentation with moderate size implants should solve your problem.
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From your photographs it does appear that you have some of the elements of what we would call a "tuberous breast". The tuberous breast usually consists of a very constricted or narrow base with a large areola with some amount of extra breast tissue behind the areola. The correction of this breast anomaly usually requires some type of circular mastopexy to change the pointed configuration of the breast to one that is more rounded. Also, because the infra-memory crease is higher than one would like, this crease likewise needs to be lowered. If lowered too much, the risk is one of a double bubble where to contours are seen at the bottom. One from the old crease and the lower one where the implant is. If one can raise the nipple a little bit, then less lowering of this crease will need to be done. Therefore, in my hands, the appropriate operation is a circular breast lift or mastopexy with a silicone gel breast implant. You need to be careful in the selection of the size of the implant as this is critical to the outcome of this procedure. Since some skin, of necessity, will need to be removed to move the nipple upward, and there is usually a paucity of skin in the transverse direction anyway, a large implant may necessitate coverage by skin that is no longer there. I would tell our patients that there are some limitations in size if this operation is to be successful. Years later, after the skin is more stretched, a larger implant may be able to be placed. I would recommend you find a board certified plastic surgeon with demonstrated experience in cosmetic breast surgery. Best of luck.
I think more than anything you have lower pole constriction. Many times the augmentation alone can help. You might need a bit of a lift or reduction of the areola as well. Best to be seen in person.
I think you can get a close to realistic and natural result with an implant and radial scoring for your Tuberous Breast Deformity. Your size would need to be determined in the office with breast measurements.
I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with and who is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery.
Hello and thank you for your question. Your breasts do have some elements of lower pole constriction. You are a great candidate
for a breast augmentation with release of lower pole 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. 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
Tubular or constricted.
A tubular breast has a high fold and a dilated areola and looks like a snoopy dogs nose. A constricted breast has a short distance from the nipple to the fold and a tight or conical shape. From your photos I believe you have a mild constriction. In a situation such as yours often implants are placed with some release of the lower portion of the breast to allow it to round and stretch. Some add a periareolar lift to help the conical breast take on the shape of the implant. In your case because the constriction is mild I would likely place the implants, allow them to drop and settle and consider a tightening in the future only if needed.
Hope this helps.
Breast augmentation for mild tuberous breasts
You have mild tuberous breasts characterized by enlarged and "puffy" areolae and a constricted lower pole. You are a reasonable candidate for breast augmentation. A large B to small C should be achievable. Any cc estimate is merely an estimate, but I would think that a volume in the high 200's or low 300's would be consistent with your request. I recommend that the implants be placed lower on the chest wall than usual (to prevent the implants from staying too high), since your lower poles are quite short. Although a periareolar mastopexy (donut lift) may be performed, I am doubtful that this is necessary.
Breast implants: You could get a normal looking, round breast
It should not be difficult for you to get a nice result with breast augmentation. An examination in person with a plastic surgeon would assist you in determining the ccs you need. If you came into my office, I would measure you breasts and your chest and we would look at pictures of women with similar measurements to you who got implants of varying sizes. This has been a very reassuring process for my patients. For more information on this and similar topics, I recommend a plastic surgery Q&A book like "The Scoop On Breasts: A Plastic Surgeon Busts the Myths." Good luck to you.