Tuberous breasts and double bubble risk: What procedure do you suggest?

Question

In 2011 I was diagnosed with tuberous breast before I tried a BA. After that I desisted! Now after 6 years and breastfeeding a child I am re-thinking my decision. At that time the surgeon told me that for sure If I was undergoing BA procedure I would have had double bubble deformity! What do you think? Do you have any suggestion of the procedure I could follow to improve my shape? P.s.( I like myself as I am... but also I would like to improve my aspect and look a little bit better!)

William Andrade, MD · Answer

Hello, I think that you will get the best advice from in-person assessments.  Often for tuberous breasts I use a shaped implant in a subglandular plane, combined with a breast lift.  However, each person is unique.

Martin Jugenburg, MD · Answer

Hi there, Thank you for your question. You will want to speak with a surgeon regarding a breast lift and augmentation to reshape the breasts and avoid the double bubble. Best, realdrsix

Bernard Salameh, MD, FACS · Answer

Thank you for your question. In my opinion, you will need conservative silicone breast augmentation including areola reduction combined with circumareolar lift. Also the inframammary fold needs to be lowered and contoured and the lower breast needs to be scorred and released for lower pole expansion. I hope this helps. Best of luck.

Douglas McGeorge, FRCS(Plast) · Answer

Because of the droop you have developed, an up-lifting procedure will be required to give you a good result from breast augmentation. Lowering the fold is likely to give you a "double bubble".
You should seek an opinion from an experienced surgeon

Rebecca Jackson, MD · Answer

In my practice I've seen many patients with tuberous breasts. The fact that your breasts are tuberous has nothing to do with a " double bubble". That problem occurs when a large implant is placed and the inframammary fold is released to make room for a large implant, that fold is where your brazierre touches your chest wall inferiorily. Releasing it to place a large implant causes a "double bubble". In my practice I use gel implants above muscle to help stretch skin and let the breast take shape. We never lower or release the fold because in 6 months to a year the skin stretches, the breast re shapes and then we re-evaluate. A lift may be needed usually not. Results can be dramatic, but don't ever let anyone plan to release that inframammary fold. It is not difficult but requires patience on your part and the surgeons. I wish you the very best, it's completely fixable. I know you're not broken but would like to look better and you can, absolutely!
Rebecca Jackson M.D.

Marc J. Salzman, MD, FACS (retired) · Answer

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-mamary 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 two 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.

Tuberous breasts and double bubble risk: What procedure do you suggest?

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