Tuberous breasts: 27 yr old, 181cm, 90kg. Advised 500-600cc silicone HP over the muscle. Will this look good? (photos)

Recommend to cut all the strings that's holding my breast back. then to have 500-600cc texture silicon drops formed over the muscle. I don't feel that I need to fix my big aroles, but I wish for bigger and rounder boobs. I fear the double bobble . I don't understand if over or under the muscle is better . I live in Norway and it's really hard to find doctors who have much experience with tuberouse breast. Can you please tell me what you would recommend from looking at my pic ?

Doctor Answers 14

Tuberous breasts

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From your photos, you appear to have a significant tuberous deformity of the breasts. This is always a challenging problem to correct and generally requires several procedures over time to correct. Although placing implants over the muscle can "stretch " the breast tissue more easily, i do not reccomend it. This placement interupts much of the blood supply to the breasts and can leave very little coverage over the implants. I would recommend finding a surgeon who is experienced with dealing with this problem.

Tuberous breasts: 27 yr old, 181cm, 90kg. Advised 500-600cc silicone HP over the muscle. Will this look good?

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500 to 600 cc is large.  Most plastic surgeons would probably recommend placing the implants under the muscle.  

Breast augmentation

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Hello and thank you for your question. 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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 174 reviews

Tuberous Breast Correction

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Thank you for your question and photo. You are correct that restrictive bands will be released/scored under and around the areola to create a rounded pocket for the implant. I would typically place a full silicone gel implant over the muscle as well in order to fill out and hold the new breast shape. I recommend that you seek a board certified Plastic Surgeon who has experience with this type of correction.  The implant which fits you best will depend on your specific breast measurements and ideally suit/balance your frame.

All the best

Breast augmentation with implant

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You are a good size woman who will benefit from the good size implants and release of your breast strings. Sounds like you have an interested plastic surgeon who is giving sound advise. Good luck...

Larry Weinstein, MD
Morristown Plastic Surgeon
4.9 out of 5 stars 11 reviews

Over or under

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5-600 cc is a very large implant, to go from having little breast tissue/breasts to 5-600cc is a big jump. Also, if you do not put the implant under the muscle you will clearly see the outlines of the implant. Dealing with the areolas is another thing, size does not necessarily have to decrease, but the herniation of the fat will have to be dealt with otherwise it will be worse post-op. 

Tuberous breasts.

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Thanks for this important question. I'm very surprised about the size recommendation. It seems excessive for your frame and the small and tight breasts I see in the photos. I also find that shape breast implants (Mentor MemoryShape) do much better in tuberous patients and patients with tight lower poles. Such a large breast implant and over the muscle is very likely to lead to ripples over most of your breast. I think you need to do more consultations with at least two other plastic surgeons to get additional advice. Best, Dr. ALDO

Aldo Guerra, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 216 reviews

Tuberous breasts: 27 yr old, 181cm, 90kg

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Need lots more information before a good recommendation can be made but from the information provided, I would consider a Allergan 410 style implant for its improved lower pole projection and ability to stretch where you need it most. I would use a dual plane approach to allow the stretch to be on the skin but the upper pole to be below the muscle for better mammograms.  410 implants fit your body like a shoe fits your foot, so what ever size fits your frame is the best size. See a board certified plastic surgeon who uses this style implant frequently for best results. Good luck. 

Robert Graper, MD
Charlotte Plastic Surgeon
4.4 out of 5 stars 27 reviews

Tuberous breasts: best operation for me?

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Thank you for the question and pictures.

Yes, I think your breasts do demonstrate some of the qualities seen with tuberous (constricted) breasts; there is a wide range when it comes to tuberous/constricted breast presentation.

Generally speaking, some of the characteristics seen with tuberous breasts include a very narrow base, short distance from areola to inframammary fold, tight (constricted) lower pole of the breasts, relatively wide space between the breasts, "puffy” areola and some degree of ptosis (drooping). 

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 the most severe cases of tuberous breast, a more complete breast lift may also be necessary. In many cases however, a lift is not necessary. The patient should be aware that the final result will take months to see and that they will need to be patient and that revisionary surgery is more likely than in patients who do not present with tuberous (constricted) breasts.

I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes). The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position. 

On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  that can be seen with breast implants placed in these sub muscular position.    Best wishes with your upcoming surgery.

 Please make sure you consult with well experienced board-certified plastic surgeons who have significant (demonstrable) experience with this type of surgery.

I hope this, and the attached link (dedicated to corrective surgery for patients with tuberous/constricted breasts) helps. Best wishes.

Tuberous breasts: 27 yr old, 181cm, 90kg. Advised 500-600cc silicone HP over the muscle. Will this look good?

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Thank you for your question. Remember, it is best to be seen in person by a double-board-certified plastic surgeon for precise diagnosis and treatment.

Moneer Jaibaji, MD
San Diego Plastic Surgeon

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.