34 years old, 5 kids - I believe I have tubular breasts, what is my best option to have nice breasts? (photos)

Thank you for your question. I recommend a breast augmentation with implants and periareolar mastopexy (breast lift with an incision around areolas) in order to improve sagging and sunken breasts, and reduce the size of areolas. Fat grafting is also recommended to reduce intermammary span since your breasts are far apart.

Thank you for your question regarding what to do with your tubular breasts. In my opinion, you do have bilateral tubular breasts worst on your right than on your left. Tubular breast deformity is characterized by a breast that looks like a tuber. A tuber is part of the potato family, therefore the breasts look like potatoes. I'm sorry that that's the name that we are stuck with but that is the medical terminology. In assessing a tubular breast, the base of the breast is very narrow and small. The breast is tubular as the name would imply and the areola is usually very large. The narrow base of the tubular breast is in contrast to a normal breast base which has a wide base attachment to the chest.

In my opinion, you would significantly benefit from bilateral breast augmentation with silicone implants. I would suggest high-profile smooth-walled implants. The size is up to you. You could go up even to a ful D if you wanted. During the surgery, it will be very important to release the base of the breast to allow for the implant as well as areola reduction. This will probably also require an anchor mastopexy or breast lift. Typically, these are performed at the same time. However, some surgeons stage these procedures. Thank you for your question regarding how to correct your tubular breast deformity.

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

The traits of tubular breasts are an indistinct breast fold, constriction of tissue around the nipples and often puffy areolae. Your breasts don’t appear to be truly tubular. To give your surgeon a better understanding of what your goals are, it would be helpful to find some wish pics that show what you mean by “nice”. Your surgeon would then be able to let you know what procedures would be most suitable for you. For example, a breast lift may be recommended to reshape your breasts to make them fuller and perkier. If you’d like to have larger breasts, breast augmentation can also be performed.

I recommend an in person evaluation with a plastic surgeon to be measured and discuss your goals. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Hello M. Aguerra! From your photo and the history of 5 children, I believe that you would get the best result with an augmentation (of the volume) and a mastopexy (breast lift) including areolar reduction. Your photo shows that you have constricted/tuberous breasts and are missing volume including upper pole volume. The breasts appear to have laxity. It will not be enough just to place an implant. The remaining breast tissue and skin would drape over the implant. The excess skin would need to be reduced and tailored so the nipple-areola is centered over the implant. Therefore, at surgery, the implant is placed first, then the breast lift is performed. The size of the implant would be based upon your chest and body measurements, and then modified by your preferences- such as breasts that are slightly larger or slightly more moderate. Based on the actual skin laxity, it would be aesthetically better to reduce the areolae. As with any of these more complex procedures, sometimes a second stage is needed. Thank you. Respectfully, Jules A Feledy, Jr, MD American Board of Plastic Surgery, American Society of Plastic Surgery

The technique I recommend is a lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Dear aguerra0416,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.The type of surgery best for you will depend on the severity of your condition.My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Good morning,
You are an excellent candidate for a donut mastopexy to reduce your areolas and tighten your skin and a submuscular augmentation. You may choose saline or silicone gel, depending on your preference. We would determine the exact size and profile when I measure your chest, we review photos together, and you have an opportunity to try on the implant sizers here in the office.

Without an examination in person it is difficult to make any specific treatment recommendations, however based on your photos it appears you would be an excellent candidate for a mastopexy alone, or with implants, depending on the size and look you hope to achieve. Please consult with an experienced board certified plastic surgeon whose aesthetic results appeal to you based on hot or her Before and After gallery. Best of luck to you.

From your photo it appears you would have the best result from a breast lift with implants. During the lift the areola tissue would be downsized and the breast lifted. The implant would give your shape and volume. The best place to begin is a consultation with a board certified plastic surgeon near you.