Would You Require a "Donut Mastoplexy" Along BA for Small Minor Tuberous Breasts?

I would like a BA from A to B cup. I have small minor tuberous breasts. One PS says I should have donut mastoplexy and other say no, that it is not necessary for the mastoplexy and that there is more of a risk of affecting nipple sensation(which I am worried about anyway) Do you think an implant alone can correct a minor tuberous breast shape? Why is the nipple size an issue?

Doctor Answers 11

Tuberous Breast Correction?

Thank you for the question.

For “minor” tuberous breasts correction options very. Sometimes it is possible to  use breast implants only without an incision around the areola;  patients  potentially will contain to have a “puffy” areola appearance.In other cases of “minor” tuberous breast  anomaly,  breast augmentation and circumareola reduction may be selected as the operation of choice. Which operation the patient chooses will depend on the aesthetic result they are looking for.
Generally, 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" and 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.
When you are ready, please make sure you consult with well experienced board-certified plastic surgeons who have significant experience with this type of surgery.

I hope this helps.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

The amount of correction may vary.


Simple implant placement may not correct the problem as well. Tuberous breasts vary regarding the extent of the problem. Some patients can benefit by more correction than others. In your case,  at least one surgeon advises that you have more than simple implant placement. If you are OK with things being less round and maybe the nipple position being lower after surgery, then implant placement alone might be OK. Then again less correction might lead to you being unhappy after your surgery and returning to the operating room again later. 

Best Regards,

John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 27 reviews

Tuberous breasts and nipple herniation

The issue of tuberous breasts is asked quite frequently on this site, and you will find several responses on my profile. Tuberous breast shape is formed by constriction of the skin, especially around the base of the nipple causing the nipple to protrude forward. A breast lift or mastopexy is not needed to correct the breast shape. The correction can look like an around the nipple mastopexy, but there is no lifting going on. The nipple herniation can be increased by the pressure of the implant behind, and therefore it is best to plan on correcting the nipple protrusion. Nipple sensation can be a risk with augmentation, but the around the nipple scar produced has not been a problem with sensation in our practice. Make sure that the surgeons you see are very well qualified and experienced as a tuberous breast correction is out of the 'routine' for many.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Require a "Donut Mastoplexy" Along BA for Small Minor Tuberous Breasts

If the breasts tuberosity are truly minor than it is possible to achieve a good result. But without photos posted I can not really address the situation expertly. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Ways to correct Tuberous Breasts

If you have tuberous breasts, restoring form and volume is best achieved through a periareolar mastopexy.  Through this approach the augmentation can be accomplished, the breast tissue can be reshaped and the size and puffiness of the areolar can be corrected.  Having said all of this, pictures would very helpful.

Dr. ES

Tuberous breast deformity

Photos would really help to answer your question, but in most tuberous deformities, an augmentation and a donut mastopexy can often do the trick.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast augmentation alone will not correct tuberous breasts.


Hard to know without examining you, but in general this is a bad idea and can create a new deformity. The breasts need to be reshaped internally and you probably need a doughnut mastopexy. Most patients retain nipple sensation.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Tuberous breasts and correction with implant only

Most patients with true tuberous breasts have a condition called nipple-areolar herniation. IF an implant alone is placed this could make the areola even larger which may be undesireable. An important part of correcting tuberous breasts may also include parenchymal radial relaxing incisions.  

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Tuberous breasts

A photo would be key here because there is an entire spectrum of tuberous deformities.  Your's might be mild enough to not need a mastopexy, but usually you do need one.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Different approaches to tubular breasts: mastopexy or not?

There are a lot of variables to address in order to answer your question, and only a plastic surgeon who has personally examined you and discussed your goals can give definitive advice. One variable is the different degrees of tubular breast; they are not all the same. Others would be the size of the implants you want, your breast base diameter, and so forth. So having said that, most of the time I think the result is better with a mastopexy (donut/Benelli/periareolar). Sometimes other procedures such as expansion-augmentation with Mentor Spectrum implants, or fat grafting are helpful too. Get at least one more opinion before deciding.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 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.