Tuberous breast correction - what treatment would you suggest? (Photo)

In addressing tuberous breast correction, understanding that the best treatments hinge on the patient's aesthetic goals is key. When considering implants, it's important to note that the nipple-areolar complex (NAC) may enlarge and stretch due to the implant stretching the soft tissue above it. Consequently, without a lift, a larger implant might be required to adequately correct the tuberous deformity and achieve a more natural breast shape.
As you consider your options between the two surgical opinions—implants with pocket revision and peri-areolar lift versus just implants and pocket revision—it's crucial to define what your goal size is and how you envision your breasts post-surgery. This will significantly influence whether additional procedures like the lift are necessary to prevent the nipples from appearing disproportionally stretched or misplaced due to the underlying condition and the implants.

I would recommend a bilateral breast augmentation below the muscle and an areolar reduction. I would recommend always consulting with a board-certified plastic surgeon with 3D capability to show you the potential outcome.

Dear Angel_1009,,
I have treated many such situations over my 24 years of practice. I treat it like your first surgeon recommended, with implants, lowering the breast crease, scoring the breast tissue. Hence, it expands and the donut lift will correct the herniation of the areola. This will help it lie flat like most areolas do. If having your areola sit like a "Hershey kiss" doesn't bother you, then don't do that part.
I have seen amazing results with this technique.
Best wishes!

The size of your areolas are slightly large compared to the size of your breasts. You can do a circumareola incision to decrease the size and projection of your areolas. It may be possible to use an inframammary incision and place submuscular implants.

Best Wishes,

Gary Horndeski, M.D.

Your breasts are significantly constricted as evidenced by both severe glandular herniation into the nipple-areolar complex and a very short nipple to fold distance. You can't have a 'pocket revision' without already having had implants, so I don't know what they mean by that (unless they are already talking about a common complication with tuberous breasts, implant drop out). The 'gold standard' of periareolar incision, scoring breast tissue, and a circumareolar reduction leads to a greater than 50% complication and revision rate. Although you could go straight to an implant, the size of which is crucial to minimize a lot of post operative complications, I highly recommend at least one round of fat grafting to increase the base diameter of your breasts, making them more amenable to a breast implant. If you choose implants as a first surgery, it should look like this: appropriate sized devices placed through a properly placed inframammary incision and into a subpectoral pocket. No areolar reduction in a first surgery or breast scoring ever. Once skin tension has relaxed upto a few years, areolar reduction can be performed with less risk of re-expansion and thickened scar formation.