Are my breasts tubular? (Photo)

Question

Hi, I'm 20 years old. I've always been really self-conscious of the size of my breasts and the fact that they aren't very rounded. Are they considered normal or are they tubular/deformed? Also do you think my breasts will grow anymore? All the women in my family (on both maternal and paternal sides) have large breasts and I don't understand why mine didn't get the memo... Thank you

Michael E. Decherd, MD, FACS · Answer

While you look like you have a shot nipple to fold distance, I do NOT see herniation of the breasst tissue into the areola.  That is usually the hallmark of a tuberous breast.  For example, your areola diameter does not appear out of proportion to your breast.Regarding your other questions, I would think at 20 the only significant change to your breasts any time soon would be either pregnancy or a massive change in weight.  So if you are considering breast augmentation, I do not think waiting is going to materially change things.Good Luck!

Vishnu Rumalla, MD · Answer

Thanks for your inquiry and excellent pictures.  I do not think you have tubular breasts and your breast can change with time and most definitely with pregnancy.  Your breasts are not deformed and I think they are very normal.  Hope that helps.

Gary Lawton, MD, FACS · Answer

Your breasts can be very well addressed by a surgeon with extensive experience in breast augmentation.  You would have an excellent outcome from transaxillary endoscopic breast augmentation.  The breasts are not likely to grow much more at this point. With respect to the things you need to consider when choosing a surgeon, I have attempted to answer some of the most common questions you might have about the technical aspects of the surgery and your decisions.The most sophisticated approach to
breast augmentation is through the armpit with a surgical camera (transaxillary
endoscopic). Using this modern approach the space can be crafted under direct
vision, with virtually no bleeding and no postoperative bruising. Most
importantly, the shape of the breast is meticulously created. The other, older
methods of insertion are technologically less advanced. Both silicone and
saline implants can be placed through the armpit by a surgeon with skill and
experience using this approach. The incision in the crease is the oldest method
of placing the implants and puts a scar directly on the breast.

A round implant would be a better
choice because they move more like breasts. The anatomic implants have a
textured surface which makes them feel very unnatural. In addition, there is no
benefit to anatomical. There is an X-Ray study that shows the implants from the
side at 6 months. Standing, the round and the antomical implants have the same
profile. When you lie down however, the anatomical implants do not change,
which is unnatural. A round implant will change when you lie down, like a natural
breast would.

HP implants, which are a more modern
shape than moderate profile implants, fit most women better. They have a more
appropriate base diameter and can be made to look very natural or very
augmented, depending on where in the range the implants are filled to achieve a
particular volume. High profile implants are the first choice in my opinion. I
rarely find an indication to use moderate or moderate plus implants. The
subtlety in the final outcome is not achieved by which profile implant is used,
it is determined by the skill in the creation of the pocket, the choice of
volume, and where in the range the implant is filled.

There
are many advantages to sub muscular dual plane placement and very many
disadvantages to sub glandular placement.  I would see no indication to do
anything but sub muscular dual plane.  Subglandular silicone implant
placement is the historical approach to this surgery, and was widely used in
the 1960's.  The implant edges are more visible, the risk of rippling is
higher, the implant is in contact with the non-sterile breast tissue so the
risk of infection and capsular contracture is higher.  The interface
between the breast tissue and the muscle is blurred so the implant interferes
with mammography more than sub muscular placement.  The blood supply
surrounding the implant is worse so the risk of capsular contracture is higher.
 The support for the implant is less so there is more long term shape
abnormalities and sagging.  The look of a sub glandular implant is much
less appealing than a sub muscular implant.  The placement of sub
glandular implants makes any subsequent revision surgeries more complicated and
less successful.  There are no advantages to sub glandular implant
placement.

The choice between saline and silicone
is one that requires a complex discussion of all of the advantages and
disadvantages of both implants. The issues to be considered are safety,
density, mobility, rippling, rupture rate, consequences of rupture, detection
of rupture, need for follow-up care, cost of follow-up, appearance, feel,
sensation of heaviness, radio-density, mammograms, and costs, among other
things. There are advantages and disadvantages of both products. The decision
will ultimately be up to you based on what is appropriate for your particular
situation. Beautiful results can be obtained with either implant.

The best way to determine the size that
fits your personal perception of the perfect breast is to try on sizers. This
way you can see how they fit on you, how they add to your current volume, and
whether they fit your frame. Although the surgeon can guide you, only you will
be able to tell what is the right size. Try on sizers. Measuring a diameter and
then telling the patient what volume they can have (in high, moderate or
moderate plus implants) in my mind is backwards. The patients should be allowed
to choose the volume. Then the surgeon carefully considers the base diameter,
projection, profile, manufacturer, and fill material that will achieve the
patients goals of size as well as qualitative look (natural, intermediate, or
bold upper pole fullness or projection), all the while taking into consideration
the patient's anatomic features that will affect the outcome. The experience of
the surgeon and the degree to which they explain the options to you is of
utmost importance. The subtlety in the final outcome is not achieved by which
profile implant is used, it is determined by the skill in the creation of the
pocket, the choice of implant. Don't let the doctor tell you what would look
good on you. They cannot tell what you perceive to be the best size. There is
no maximum. That is up to you.

Luis A. Mejia, MD · Answer

Hi, thank you for the question, in my opinion you dont have the complete diagnosis os tuberous breast.. You do have a short distance between areora and mamary inferior fold, but this could be solved with a breast augmentation surgery alone...

Guy Watts, MBBS (Hons), FRACS (Plast) · Answer

Thank you for your questions and images. You do demonstrate some restriction of the lower pole of your breasts but the other aspects of your breasts fall within a normal range. At your age I would not expect a further significant increase in breast volume unless your changes relate to weight fluctuations or pregnancy. I can understand that you feel a little hard done by compared to other family members but the good news is that there are solutions available to you. I would suggest a consultation with a plastic surgeon to explore your options. Best of luck.RegardsDr Guy Watts

Ravinder Jarial, DO · Answer

Greetings. Based on the photos provided, it does not appear that you have tubular breasts. It would be helpful to see a plastic surgeon in your area to discuss your concerns. Good luck!

C. Bob Basu, MD, MPH, FACS · Answer

Based on your photos alone, it does not appear that you have a classic tuberous breast deformity.  However, a physical exam during an in-person consultation is required to give you any meaningful advice/recommendations.   Based on your photos, you may have some mild components of tuberosity (perhaps a tighter lower pole).  This can be treated with a breast augmentation procedure.  Please see a board certified PS to learn more about your options.  Best wishes.Dr. BasuHouston, TX

Donald W. Kress, MD, FACS · Answer

You have a slight tendency toward tuberous breast. Don't have a tuberous breast correction. Your tendency would be corrected with implants alone and a little time. Tuberous breast corrections would add scarring.

Tom J. Pousti, MD · Answer

Thank you for the question and good quality pictures.
Yes, I think your breasts do demonstrate some of the qualities seen with tuberous (constricted) breasts.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.
In your case, if the appearance/shape/size of the breasts are a concern,  you may be an excellent candidate for breast augmentation surgery.  
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,  and the attached link (dedicated to surgery for constricted/tuberous breasts) helps.  Best wishes.

Robert N. Young, MD, FACS (retired) · Answer

The photos you provided do not look like you have true tubular breasts. By age 20, most women have achieved full breast size. It would appear that you may be a good candidate for breast augmentation surgery with a board certified plastic surgeon who has achieved good results with women who have had similar shaped breasts. Most surgeons have before-after photo books that have an assortment of breast implants in women with a variety of body shapes and sizes, so it should be possible to see what they've been able to achieve for others like you.

Are my breasts tubular? (Photo)

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