Constricted Breasts, what are my options for breast augmentation?

I am saving for a breast aug & have wanted one since high school. have very puffy areolae & almost no breast tissue in the lower poles of my breasts, especially in the right one. I 5'3" and about 130lbs and would like to acheive round, perky breasts (think halle berry or brooke burke) - as a surgeon, how would you correct my breasts & what size/ placement would you recommend? Just trying to get a rough idea...

Doctor Answers 13

Constricted Breasts, Options?

Hello and thank you for your question. Based on the information provided, it seems that you have a tubular breast; there are several different approaches to correct the shape and the size, depending on the degree of the problem.

The treatment can be a breast augmentation with anatomical implants up to a breast reshaping with an areola reduction and lowering of the infra mammary fold. Best advice is to go and see an experienced plastic surgeon and explain what you would like to achieve. I have attached the link of one of my patient with the same condition, before and after the augmentation with anatomical implants and release of the constricted lower pole.

Best of luck

Andrea Marando

Manchester Plastic Surgeon
5.0 out of 5 stars 110 reviews

Form stable implants for constricted breast patients

i think you would be a good candidate for a reasonably sized form stable (gummy bear - Allergan 410 or Mentor CPG) implant - these implants will place volume in the lower pole of your breast and minimize upper pole fullness. a dual-plane placement with the use of a surgical drain is my current technique for 'gummy bear' implants.

Constricted breasts

I would not consider your breasts to be technically constricted. You do have a short distance between your nipple and the inframammary crease which can be corrected at the time of breast implant surgery. I would recommend around 350 cc's to achieve a full C cup.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 24 reviews

Circumareola approach for constricted breasts

Unfortunately, you have not told us your bra size. If you are a 32 or 34 each 100 cc's of implant corresponds to 1 cup size change. If you are a 36 or 38 each 200 cc's of implant corresponds to 1 cup size change. From this, you can compute the volume required to achieve your goal. I always recommend small silicone gel implants placed retro-pectoral since they look and feel more natural, are more stable, less likely to ripple or have complications needing revision. Because of your widely spaced breasts and nipple position, I recommend a circumareola approach. Using this technique it is possible to reshape your breast creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.7 out of 5 stars 208 reviews

Dr. Kimberly Henry

You are a great candidate for breast augmentation! I would suggest placing the implants sub-muscularly for a more natural look, and minimize scarring by placing the incision in the infra-mammary crease. You would look very nice with implants, bringing you to a full C. Reducing the areolae is up to you, depending on if you want the scars that come with it. Come up and see us, or check out our photos at! We'd love to see you!

Kimberly A. Henry, MD
Greenbrae Plastic Surgeon
4.7 out of 5 stars 36 reviews

Constricted Breasts, Tubular Breast Surgery

Constricted Breasts, Tubular Breast Surgery

There is not enough info provided to tell you implant size but standard periareola correction of the puffy areolas along with a highly cohesive, probably shaped implant will help push out the lower part of the breast for an improved contour. I usually use Sientra shaped implants for this.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Constricted Breasts, what are my options for breast augmentation?

I think that trying on sizers in the office will give you the best idea for the size that would be best for you. Perhaps, 300 cc to 400 cc. You may choose either type of implant placed in the submuscular plane. I perform breast augmentations through all 4 approaches. I also perform fat grafting, but this is not my first choice in most patients.

Kenneth Hughes, MD

Los Angeles, CA

Constricted Breast Augmentation


There are three directions that you could choose, one leading to a good result, two leading to a great result. Certainly the tried and true use of an implant, preferably silicone, in conjunction with a circumareolar reduction will give you a nice result. However, due to skin elasticity issues (too tight), implant volume needs to remain low in order for your tissues to accommodate without a problem.

Alternatively, you could first pursue fat grafting as an initial treatment to both increase breast volume in the lower pole and expand skin (using the Rigotti technique of serial skin punctures). After a period of healing, usually 3 months, get a silicone implant based breast augmentation. Please note that the order can be reversed, implants followed by fat grafting. This technique will give you both the best shape and the most volumetric increase.

Finally, you may opt for fat only augmentation. Although volume increase would be limited, you would still get a great result and improvement in shape, better than implants alone.

I am a believer in the Brava system as the best way to maximize graft yields. Stem cell therapy is not proven, has uncertain risks in breast tissue, and should only be done in very tightly controlled research environments. Please note that you'll find plenty of 'stem cell expert' breast and face surgeons; you should shy from these people.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 78 reviews

Breast Augmentation for Constricted Breasts

Dear tweedledee01,

You may be a good candidate for breast augmentation with release of the constricted lower pole, lowering of the inframammary crease, and reduction of the areolae.

Please see an experienced, Board Certified Plastic Surgeon for an evaluation.

Warmest wishes,

Larry Fan, MD

Larry Fan, MD
San Francisco Plastic Surgeon
4.6 out of 5 stars 14 reviews

Constricted Breasts

Thank you for your photos

After looking at the photos I feel you should get a wonderful result with either fat grafting or an augmentation.

Clearly one would be able in one sitting to make your breasts larger with an implant then fat

Be sure to go to a breast expert for your procedure

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 58 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.