Do I have tubular breasts? How can I improve the gap? (Photos)

Question

I have a big gap in the middle of my breast, i find that they have some tubular breast characteristics. What procedure can I look into that would correct these?

Donovan Rosas, MD · Answer

Tuberous breast is not, technically speaking, a "yes" or "no" question. There can be different points on the continuum. The typical hallmarks include a high, tight fold with "puffy" or distended areola, minimal breast tissue and potentially herniation of the breast tissue through a tightened ring thus the "tuberous" label. It is a congenital deformity which usually manifests at puberty. To what degree it manifests will vary from one patient to the next.

Treatment of tuberous breasts varies depending on the degree of the breast architectural distortion. Surgical correction typically involves:

-areolar reduction

-submuscular augmentation

-release of constricted breast tissue

All of these techniques work in concert to correct the tuberous deformation of the breast.

Based on your photos, you demonstrate some mild features of a classically "tuberous" breast. You would benefit from some of the techniques described above. Augmentation and mastopexy will improve overall appearance. However, the gap or spacing is a function of anatomy and is likely to be unaffected.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Daniel Barrett, MD · Answer

Dear Beautiful3559,

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

Sibel Atalay, MD · Answer

What you’re noticing is actually really common, many women have some degree of tuberous breast shape, and it can create that wider gap in the middle along with a bit of a “bottom-heavy” look. The wonderful news is that there are procedures designed specifically to reshape and soften this.
The surgery most often used is called tuberous breast correction. Instead of just placing an implant, the surgeon carefully releases the tight tissue that causes the constricted shape, then adds volume in a way that rounds out the breast and brings them into better balance. Sometimes a small implant alone is enough, and other times it’s combined with fat grafting or a little lift to really refine the cleavage area.
While it’s important to know that everyone’s natural chest wall plays a role, meaning no surgeon can promise perfectly “touching” cleavage, correction can make a big difference in fullness, shape, and how close your breasts sit together. The goal is always to give you a softer, more feminine contour that feels natural and makes you feel more confident in your own skin.

Leila Kasrai, MD, FRCSC · Answer

You have a distinct breast fold and no constriction of tissue around your nipples, therefore it doesn’t appear that you have tubular breasts. It would be helpful to specify the issues you have with your breasts so that your surgeon can determine if your goals are possible with cosmetic breast surgery.

Sean Hill, MD · Answer

Answer from Dr. Sean Hill, Board-Certified Plastic Surgeon at Lone Star Plastic Surgery in Frisco, TX:
Thanks for your question and for sharing your photos &mdash; they give a helpful starting point, though a full assessment is always best done in person.
Based on the images you provided, you do not appear to have a classic or severe tuberous breast deformity. Tuberous breasts typically involve specific features like a constricted base, high inframammary fold, puffy or enlarged areola, and minimal lower pole volume. While there may be subtle elements that resemble this shape, what I see is more likely within the range of normal breast variation.
That said, determining a true diagnosis &mdash; and more importantly, creating a surgical plan if you’re considering augmentation or reshaping &mdash; is best done through a hands-on physical exam. This allows me to assess things like skin elasticity, base width, fold position, and volume distribution.
At Lone Star Plastic Surgery, I focus on creating personalized treatment plans that match both your anatomy and goals. If you’re thinking about breast enhancement, I’d be happy to meet with you, answer your questions, and discuss options that would give you the most balanced, natural result.
Warmly,Dr. Sean HillBoard-Certified Plastic SurgeonLone Star Plastic Surgery – Frisco, TX

Wayne I. Yamahata, MD · Answer

A definitive answer cannot be given without a physical examination, but your photos suggest a mild tuberous condition. With the limited information available, it appears that you would benefit from a breast lift, augmentation, and release of any identified constricted bands.

Kerry Owens, MD · Answer

Thank you for providing photos.  While you do have some mild tubular breast characteristics, the primary consideration in changing breast shape would be nipple positioning.  This requires a lift, which allows your surgeon to place the nipple more centrally over the breast mound.  With reshaping of the breast alone, you may see an improvement in the percieved gap between the breasts (this requires in person exam to fully evaluate).  This could be accomplished without an implant if you wish.  However, in some cases the only way to narrow your natural gap is to add an implant, and the best way to control this specific issue would be to place the implant above the muscle, since you likely have a wider gap between the muscle origins naturally, which would limit implant positioning in a submuscular space.  This situation is one that requires a comprehensive exam and discussion with your surgeon to review all options and their potential risks and benefits to make the best choice of procedure that will meet your goals.  Best of luck!

Ted Eisenberg, DO, FACOS, FAACS · Answer

Unfortunately, surgeons have created the term tuberous breasts, a fact which causes unnecessary concerns for women. Many women just have different sizes and shapes and in my opinion shouldn't be labeled. I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. 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. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Zoran Potparic, MD · Answer

Based on these photos, you do not seem to have tubular breasts. However, it is possible t that you have a narrow base breasts, which is one of the types of breasts malformation. In person evaluation with an experienced plastic surgeon would give you chance to find out more about deformity and how to correct it. Good luck.

Gary M. Horndeski, MD · Answer

Your breasts are very ptotic and extend inferiorly and laterally. The technique I recommend is 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.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Do I have tubular breasts? How can I improve the gap? (Photos)

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