Do I have tubular breasts? What procedure would be best to improve my shape? (Photo)

Question

I’m 30 years old with no children. I’ve always been unhappy with my breast shape as they are widely spaced, triangular/conical with puffy areolas. However they appear more “normal” when cold. I have recently lost 50lbs. What procedure would be best to improve their shape? Would I be able to avoid an anchor/lollipop scar? Thank you

Chul Hwan Seul, MD, PhD · Answer

Only surgery to insert an implant can improve the shape of your breasts. You may need to puncture the glandular tissue if necessary. If you want to improve to Areola, you should also do peri-areolar mastopexy. In this case, a circular scar is formed around the areola. In your case anchor/lollipop scar seems to be avoidable.

Ted Eisenberg, DO, FACOS, FAACS · Answer

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 then get to choose what looks right for them. 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. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Vishnu Rumalla, MD · Answer

Thanks for your inquiry and picture, a peri-areolar mastopexy with or without breast implant depending on your size goals would help correct the tubular appearance of your breast,  please seek the opinion of a board certified plastic surgeon.

Martin Jugenburg, MD · Answer

Hello, thank you for your question. Determining what surgery to be performed is first figuring out if it is just the shape you are unhappy with or the size. If you want to go bigger then implants would be required however this may also mean you would need some sort of combined lift/reshaping. It is is very difficult to tell just from the photo alone. An in person consultation would be optimal. If you just want a breast reshaping this will most likely involve a lollipop scar.

Gary M. Horndeski, MD · Answer

The best technique for you 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. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ram Kalus, MD, FACS · Answer

Thank you for your question and photo. What you describe is certainly within the spectrum of "normal" but only an examination in person by an experienced board certified plastic surgeon would allow for providing you with a proper treatment plan. From your photo you may benefit from a modified breast lift, with or without implants if you also feel you would like to be larger or fuller. The fact that you have lost a significant amount of weight also suggests that a breast lift may be required in addition to implants.

Volume (300 versus 400), is far less significant than implant width and projection. Saline versus silicone is also important, as is "round" versus "anatomical" or "form stable" or "shaped".

Because all of these options to consider can leave you quite confused, it is crucial that you select an experienced board certified plastic surgeon whose aesthetics align with your own, and with whom you feel comfortable. Don't be reluctant to seek a second or even third opinion to be sure and feel confident. Make sure that your surgeon sees photographs of your "favorites" or ideal. Expressing your desired cup size is notoriously inaccurate, and final breast size is the most common reason for patient disappointment after breast augmentation, either too big or not big enough.

Take your time, do your research. Best of luck to you.

Daniel Barrett, MD · Answer

Dear rhinouk18,
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

Camille Cash, MD · Answer

From your photo it appears you lack upper pole fullness to the breasts.  Implants can help to reshape the breasts and add volume to the top portion of the breasts.  An in person evaluation is needed to determine if other procedures are recommended for you.

Connie Hiers, MD, FACS · Answer

You only showed one photo, with one view, so the diagnosis of tubular breasts cannot be made. I would suggest meeting with a board certified plastic surgeon and discussing your concerns and options.

Douglas McGeorge, FRCS(Plast) · Answer

Your nipples are above the fold and so you are a good candidate for straight forward breast augmentation, to improve and enlarge your breast shape.
I would suggest seeking a consultation with a member of the British Association of Aesthetic Plastic Surgeons, to be properly counselled for care

Do I have tubular breasts? What procedure would be best to improve my shape? (Photo)

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