Would You Recommend Fat Grafting to Correct my Tuberous Breasts and Am I a Candidate for a Tummy Tuck or Lipo? (photo)

Overweight as a kid, also been underweight, now I'm 160 and 5'9. I have always had a fat stomach even when thin. Can this be corrected with lipo or is a tummy tuck needed? Also, what is your opinion of fat grafting with lift to correct breast deformity?Iwant to be a C cup. The discoloration on the areolas is from self injury- picking my skin. Is there anything that could be done to restore pigmentation? Can you recommend a good surgeon in my area (Seattle) or somewhere on the west coast? Thanks

Doctor Answers 15

Mommy Makeover and Addressing Tuberous Breasts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The Mommy Makeover is a combination of procedures to bring a woman’s body back to the way she looked prior to pregnancy. Most commonly some variation of a #TummyTuck and #BreastSurgery are performed. Additional procedures can include liposuction, umbilical hernia repair.  The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction. It is best to undergo #MommyMakeover procedures when your weight has been stable for at least one year. 

Tuberous Breasts or #tuberous breast deformity are breasts with an unusual shape. They may be very narrow at the base on the chest, or the whole breast can be very narrow in shape. There are different variations of #TuberousBreasts but is a growth and development problem which may create a great deal of angst for a young woman. Those with #TuberousBreasts are ideal candidates for #BreastLifts. Also, women with asymmetric or enlarged nipples or areolae (pigmented areas around nipples) also may be candidates for a breast lift or a modification of a lift. #Asymmetric breast can be adjusted by adding or removing volume. One side can be tightened more or less than another. In addition #BreastImplants commonly complement a Breast Lift (#Mastopexy) . Such is called #AugmentationMastopexy. 

Without the Breast Lift, the breasts may appear larger and more droopy with solely implants. They will sag more and sooner, due to the sudden and excess weight. It's also possible for a “Snoopy” breast or double bubble to develop as a result. The implant with lift can also re-position the nipples which may have been affected by ptosis or drooping. One of the primary intentions of a Breast Lift (#Mastopexy) is to improve the shape and position of the breast without reducing their size. It is used especially for breasts which sag or droop (#ptosis). Both procedures are commonly done together, in the same surgery to correct the effects sagging and turberous breasts

Your procedures should be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Augmentation and Keyhole Mastopexy Would Be Most Helpful

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It’s always difficult to recommend abdominoplasty surgery to patients who are younger and may eventually want to have more children.Under these circumstances, liposuction is probably a better option even when there’s some excess skin.
Correction of your breast deformity will require submuscular breast augmentation performed in combination with a keyhole mastopexy.In the majority of tubular breast deformities, fat grafting isn’t necessary.Depigmentation of the nipple areola complexes can be treated by tattooing the area.
This approach is usually associated with high levels of patient satisfaction and excellent clinical results.If you’re considering this type of procedure, it’s important to contact a board certified plastic surgeon with experience in this area.

Mommy Makeover

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

  Breast augmentation and breast lift with liposuction may give good results.  However, the issue of skin laxity and fat deposits should be assessed in person.

Mommy Makeover

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question and photos.

I would recommend that you have a breast lift procedure and if you would like to increase your breast size, have breast implants placed.  In regards to your tummy, I think liposuction may give you nice results.

Please visit with a well experienced plastic surgeon and ask to see examples of their work.

Best wishes.

Fat grafting not recommended for tuberous breasts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your breasts are too far apart and too low.  You need your breasts repositioned and reshaped.  This can be done using a circumareola approach that will lif your breast tissue higher, displace it more medially and change the shape of your breasts to increase projection.  If you want to be bigger then implants can be placed through the same incision.  I recommend silicone gel implants placed retro-pectoral since they look and feel more natural.  Your abdomen could be improved with either liposuction or an abdominoplasty.  However, I would not do a tummy tuck if you are considering pregnancies in the future.  If you are done having children then an abdominoplasty can be done with mesh reinforcement, which will decrease your weight and help maintain the reduced weight.  Also, the abdominoplasty will make your breasts appear to be larger and you can use smaller implants, which are more stable long term.  In summary, I recommend Breast Augmentation with Mini Ultimate Breast Lift and Abdominoplasty with Mesh Reinforcement. I have never recommended fat garfting as it is unproven and can lead to complications.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Would You Recommend Fat Grafting to Correct my Tuberous Breasts and Am I a Candidate for a Tummy Tuck or Lipo?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Yes I would consider all those surgical options you wrote about. Best to seek a few IN PERSON consultations in your city. 

Tuberous Breasts and fat grafting

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I would not recommend fat grafting for your breasts. You need a concentric lift and an implant.  In terms of  your stomach you may do very well with liposuction. You do not need a tummy tuck. 

You will have more areas to pick after your surgery which could lead to more scarring so you need to get that under control before surgery.

Robert Kearney, MD, FACS
La Jolla Plastic Surgeon
5.0 out of 5 stars 32 reviews

Tuberous breasts and fat grafting

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Here is my approach to tuberous breasts, and the information in your photos.

  • Avoid fat grafting. Most of the fat will absorb over a year.
  • A combined lift, tuberous release to reshape the breast and a small implant.
  • To find a surgeon, go to the American Society of Plastic Surgeons for the Board Certified Plastic Surgeons in your zip code. Seattle has excellent surgeons.

Do you still pick at your skin? It has to stop before surgery or you may pick at the surgical incision and get an infection. Sorry you have been under such stress. Be sure to have the support, even the therapy you need.

Hope this helps!

Treatment of tuberous breasts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi, you have correctly identified yourself as having tuberous breasts - big areolae, a droopy appearance, the crease under the breasts is high up and the breasts are further apart. I think you will get the best results with an augmentation, rearrange the breast tissue at the same time (I unfold the lower breast so that it is more even on the chest), and a circumareolar lift.

If you do just fat grafting, your areolae will still be large and the breasts will not radically change in shape. It would be better, especially with a lift, but not a home run. There are also some issues to fat grafting when rearranging/lifting breast tissue - basically surgeons can only graft into the tissue that is NOT be moved at the time of surgery.  As a surgeon, that picking thing bothers me - why are you doing that? If you were my patient I would yell at you. Don't pick your incisions after surgery. Never pick anything unless you just washed your hands, that will stop you at least from absentmindedly picking all day. Try IPL (often called "fotofacial") to get rid of it, a Cosmelan treatment, or topical hydroquinone to lighten or eradicate the spots. No picking.

Lisa Cassileth, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 16 reviews

Options for a not so tuberous breast

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Actually your breast is ptotic and asymmetric, and options involve lift, implants, or both, though fat grafting is certainly possible depending on your goals. Your abdomen is likely to need only liposuction and the fat could be put to use in the breast if you wish to avoid an implant, but only a lift will get the nipple up front and center.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 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.