What are the best options for my small, shapeless breasts and large areola? (Photos)

I'm 32 and I have always had small breasts. Far from being perky and firm, they are soft and completely lacking any fullness. The only time I feel confident about them is when my nipples are erect and my areola is pulled tighter, which gives a cute overall shape. I don't hate having small breasts but I do hate how low my areola sit and how big they are relative to my breasts. Are small, perky breasts even possible for me and what procedures should I be looking into?

Doctor Answers 5

Breast Implants Can Help

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It does appear that you some signs of tuberous breasts, which can be addressed during breast augmentation surgery. The procedure releases tightened breast tissue and creates a larger space for breast implants. It will also produce a more contoured breast crease. In your case, I believe that after breast augmentation, your areolae will look proportional and may not need to be surgically refined. Choose a qualified plastic surgeon with extensive cosmetic breast surgery experience for the best possible results.

Small shapeless breasts

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You appear to have tuberous breasts. These can be improved typically with insertion of a breast implant, lowering the inframmary fold, scoring the breast tissue in the lower pole of the breast in order to expand it and reducing the width of the areola. Obtain a consultation with a board certified plastic surgeon near you experienced in breast augmentation surgery to undergo an examination and full discussion of treatment options.

Tuberous Characteristics

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Thank you for your question and photos. You may have some characteristics of tuberous breast constriction which would explain the lack of a defined fold under breast, constricted shape and herniated or puffy nipples. This can be corrected with a combination of procedures to release the constricted breast base using radial scoring, and placement of silicone cohesive implants. They do not need to be large but implants do help to fill out and round out the breasts after release of constriction. Areola reduction or set back can be done as well to reduce the puffiness.

I recommend that you meet with a board certified Plastic Surgeon in person who has experience in this area and discuss your concerns. They will examine you and provide options.

All the best

Breast augmentation

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Thank you for your question and photographs.

A small implant alone I believe would help give your breasts a better shape and make the areolas more proportional to your breast so they do not appear as large. I would recommend that you schedule a consultation with a board certified plastic surgeon so they can perform a physical examination and take measurements so they can recommend the best implant type/sizes for your body. There are 3D simulators that can show you what you would look like with different types of implants and different sizes, this can be helpful when trying to decide what size would achieve your cosmetic goals. At my office, I use high profile Sientra implants to create a round full result that looks natural, giving you the result that you want. Additionally, i use Crisalix which is a virtual reality device that will allow you to view different sizes of implants and pick which best suits your desires.  As the only board certified plastic surgeon in Pittsburgh offering this virtual reality imaging system, we have a 100% satisfaction rate.  Crisalix is truly a unique experience for our patients as they can view themselves using virtual reality goggles and can instantly visualize their own breasts changing in size and shape with all of the various brands, sizes and shapes of breast implants.  Thus, our patients leave the consultation feeling confident with the size of the implant they chose. Best of luck in your endeavors!

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 86 reviews

What are the best options for my small, shapeless breasts and large areola?

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Thank you for the question and pictures.

  I think your breasts do demonstrate some of the qualities seen with tuberous (constricted) breasts; there is a wide range when it comes to tuberous/constricted breast presentation.

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 your case, if the appearance/shape/size of the breasts are a concern, you may be an excellent candidate for corrective surgery.

***When you are ready, please make sure you consult with well experienced board-certified plastic surgeons who have significant (demonstrable) experience with this type of surgery.

I hope this, and the attached link (dedicated to corrective surgery for patients with tuberous/constricted breasts) helps. Best wishes.

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.