What's the best technique to improve tuberous breasts? (Photo)

Question

I am 43 years old and I decided to have a breast augmentation but I am not sure if I will need a lift for my breast. I don't like scars, I would like to have round silicone high profile. Any suggestions?

Damien Grinsell MBBS, FRACS (Plast) · Answer

Hi
I’m not sure there is a best technique. You need an operation that adds volume to the breast whilst expanding the lower pole to make it more round. In addition you may choose to have a periareolar reduction to make the areolae smaller. I would recommend a dual plane approach with anatomical implants to expand the lower pole. Smooth rounds will also do this over time but it is not as controlled. 
Cheers Damien

Elizabeth Kiwanuka, MD, PhD · Answer

If you have mild tuberous breasts and are considering breast augmentation, using large, high-profile silicone implants could potentially help stretch out the skin envelope and correct some of the tuberous deformity. This approach can be effective in filling out the lower part of the breast and creating a more rounded appearance, which might reduce the need for a lift, especially if the sagging is not severe.
However, it's important to consult with a plastic surgeon who can assess your specific case and determine if implants alone will achieve your desired look, or if a lift might still be necessary to address any sagging or to position the nipple and areola appropriately. Since you prefer to avoid scars, discussing options that might minimize scarring, such as a periareolar lift (if a lift is needed), could be part of your consultation.

Gianfranco Frojo, MD · Answer

This is a complex breast issue to address adequately. You need to see a physician in person and have an extensive discussion that includes a proper physical exam.  I recommend finding a surgeon certified by the American Board of Plastic Surgery. Ideally, one with experience in facial aesthetic surgery.

Gerald Minniti, MD, FACS · Answer

The reality it that primary augmentation with implants, especially when combined with a lift of any sort, and/or delivery of the implant through a peri-areolar incision, has a greater than 50% reoperation rate. Although an implant is ultimately the goal, along with some sort of li possibly, ideally the first step in the process is fat grafting to the lower pole and inframammary fold of the breasts. This addresses the heart of the problem: insufficient soft tissue and skin formation in the lower pole of the breast. This first step both expands and augments that tissue with your own tissue (fat), making the resulting breast a much better candidate for an implant.

Ram Kalus, MD, FACS · Answer

Thank you for your question and photos. An examination in person would be necessary to properly evaluate you and make specific recommendations. That said, based on your photos, it appears that you would be an excellent candidate for an augmentation mastopexy (breast lift with implants. This can theoretically be accomplished with purely a circumareolar scar that is generally well concealed and minimally conspicuous.

Please consult with an experienced board certified plastic surgeon whose aesthetics align with your own based on his or her before and after gallery, and whose reviews resonate with you. When in doubt, a second opinion can always be of value. Best of luck to you.

Shlomo Widder, MD · Answer

Dear Virginian,
    Thanks for posting your pictures. From observing your pictures , you appear to be a small A cup size with classical ptotic ( droopy )  tuberous breasts ( herniated areola and narrow base )and very large areola. In my experience of 37 years in plastic surgery, I can tell you that the best option for your condition is breasts implants with  mini lift procedure ( donut. purse string) . This technique will result in perky breasts with smaller and more attractive areola, nice cleavage, nice upper pole fullness and nice projection of breasts. You can contact my office for information in regard to  best implant type for you and optimal size selection.
    Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery to make sure that they are numerous, consistent and attractive with the features mentioned above.
                Best of luck,
                              Dr Widder
                     widderplasticsurgery.com

Zoran Potparic, MD · Answer

A combination or breast tissue reshaping, reduction of areola size, breast lift and augmentation  with implants is a set of procedures to correct tuberous breasts. In person or teleconference consultation with a board certified plastic surgeon recognized as an expert in tuberous breast correction is recommended. Good luck.

Dana Goldberg, MD · Answer

Based on your photos, I think you could get a nice result from an implant alone without additional scars. Typically, a Perry area incision is created, and the natural breast fold is released. This allows the implant to sit lower and stretch out the skin under the nipple.

Unfortunately, it is fairly common to end up with a double bubble. This is where you can see the bottom of the breast implant, and you can also see the natural breast crease slightly above it. Most of the time, releasing the breast fold minimizes the appearance of a doible bubble. A lift minimizes it further, but if you want to avoid the scars, I think you can still get a nice look.

Some patients like using an anatomic (or “tear drop”) shaped implant since this pushes out the bottom part of the breast more than the top, which can help stretch the skin. However, there is a risk the implant could turn and not maintain the right breast shape.

Finally, some surgeons will incorporate fat transfer into certain areas of the breast to add more tissue coverage over the implant where the breast tissue is naturally thinner. I have had success with this as well.

Best wishes!

Kenneth R. Francis, MD, FACS · Answer

Dear Honest,
With the extent of tuberous breast shape that you have, you will require a breast lift with your breast augmentation.  The profile of breast implant that you choose, if high profile, will not significantly change that fact.  Good luck!

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