Solution for my Herniated Areolas/tubular Breasts? (photo)

Question

23. Currently a 38 A/B depending on the bra. I definitely have herniated areolas - not sure about the tubular breasts. It's been quite an issue for me. i have photos which I can share privately. 1) will areolar correction surgery and/or breast implants influence/impede my ability to breast feed? 2) is there a way to correct the areolar herniation without implants? 3) what would the average cost of such a surgery be? 4) any good surgeons in Toronto? photos used are not mine but look like me

W. Thomas McClellan, MD, FACS · Answer

Great questions and difficult reconstruction. Any breast surgery can effect your breast feeding. If breast feeding is critical to you then I would not have breast surgery. Additionally you may loose nipple sensation during the correction. Although not common it can happen and you should discuss it with your surgeon. You could correct the herniation of the breast tissue by only incising the constricting ring through a periareolar incision, which is the root cause of tuberous breast, however you would not gain size or projection without an implant. An implant would most likely be placed in a subglandular plane which affects the capsular contracture rates and hence the life of the implant result. (saline lower rates in that position.)

	Fat injections are an option however there is no long term data on the safety of such a procedure and its controversial within plastic surgery circles.

	Cost is probably around $7k US. I dont know any Plastic Surgeons in your area however please make sure they are certified in plastic surgery and deal with breast surgery on a daily basis. Best of Luck!

Elliot W. Jacobs, MD · Answer

This is a difficult problem.  Placing a breast implant can help -- but not totally.  There are two basic approaches.  One is to lift the breast gland off the chest wall muscle and then make radial cuts (like spokes of a wheel) on the undersurface of the gland to splay it out.  Then the implant can keep the land splayed out over the chest rather than  "constricted" just under the nipple. One can also do an areolar reduction at the same time. 

	A newer method, albeit slightly controversial, is to enlarge the surrounding breast around the constriction with the use of large volume fat grafting.  This basically camouflages the defect and produces a round breast.

	Not sure if there are any surgeons in Toronto who do the latter procedure -- but most plastic surgeons are familiar with the former procedure.

	Elliot Jacobs, MD

	New York City

Solution for my Herniated Areolas/tubular Breasts? (photo)

Answers (2)

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