Tuberous Breast Correction Without Areolar Incision

Is there a way to correct the shape of tuberous breasts without an areolar incision? I want to fix my tuberous breasts without affecting my ability to breastfeed. Is this possible? I'm okay with my puffy areolas, I just want round breasts.

Doctor Answers 10

Tuberous Breast Correction Without Areolar Incision

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Tuberous breast deformity involves a constricting ring that grows around the breast base. This ring stops the horizontal and/or vertical expansion of the breast, leading to constricted appearance with large areolas and irregular nipples. Surgery is necessary to release constricted tissue, and implants may be placed to enhance volume. 

You would have to see an experienced board certified plastic surgeon to determine whether your surgery could be performed without a peri-areolar incision.

Tuberous breast and its correction.

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The complete, classic form of the "tuberous" breast has four main components.  1:  an enlarged areola,  2:  most of the breast tissue located immediately behind the areola,  3:  a short distance from the nipple to the inframammary crease, and 4:  breast ptosis (droop).   But not every person has all four.

If your areolar size is not enlarged significantly, you may be able to avoid a peri-areolar incision.

But, for most patients, the combination of  1:  areolar reduction, 2: internal "unfolding" of the native breast tissue combined with an appropriately sized breast implant and 3:  peri-areolar mastopexy (lift) - works pretty well.

More recently, delVecchio from Boston has reported a case where he used autologous fat grafting to the breast with BRAVA pre-expansion to correct the tuberous breast shape without any implants at all.  

Treatment of tuberous (commonly called tubular) or constricted breast deformity without areola/nipple incision & nursing concern

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You can place an implant without an areolar/nipple incision but you will not be correcting the basic deformity. The reason for this is this is commonly associated with a herniated nipple and areola and this commonly requires a circumareolar incision. Secondly the breast tissue must be released from its tube like shape using radial relaxing incisions even without an implant. This latter intervention can also interfere with nursing. Sadly, we do not even know if you are capable of nursing. An emerging technique we have used is the the fat injection techniiqe.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Tuberous Breast Deformity

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It is possible to perfor the procedure without a periareolar incision.  Over the years I have taken care of many patients with the deformity you are describing.  The need to make an incision around the areola is dependent on your anatomy.  I have taken care of a number of patients who did not want that incision, so we proceeded with just  implants to augment the breasts.  Typically the result is better if the implant is placed under the breast in a subglandular position rather than under the muscle.  Over time the tissues do relax, rounding out the breast.  The approach to take is formulated on a per patient basis.  What works well for one patient does not necessarily work well for another.

Benjamin Schlechter, MD, FACS
Reading Plastic Surgeon

Tuberous Breast Correction Without peri-Areolar Incision is a poor idea

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Regarding: "Tuberous Breast Correction Without Areolar Incision
Is there a way to correct the shape of tuberous breasts without an areolar incision? I want to fix my tuberous breasts without affecting my ability to breastfeed. Is this possible? I'm okay with my puffy areolas, I just want round breasts

Tuberous Breast is a sub condition of CONSTRICTED BREAST. Essentially, the breast tissue assumes the shape of a TUBER (root) or a dog snout (Snoopy dog deformity) by being held in compression by bands of fibrous tissue much like Christmas trees are tied up on sale on street corners. To allow the breast tissue to assume a dome shape, these bands must be cut in vertical radiating pattern starting near the areola and diverging to the breast periphery. The BEST and most accurate way to place these cuts is through a peri-areolar incision.

The cuts DO go through some of the breast gland and ducts of the lower half of the breast and thereby could affect breast feeding. As a result, you may wish to postpone your surgery until you are done breast feeding your children since releasing cuts through the breast tissue would be required in any case. The only difference is that the periareolar approach offers MUCH better access and visibility.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Tuberous breasts

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You need to do something with the part that is the problem and that is why you would need a correction with a cut at the areola where the problem exists. The good thing is that there should not be a loss of nipple sensitivity. Watch my videos!

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 28 reviews

Breast augmentation alone in a tuberous breast

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The traditional approach to a tuberous breast, one in which the nipple and areola are herniated and mushroomed forward, does include an around the nipple incision. Of course the breast may be augmented without correction of the nipple, though the pressure of the implant does tend to push the nipple forward. This may please you, or work out depending on the degree of the tuberous shape. Despite the 'different' shape of the tuberous breast they do indeed work and will support breast feeding. Breast augmentation will not reduce the chances, though the release of the skin around the nipple areola may not either as the sensation and ducts are not affected.

Best of luck,


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

Tuberous Breast Correction

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I agree with Dr. Lentz. The best way to correct your tuberous breasts and give you round breasts is with a sub-glandular implant and release of the constricted breast to allow it to drape over the implant. You could, at the same time, correct the “puffy” areolae without affecting the ability to breast feed. This does, however, require a periareolar incision. Do understand that breast feeding after a breast augmentation may cause droop of the breasts requiring a lift.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Tuberous breasts and incisions

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Tuberous breasts usually require an incision areound the areola and scoring of the bresat parenchyma and capsule.  Without an exam it is difficult to say for sure.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Best way to treat tuberous breast is with peri areolar incision and sub mammary silicone breast implants

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The best way to address the problem of tuberous breast is to make an incision on the lower half of the nipple areolar complex, release the constricted breast from in side and place a silicone gel implant. This can be done with or with out a doughnut mamoplasty to correct the puffy nipple areolar complexes. While you might want to avoid this approach it is the best way to get the best result and the loss of nipple areolar sensation should be quite small (15%) and you should be able to nurse with out a problem. I have had many women nurse after this approach. 

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 17 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.