Tuberous Breast Implants Help? (photo)

I have tuberous breasts and I've recently been to a surgeon that has recommended at least 240cc mod profile implant because the width and size is best to fix the issue. I really don't want to go that big at all and would be happy with a small low profile implant but will go with the larger option if thats whats needed to fix them. Does anyone have any advice? NB The implant would be placed over the muscle, inframmary incision, lowering the crease and releasing the constricting tissue.

Doctor Answers 10

Tuberous Breasts Concerns…

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Thank you for the question and pictures.

 There are many different ways to approach  your situation. Personally, I would suggest a sub muscular (dual plane) breast augmentation  approach through a infra areolar or circumareolar  Incision.  I think that this approach minimizes risk of postoperative complications in my hands. It also allows me to better “control” the work that needs to be done on the lower poles  of the breasts.  In regards to breast implant size/profile, it will be very importance to communicate your goals carefully with your plastic surgeon. I prefer the use of goal pictures  during this communication process. Show your plastic surgeon what you are trying to achieve, as well as what is too big or too small.  Careful  design dimensional planning ( measurements)  will be important to select the breast implant that will best achieve goals. For example, the breast implants should be wide enough to help improve the spacing between the breasts ( improved cleavage area).

It is extremely common to receive different opinions from different plastic surgeons about the best way to treat a specific “problem”. Each plastic surgeon may have his/her opinion that is based on their specific/unique education, experience, and personal preferences. Their opinions may also be shaped by unfavorable results they have encountered in their practices.

Although these different opinions can be confusing and a source of anxiety for patients, it is good for patients to understand the different options available. Ultimately, it will be up to each patient to do their due diligence and select their plastic surgeon. Part of this selection process will involve the patients becoming comfortable with the plastic surgeon's experience level and abilities to achieve their goals as safely and complication free as possible.

I hope this helps.

Breast lift ESSENTIAL for tuberous breasts

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The question is "do you want larger breasts"?  If you do then you will need implants.  However, you definitely need the breasts lifted.  This can be done through a circumareola approach avoiding the vertical scars or boat anchor shaped incisions.  With this technique, it is possible to lift your breast tissue higher, creating more upper pole fullness, move your breast tissue more medial to increase cleavage and reshape your breasts.  You are a perfect candidate for this new technique called The Mini Ultimate Breast Lift.  You should not have your implants placed over the muscle since it provides less mechanical support.  Lowering your crease will not be helpful and you will look older and less athletic.

Best Wishes,

Gary Horndeski, M.D.


Tuberous breast

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The correct implant sizing depends on your breast width. I would not concentrate as much on the volume as the width of the implant. I would also place the implants in the submuscular plane.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

Tuberous breasts

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Without an exam it is difficult to say what would be the best implant for you.  It does sound like a reasonable plan for surgery.

Tuberous breasts

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Your posted photos show widely separated breasts, most of the breast tissue at and above the nipple level and possibly high inframammary folds. Just putting in breast implants will not fix these issues. The breast tissue needs to be more evenly distributed/centered under the nipple by releasing incisions in the breast tissue, moving the breast tissue closer to the midline and possibly lowering the folds. I think most surgeons would then prefer to put the implants under the muscle.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Do I have tuberous breasts? How are they best treated

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Dear Maria

Many thanks for your question and the very helpful photographs you sent in. In my opinion, you don't fulfil all the criteria that would give you a diagnosis of tuberous breasts.

Examining the pictures, your breasts are widely spaced apart, the nipples are low and you have a relatively short nipple to inframammary crease distance. You do not have any herniation of the breast tissue into the nipples nor do you have a "constricted breast base".

Therefore I think surgery using an implant to increase the breast size, lowering of the inframammary crease, radial scoring of the breast tissue all combined with a circumareolar mastopexy (breast lift keeping the scars around the areolae) if required following the first steps.

If in doubt, seek a second opinion, but in my view your surgeon is not far off the right track.


Good luck!


Tuberous Breast Implants Help?

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Best advise is to see 3 or more boarded PSs in your city to discuss options of surgery you have. I would recommend implants with fat grafting to the inferior poles of your breasts. 

Tuberous Breast Implants Help?

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You do indeed have tuberous breasts.  In regard to recommended breast implant sizes, there is no one size that is best. We have our patients try sizers on in a stretch bra to give them some idea of what adding that volume of implant in cc's to their current breast volume will give them in terms of eventual breast mound volume. This does not indicate what shape will result, but it does help give the patient an idea of volume.  Implant width should be matched relatively closely to breast width, and we generally choose implant profile based on the width that best matches a patient's breast.  The "moderate" profile implant, at least by Mentor, is their lowest profile implant. For a given size, it has the widest width.  Since you prefer a relatively smaller implant, 240 or less, I would predict that the lowest profile widest implant may be best.  Your short distance from nipple to inframammary crease will necessitate lowering your crease and releasing the constriction in the lower pole of your breast.  You do not necessarily need to place the implant above your muscle for the best result...if you need the additional padding and camouflage in the upper pole of placing the implant under your muscle, a dual plane technique will allow muscle coverage in the upper pole, while allowing the implant to "expand" your constricted lower pole.  Make sure your surgeon has experience in dealing with constricted or tuberous breasts.

Options for augmentation of tuberous breasts

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There are unique problems with the tuberous breast, and each one is slightly different. One of the typical problems is that the breast is wider than it is tall, with a short distance from the bottom of the areola to the bottom of the breast. So the breast has an oval base rather than a round one. This makes it very difficult to position a round implant, because the fold can only be lowered a small amount before it creates a double bubble profile, but a smaller diameter implant will leave a wide gap between the breasts. You might do well with a shaped impland, which would give you more options of size while still matching the shape of the breast. At the present time only one company has approved shaped implants in the U.S. but it might be woorth looking into.

Tuberous Breast

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Thank you for your question and for the photos. From those photos it is clear that you do have tuberous breasts. 

Your surgeon's plan seems reasonable, though I don't see why you should have a bit more flexibility to choose implant size. The width of your breast tissue may affect choice of contour--we prefer to keep the implant diameter within the dimensions of the breast, so it may be that a low profile implant, which has a wider base, may be a lesser choice.

In this setting, either further discussion with your surgeon or a second opinion seems like the way to go before you decide to proceed.

Best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.