You have tuberous breasts. This challenges the plastic surgeon, because few of us deal with this problem frequently. So two papers that discuss the issue show that the tuberous breast comes in a lot of variations with different degrees of lower pole hypoplasia, volume, nipple areola configuration. Using just one method like an implant and lift can lead to a double-bubble in some variations due to the insufficient and short nipple to fold distance to fit an implant. In some cases, two sessions of fat grafting gave very nice results with a natural look and no scars. You can check out these two articles on PubMed and discuss them with your plastic surgeon as a starting point on deciding on a surgical plan that works best for you: Aesthetic Plast Surg . 2022 Sep 26. doi: 10.1007/s00266-022-03089-x. Online ahead of print. Tuberous Breast, Deformities, and Asymmetries: A Retrospective Analysis Comparing Fat Grafting Versus Mastopexy and Breast Implants and Aesthetic Plast Surg . 2022 Dec 22. doi: 10.1007/s00266-022-03233-7. Online ahead of print. Comment on: ''Tuberous Breast, Deformities, and Asymmetries: A Retrospective Analysis Comparing Fat Grafting Versus Mastopexy and Breast Implants'' Stefano Vaccari 1, Flavio Bucci 2, Riccardo Di Giuli 2