Tubular Breast Awkwardness? (photo)

Hello, Which procedure would you (as doctors) recommend for my tubular breast and large nipples? It is so confusing and each surgeon I speak to offers different advice. I am more inclined to fat harvesting from my abdomen and thighs rather than an implant because I don't want unnaturally high or overly firm, too large breasts. I also do not want my nipples to point at the floor, I just want soft, tear drop, perky nippled boobs. :( Lol!

Doctor Answers 13

Perky after tubular breasts?

There are so many ways to approach your problem but you mention perky and you won't have perky without some kind of lift or areola reduction.  As for size, you could certainly improve your volume with either fat grafts or implants and you simply need to gather the information and make the best decision for yourself. 

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Tubular breasts easily treated with sub glandular silicone gel implants.

Sub glandular placement a silicone gel implants with concurrent release of the base of the constricted breast should leave you with an excellent result after breast augmentation.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

Tubular breasts with asymmetry can be corrected.


1)  For you the asymmetry is the main problem.  You have mild tubular shape. Don't recommend fat transfer.

2)  Everything can be done through a circular scar around the nipple.  You need a lift with reduction of areolas (one more than the other), lowering of the folds, release of the lower breast tissue, and different sized implants over the muscle.  I would think you can expect a lot of improvement.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Ideas for Correcting Tuberous Breast Shape...Ask Dr Ellen

Hello Bluebell26,

Well, your frustration is understandable- the fact is, there are a variety of techniques to gain better symmetry between tuberous  breast.  In addition, there are a multitude of factors to consider- your exam, skin quality, age, plans for children/breast feeding, budget...the list keeps going.  These days, fat transfers are a hot topic which I might add, doesn't make them a universal cure for all forms of breast surgery.  There are pros and cons.

The most predictable results presently are to combine lifting procedures with implants- when additional volume/size is desired.  Your photos reflect tuberous shape but not of a severe degree.  If it were me,  I would go with with implants and a lift.  The issues of  "too high" or "too firm" can be managed by the size of the implant, position of it and design of the pocket shape/size.

Thanks for asking!  Dr Ellen

Ellen A. Mahony, MD
Westport Plastic Surgeon
5.0 out of 5 stars 27 reviews

Tubular Breasts

Thanks for the questions,

The solution to tubular breast will involve three issues- breast volume, skin envelope and nipple diameter/herniation

Each of these needs to be consider by you when you decide the best plan.

To correct volume will most likely need an implant, to achieve " perky " breasts may need a breast lift to place the nipple on the top of the breast mound and avoid it facing the floor, as well address the "pouting" of the nipple.

I appreciate the result you want and the key will be that you may need to accept some compromises in terms of accepting an implant and a possible lift achieve the cup size, shape and volume you desire.  

I hope that is some help - all the best

Jeremy Hunt


Jeremy Hunt, MBBS, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 120 reviews

Tubular Breast Treatment

I'm sorry to hear that you are confused by the myriad of treatments for your breasts - that is not unusual as it is a complex problem with a variety of solutions.

Tuberous breast is characterised by degrees of 4 factors: 1. deficient breast size especially of the lower half, 2. an enlarged areola, 3. a high riding breast fold, and 4. a constricted breast base. As such, treatment is focused at addressing these factors and options such as fat grafting or an implant can both increase volume for example. Hence your conflicting opinions.

Given you are focused on a result - 'soft, tear drop, perky nippled boobs' - provided you convey that to your plastic surgeon, they should be able to aim for that result.

In my hands, provided your photos examine as such, I would use a combination of implant and breast lifting techniques with fat grafting as an adjunct to those. Part of the breast lift would include an areola reduction.

I hope your journey goes well.


Dr Kevin Ho


Sydney Plastic Surgeon
5.0 out of 5 stars 83 reviews

Tubular Breasts

Hello there

Your surgeon will select the technique that they feel in their hands is most likely to get you the best result .

Looking at your photo I would expect that a lift is going to be required and then an implant to one or both sides , depending on what size you prefer to be . Fat grafting can help improve the shape but is more often used with an implant than alone . \

The implants don't have to be large or fake-looking and the lift is not planned to be too high . The main aim is to get a nice shape and to get you to match .


Terrence Scamp

Gold Coast

Terrence Scamp, MBBS, FRACS
Gold Coast Plastic Surgeon
4.8 out of 5 stars 7 reviews

Confusing advice regarding from different surgeons.

I am sorry that you are getting confusing advice.  I think that it is good to get different opinions, but you will find that different surgeons will have different views on how to approach things.  I hope that you will start to see some common themes coming through and that you will be able to come to a  balanced and informed decision.  I would say that the shape of your breasts and the volume of your breasts need to be addressed. To improve the shape, you need a mastopexy, which will leave a scar around the nipple and probably one going vertically down (lollipop), with or without a small horizontal portion in the fold of your breast.  As well as improving the shape, this will reduce the size of your areolae.  To address the volume, you need your left breast to be made larger to match the right, and if you are unhappy with the volume of your right breast, then you need both breasts to made larger, the left more than the right.  This can be done with fat grafting or implants.  Fat grafting will only give a modest increase in volume, and so would probably be alright if you were just to have grafting to the left side, but if you wanted a significant increase in volume of both breasts, then implants may be a better option.  You could either have a larger implant in your left breast than the right, or a reduction of your right breast and the same size implants in both sides.  I think that your goals are reasonably - not many people want overly firm, too large breasts and it would be possible to give you soft, tear drop, perky breasts with implants.  Clearly there is a lot to think about, so good luck with everything.

Jonathan J. Staiano, FRCS (Plast)
Birmingham Plastic Surgeon
5.0 out of 5 stars 20 reviews


Every surgeon will have a different approach to reaching your goal.  I suggest you find a plastic surgeon in your area who has excellent results, and whom you trust.  In my practice, I would offer a similar approach to that offered by the other surgeons here - implant based augment +/- peri-areolar lift if needed.  A thorough physical exam and consult with an experienced board certified plastic surgeon is what you need.


Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Best Breast Operation for Me (Tubular Breasts)?

Thank you for the question and pictures.

Some of the characteristics seen with tuberous breasts include a very narrow base, short distance from areola to inframammary fold, tight (constricted) lower pole of the breasts, relatively wide space between the breasts, "puffy" areola and some degree of ptosis (drooping).  

Generally,  correction of tuberous breast anomalies involves breast augmentation with areola reduction / mastopexy procedure. The distance from the inframammary fold is increased (to create a more rounded out appearance). Proper implant positioning improves the distance (cleavage) between the breasts. The areola reduction helps to treat the pointed and "puffy" appearance of the areola.

In my practice, I would offer you breast augmentation surgery with implants ( probably different sizes), along with breasts lifting of the lower breasts;  these maneuvers will help improve the asymmetry present.

 Careful communication of your goals prior to surgery will be critical;  your plastic surgeon will want to know what you mean by “too large breasts" and what type of look you are hoping to achieve. In my practice, I find the use of goal pictures helpful during this communication process.

I hope this, and the attached link, helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 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.