Can Tubular Breasts Ever Look Pretty?

I see a lot of room for improvement in treating your tubular breast deformity. I would use a larger base diameter implant to improve your medial cleavage area. In addition, more lifting of your nipple/areola to centralize them and make them more symmetrical would be advised. As far as size, I would need to do an exam to get your dimensions, and assess your tissues and tone. But the answer is Yes, you can definitely end up with attractive breasts after surgery. 

The nipple needs to be in a specific position and then the breast tissue needs to be centered under the nipple & the implant centered under both for the best result. A large number of women do not have breast tissue centered under the nipple even if they have never had breast surgery. In these patients some adjustment of the breast tissue is required prior to placing the implant. There are a variety of procedures that can be used to change nipple/breast tissue position at surgery just before inserting the implant. Another problem is some women have breast tissue that is not centered under the nipple but this does not become apparent until after an implant is placed under the breast.

Looking at your photo the nipples are different distances from the midline and different distances from the notch above the breast bone. That would need to be corrected to some degree before placing breast implants. The photo looks like an incision was made in the lower half of the areola. That type of incision would not be expected to correct the nipple position. Unfortunately you will have to have the implants removed and then a breast skin/tissue procedure before replacing the implants in order to have an optimal result. As for how big an implant to place, that would depend on the size of the current implants and how much breast tissue is present.