Small, tubular, breasts, large areolas, far apart with low nipples. What treatments will not include an implant? (photo)

Treatment

Because there is a wide range of appearances, from mild to severe, the surgical treatment for Tuberous Breast Deformity or TBD must address the following elements for a successful result :

Breast Base Grade: l,ll, or lllAsymmetry left and rightSkin envelopeAreola size, shape, herniation, and positionBreast volumePtosis (drooping)Breast fold position and size.Mild forms of TBD can be undiagnosed often leading to incorrect or incomplete surgery. The surgery must address all of the anatomical problems including: breast fold malposition, constricted or narrow breast base. Surgical procedures may include the following:

Implant aloneType and shape of implantOne or more stagesThe use of tissue expansion and implantsPocket placementPlacement of incisionsBreast lift and typeCorrection of the breast base and breast fold,Correction of the areola.The use of fat grafting or natural breast enhancement to help shape the breast with or without implants

Your posted photos show significant asymmetry with the breast tissue on the right at and below nipple level while that on the left is at and above nipple level. On front view the breast mounds seem widely separated but on oblique view you can see the bases of the breasts are closer together and it is the shape of the breasts outside the bases that makes them seem widely separated. I suspect the left breast crease is higher than the right one. With or without implants surgery will not be easy and it is clear that implants alone will be insufficient.

At a minimum some cuts will need to be made in the breast tissue below the level of the skin to reshape them.

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.

Hi there

You definitely have tubular breast deformity.  As you have good volume it can be well corrected through a periareolar incision, which can also correct the areolar size and breast asymmetry. If you have health insurance there is an item number which means that insurance coverage applies to the hospital costs of treatment.  Best thing to do is, when you're ready, is have a consultation and find out more about correction in specific detail.

good luck

There are a number of features that define a tubular breast:
•Wide and puffy areolae
•widely spaced breasts
•high breast fold
•constricted lower pole (deficient tissue in lower half of the breast
•minimal breast tissue
•high breast fold
•narrow base of the breast

From the photos, you seem to have most of these features. 

 

The surgical options are numerous and may be complex, and as always would depend upon the patient's goals. A breast lift could reduce areolar size and improve the position. Breast implants could provide added volume as well as improve the shape and to a small extent the position of the breasts, but are of course not necessary. Fat injections can also be used to increase volume.

When you ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S.
Thank your for your question, best wishes.

 

Hello,

Thank you for your photos.  Tubular breast deformity is much more common than people suspect and can be found in all varieties of severity.  What you exhibit is a mild form or tubular breast deformity.  It can be corrected well by expert hands using either an implant and breast tissue modification (scoring) as well as an areolaplasty or it can be corrected by several sessions of fat grafting.  Whatever you decide I would encourage you to educate yourself about your options and seek several consultation with board certified plastic surgeons that have good experience and results with these procedures.

All the best,

Dr Remus Repta