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

Question

I've always had small breasts and a comparatively large areola. It is only recently that I've become aware of tubular breast deformity and I think that I may have it. My breasts aren't very saggy, but they are kind of far apart and the nipple is low. The part that really bothers me about them is the areola size. Do you think that my breasts are tubular? Do you think I would benefit from an areola reduction? What other treatments are available? I'm not interested in getting implants.

Jed H. Horowitz, MD, FACS · Answer

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

Aaron Stone, MD · Answer

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.

Howard Webster, MBBS (Hons), FRACS · Answer

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

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.

	I think your breast photos do demonstrate some of the characteristics seen with tubular (constricted) his breast. For example, the distance from the areola to inframammary folds seems to be tight and relatively short.  Your inframammary folds seem to be widely spaced from the midline of your chest. The areola do demonstrate some features associated with tubular breast such as  an increased width  and “puffiness”.

	 You will benefit from an in-person consultation with well experienced board-certified plastic surgeons. This consultation will allow for accurate advice that is best provided after a thorough history, physical domination, and detailed discussion of your goals. There are a lot of factors to consider when making recommendations; for example your life circumstances ( planned pregnancies, psychosocial situation…) and tolerance for scars  are factors that should be taken into consideration by you and your plastic surgeon.

	I hope this helps.

Jourdan Gottlieb, MD · Answer

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.

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

Answers (8)

Answer: Tubular Breasts?

Answer: Tubular Breasts?

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Answer: Tubular breast

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

Answers (8)

Answer: Tubular Breasts?

Answer: Tubular Breasts?

Answer: Tubular breast

Answer: Tubular breast

Browse related questions

Recommended reading

Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.