Do I Have Tubular Breasts and Ptosis?

20, no children. might have tubular breasts & ptosis. In my teens I had puffy tubular breasts & never perky. They have sagged and now look more like ptosis, less puffy. They are wide but flat. The areolas need lifting, shrinking, and I'd like a tear shaped implant No plastic surgeon yet & havent been evaluated. My health insurance will pay for the reconstructive surgery if this falls under "Mammoplasty, Reduction". Will this fall under Mammoplasty Reduction?

Doctor Answers 21

Do I have tuberous (tubular) breasts?

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Whatever terminology you choose your breasts are ptotic (droopy), they lack upper pole fullness and the areolas are overly large.

Here in Canada we have fairly unrestricted access to all the silicone gel implants. I prefer to use a tear-drop silicone gel implant (the so-called 'gummy bear' implant) combined with a vertical (or 'lollipop') breast lift. I like to place the implant over the muscle, as over time it stays together with the breast much better than when it is under the muscle.

I would discourage you from the donut mastopexy, where there is only a scar around the areola. This operation can cause a great deal of areolar distortion and has a flattening effect on the breast. I can honestly state that some of the worst results I have seen in breast surgery have come with the donut breast lift.

Whatever you decide on, make sure you see a very experienced plastic surgeon with expertise in aesthetic breast surgery.

Correction of tubular breasts with ptosis

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I believe you do have a tubular breast deformity, best treated with a specialized lift and augmentation if you desire a larger size.

Your surgery is not a breast reduction, so would probably not quality under any insurance guidelines.

This surgery is technically more difficult than straightforward augmentation or lifts, so make sure your prospective surgeon has experience and a good series of photographs to show you.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Tubular Breasts?

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Thank you for the question and good quality pictures.

Yes, I think your breasts do demonstrate some of the qualities seen with mildly tuberous (constricted) breasts. Your  pictures definitely demonstrate breast ptosis.

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" and 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 your case  more complete breast lift will also be necessary.  You should be aware that the final result will take months to see and that they will need to be patient and that revisionary surgery is more likely than in patients who do not present with tuberous (constricted) breasts.

In your case, if the appearance/shape/size of the breasts are a concern,  you may be an excellent candidate for corrective surgery. This would best be done when you are ( and you may already be there)  close to your long-term stable weight.  

When you are ready, please make sure you consult with well experienced board-certified plastic surgeons who have significant experience with this type of surgery.

I hope this helps.

Tubular breasts

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You would not qualify for breast reduction because the breasts are too small to meet insurance criteria. You could consider a mastopexy with regard to the sagging but this would be cosmetic and not covered by insurance.

Breast lifting tuberous breasts

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Dear Angel,

You definitely have breast ptosis and a form of tuberous breast deformity.  Correction would involve a lift operation using a lollipop scar.  It would not qualify as a breast reduction.  Good luck!

Breast contouring, #BreastAugmentation, #Breastlift, #mastopexy

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Dear Angelteddy

If you want a reduction in size, the amount of tissue to be removed will determine the insurance coverage. The shaping of you breasts can be done with several different techniques including, lifting only, lifting with breast implant, and lfting with micro fat grafting.

Considerations include- scarring, change in sensation, breast feeding and changes with pregnancy.

With Warm Regards,

Trevor M Born MD

Tubular Breasts

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It does appear that you have a mild variant of what can be considered a tubular breast deformity with herniated glandular tissue into the nipple areolar complex.  You also demonstrate ptosis(sagging) and an expanded nipple areolar complex.  These problems can be addressed with a vertical augmentation mastopexy (lollipop incision and an implant).  The question of insurance coverage is always a difficult one as insurance companies get to decide which services they cover and which they don't.  If you are so inclined, it is worth seeing a board certified plastic surgeon to at least discuss any possible surgery and pursue any precertification process that your insurance company may offer.  Based on my experience, it is impossible to know ahead of time whether an insurance company will precertify a procedure for your breast deformity, but at least you will be aware of all of your options.

Tubular breasts and ptosis

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Yes, it looks like the base of your breasts are narrow and they are sagging.  They do not need to be reduced but do need to be lifted and this is not covered by insurance.  An implant can help as well.

Do I Have Tubular Breasts and Ptosis?

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You have a variant deformity ,it is the tuberous deformity with the hallmark signs.

In addition you have ptosis of the breasts which goes hand in hand with tuberous breasts

Here you have a high infra mammary anchoring and the rest of the breasts tissue "spills" over withe nipples pointing to the floor

Braest lift may be sufficient but because of your young age   try to avoid the vertical scar and use only the periareolar  incisions  and a true parenchymal lift.

Your correction doesn't fall under breast reuction category since you are also looking foe implant insertion.

Breast lift with Augmentation

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You appear to have nothing but ptosis. You would probably benefit from an augmentation with breast lift from what you said. A preiareolar lift may accomplish your needs (with the augmentation) or you may need a full vertical lift. Unless you find someone on an investigational protocol, the only “tear shaped implants” are saline. These would be OK, though I would prefer silicone implants. I would use textured implants and put them sub glandular because of your ptosis and tendency toward a tuberous breast. The only way to sort this out is with a consultation with a Board Certified Plastic Surgeon.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

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.