Breast Implants & Fat Grafting - Tuberous Breasts
Thank you for your question. That's a newer modality to treat this condition, I agree with fat grafting and releasing the constricted pole. Using a shaped implant would be beneficial, but may be difficult to do all at the same time. The shaped implant will help expand the lower pole.
Sientra form-stable implants for tubular breasts
Your pictures do show tubular breasts and very little breast tissue or subcutaneous fat layer for "padding." Sientra's form-stable ("gummy bear") implants can be very helpful in these cases, along with a mini Benelli to reshape the nipple-areola. Fat grafting could be done later to refine the contour, but some recommend doing it ahead of time to help expand the skin envelope.
Tuberous Breast and Sientra Implants with Fat Grafting
Great question. You have a pretty classic tuberous, constricted breast. The Sientra, textured and shaped inplants have been an absolutely great addition to the treatment of this condition. It is very possible that you might be able to achieve complete correction with a textured shaped implant alone, without any fat grafting. One of the risks of doing this procedure is that of a "double bubble" in the inferior pole. Again, this impplant significantly reduced that risk, but fat grafting is a great treatment should this condition occur after placment of the implant. I would therefore recommend the Sientra textured, shaped implant alone and reserve the fat grafting should a double bubble occur after you have healed.
Fat Grafting not Necessary in my Opinion
Thank you for the question and good quality pictures.
I think your breasts demonstrate many of the qualities seen with tuberous (constricted) breasts.
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.
Patients 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. Surgery will likely involve breast augmentation and some degree of breast lifting (circumareolar).
When you are ready, please make sure you consult with well experienced board-certified plastic surgeons who have significant demonstrable experience with this type of surgery. Ask to see lots of examples of their work and communicate your goals carefully as well.
I hope this, and the attached link (dedicated to tuberous/constricted breast surgery concerns) helps. Best wishes.
Tuberous breasts and fat transfer
Thank you for question. Yes it is very common and often necessary to use fat grafting along with augment in your situation.
Thanks for the question, sounds like you have a very thoughtful surgeon with a great plan, if you are not comfortable with fat grafting don't do it, you could have a nice result without it!
PAY HEEDS TO ALARMS ABOUT FAT GRAFTING OF BREASTS
You do have tuberous breasts. Breast implants improve but do not overcome limitations posed by tuberous features. Do not discount what you have learned about fat grafting of breasts.