Tuberous breast correction with small implant and breast remodelling

Tuberous breasts

Many people I see requesting breast augmentation or correction of a breast asymmetry actually have tuberous breasts and are unaware such a condition exists. The information below is of a very general nature as there is a wide variation of tuberous breast types and consequently a wide variation in the type of surgery that can be used to improve symmetry and shape.

Frequently asked questions

General questions

The natural attachment of the breast gland to the chest wall has a smaller footprint than normal (small breast base). This is a variation of normal development.

As the breast grows, it will lack fullness in some areas and so there may appear to be a large gap between the breasts, or the distance from the nipple to the fold under the breast may be much shorter than usual. This will give the breast a more pointed shape and in extreme cases a tube shape.

The breast skin is stronger than the areola tissue. As the breast grows it will push out (herniate) through the softer areola causing puffy nipples in some cases.

The general appearance of smaller tuberous breasts can often be improved with the careful use of breast implants. Often the fold beneath the breast is too close to the nipple. The fold may need to be lowered which means some of the chest wall skin is turned into breast skin. The breast gland tissue may need to be altered to cover the implant or fat grafting can also be used to give more fullness to the lower part of the breast. Simply placing an implant without other maneuvers will give an inadequate correction.

A careful examination of the tissues is needed to see the most appropriate procedure required. There are many possibilities and the full gamut of breast reconstructive techniques may be used as required and would be explained in detail, along with the rationale of using these.

In some cases I have performed a breast augmentation on one side with fat grafting whilst on the other side a breast reduction and breast lift have been performed in order to achieve the best shape and symmetry.

Surgeons talk about three grades of tuberous breasts. In actuality many of these grades overlap and it is the individual shape that determines the suggested treatment rather than the grade.

It is possible to surgically improve puffy areola but in many cases it is preferable to wait and not operate. As the breast skin envelope becomes more compliant, this reduces the force of internal breast tissue pushing out and the puffiness will improve without surgery.