31 year old woman 5’7” 143lbs 34A/B with moderate-severe tuberous deformity. Procedure performed-Dual plane augment with periareolar mastopexy and small vertical tuck 275cc moderate plus smooth silicone implants

26 year old white female 5’6” 135lbs with constricted small breasts. Procedure performed- dual plane augmentation with 450cc high profile smooth silicone implants

22 year old white female 5’7” 132lbs right tuberous breasts and asymmetry. Procedure performed- bilateral augmentation with vertical mastopexy on the right and a periareolar mastopexy on the left 350cc moderate plus silicone implants

This is a 38 year old white female. She is 5’3” and 129lbs. She has had one child, but did not breastfeed. She had a moderate degree tuberous component with some inferior constriction and some slight asymmetry. Her areola were also larger than her desire. She initially did not want to be much larger than her present size, but after external sizing preoperatively she chose a 350cc moderate plus smooth silicone implant. She underwent the standard tuberous approach with the release of the lower pole, dual-plane augmentation and periareolar mastopexy. Photos obtained at two weeks, upon her return from out of town show that the breasts are healing nicely and her tuberous situation has been well corrected. She does feel that she’s larger than she ultimately wished and secondarily a smaller implant can easily replace her present 350cc’s.

This is a 22 year old healthy young woman, whom I initially spoke to when she was 20 years old. She is 5’3”, 120lbs and a non-smoker. Her bra size was a 32B, but unfortunately she had a severe tuberous breast deformity with large herniated nipple areola. After an extended phone consultation she decided to travel to the United States where examination confirmed the severe deformity. The areola themselves encompassed the majority of her breast as well as having a marked constricted nature. In order to diminish the areola size a vertical component would be necessary as part of the release and augmentation mastopexy. She decided to proceed knowing that she would need to stay in the States for 8 days. She underwent the tuberous correction, release of the lower pole, dual-plane augmentation utilizing a 275cc moderate plus smooth silicone implant combined with a vertical mastopexy. Postoperatively she has done quite well. At one week the interrupted sutures were removed and the steri-strips were changed. At this point in time the breasts are doing quite well. They are symmetric, the superior fullness which is present in the early postoperative phase will resolve over the next one to two months. She has a nice release of the lower pole and a much smaller nipple areola. The bruising from the release will continue to fade over the next week or two. Her results show that even a severe tuberous deformity can be corrected in a single stage. She is quite pleased, has returned to her country and knows that she can resume all normal activity within a month or two.

This is a 26 year old healthy young woman with no previous surgery. She is 5’8” and 124lbs. Who presented with asymmetric tuberous breasts from out of town. The breasts were small with a short nipple to inframammary fold distance and constricted with a prominent nipple areola complex. Her bra size was a 34A and she wished to be in the full C range. After an initial phone consultation she decided to proceed and knew she would need to stay in the area for approximately one week. The following day she underwent a standard approach though a periareolar incision, release of the lower pole, dual-plane augmentation and periareolar mastopexy. I was able to elevate the right nipple areola without resorting to a vertical component. Her postoperative course was uneventful. At one week we changed the steri-strips. Examination showed excellent symmetry. She has achieved her desired size. The tuberous component has been removed and she is quite pleased with her surgical outcome, knowing that over the ensuing months the breasts will get even more nature in appearance and shape. She will be back to all normal activities within a month.

This patient is a 30 year old black female from out of town. She is in very good health. Her only pervious surgery was for an excision of a pilonidal cyst. She is 5’1” and 100lbs. Her bra size was a 34A with a significant tuberous deformity. The chest is narrow with a short nipple to inframammary fold distance and pointiness to the nipple areola complex. Her desire was to be in that full B small C cup range. She had seen several other plastic surgeons concerning her desires. After her initial phone consultation she decided to proceed with the tuberous breast correction. This would require a dual-plane augmentation, release of the lower pole and a bilateral periareolar mastopexy. A 300cc moderate plus smooth silicone implant was chosen on her pre-surgical visit. Her postoperative course was uneventful. She returned at two weeks at which point the postoperative photos were obtained. She is healing nicely and back to all normal activity. She is quite pleased with her surgical outcome.

This is a 22 year old healthy young woman. She is 5’4” and 140lbs who presents with asymmetrical breasts. On the right side she had a bit of tuberosity with a short inframammary fold distance, which would require release with a dual-plane augmentation and periareolar mastopexy. On the left she had some glandular ptosis and would require a vertical component with a small reduction and differential size implants. After discussing all of the risks and benefits and the healing process she decided to proceed. She presented the day before surgery for sizing. A 425cc moderate plus smooth silicone implant was chosen for the right and a 400cc implant for the left with a small reduction and a vertical mastopexy. She underwent an uncomplicated procedure and she returned home the following day. Evaluation at two weeks shows her healing nicely, her symmetry is excellent, nipple areolas are in good position and the breasts themselves are already starting to develop a natural appearance. She will gradually increase activity and understands that over the coming months the breasts will soften and become even more natural.

This is a 22 year old healthy young female. She is 5’3” and 126lbs. She’s had no previous surgery and is a non-smoker. Her bra size was a 36A and she presented with a true tuberous deformity. The breasts are narrow with a tight inframammary fold and large herniated areola. I initially saw her when she was 21, but advised waiting until the age of 22 so that she would be eligible for silicone implants. In order to correct her deformity she required a traditional periareolar approach, release of the lower pole, dual-plane augmentation and periareolar mastopexy. We did external sizing and she chose a 350cc moderate plus smooth silicone implant to give her a nice C cup bra size. Her surgical procedure was unremarkable. She returned home after two days and early follow up photos at two weeks shows that we have obtained the desired result. The breasts are now round and natural appearing with a much smaller areola with the removal of the herniation. She is delighted with her surgical outcome and knows that the breasts will continue to soften over the upcoming months.

This is a 27 year old healthy white female from out of town. She is 5’7” and 150lbs. She has had no previous surgery and has three children whom she was able to breast feed to a mild degree. Her bra size was a 36AB. Her desire was to be in the full C cup range. Examination showed a mild tuberous shape to the breast. There was a short nipple to inframammary fold distance with a tight lower pole and enlarged areola, but no significant herniation. After external sizing she wished to go with a larger prosthesis in the 500cc range. She underwent my standard approach for a tuberous breast case with an initial periareolar incision, aggressive release of the lower pole, dual plane augmentation and periareolar mastopexy. Postoperatively she has done beautifully. I saw her back at two weeks and as demonstrated by the photos the breasts are healing nicely. She now has a distinct lower pole, smaller and more natural appearing nipple areola and she is achieved her desired increase in bra size. The breasts will continue to soften and become even more natural in appearance over the upcoming months and all the appearances of the mild tuberous nature have been removed. She is quite happy.

This is a 25 year old healthy white female with no previous surgery. She is a non-smoker. She is 5’3” and 120lbs. Her bra size was a 34A with a tuberous component, more so on the left than the right. She had herniation of the nipple areola, but not an overly constricted lower pole. Since she lacked much in the way of breast tissue to correct her abnormality and asymmetry she would be approached as a full tuberous case with a release and creation of the lower pole, dual-plane augmentation and periareolar mastopexy. Her desire was not to be much larger in size but to have a more natural appearing breast shape. That being the case, having done external sizing she chose implants in the low to mid 200cc range and underwent the tuberous correction utilizing a 250cc moderate plus smooth silicone implant on the right and a 225cc implant on the left with standard release and periareolar mastopexy. Her postoperative course was completely unremarkable and two months after surgery she is healing beautifully. The breasts are round, symmetric, she no longer has the small nubbin tuberous areola and the scars are settling in quite nicely. She is ecstatic with her surgical outcome with improved self-confidence and self-esteem.

This is a healthy 22 year old white female. She is 5’7” and 137lbs. She has not had any previous surgery. Her bra size was a 32A with asymmetry. Examination showed a mild tuberous deformity. She did not wish to be excessively large just in the full B cup range. Examination confirmed the mild tubular deformity and the left breast was slightly larger by approximately 25cc. Her base width was 11.5cm. In order to correct her asymmetry she required a dual-plane augmentation with a periareolar mastopexy. Due to the mild asymmetry a 300cc moderate plus smooth silicone implant was placed on the right and a 275cc implant was placed on the left. The lower pole was released on both sides. A more aggressive periareolar mastopexy was performed on the left side to being the nipple areola to a higher, more even position with the right side. Her postoperative course was uneventful except for a minor suture infection on the left superior mastopexy incision. Photos obtained at six months demonstrate the marked improvement in her asymmetry and tuberous nature of her breasts. They are fuller and round with good lower pole projection and the nipple areola are at a nice even height. The scars have settled in nicely and she is quite pleased with her surgical outcome.

This is a 35 year old white female. She is 5’7” and 135lbs. She has had one child and is a competitive body builder. She presented with moderate tuberous breasts with a poorly defined inferior pole and a large nipple areola complex. Her bra size is a 34A and her desire was to be in the small to mid C range, giving her a natural appearance while wearing a bikini during her competitions. In order to correct her deformity she underwent a dual plane augmentation mammoplasty releasing the entire lower pole and lowering the crease. This allowed placement of a 350cc Mentor moderate plus smooth silicone prosthesis with the upper half beneath the pectoralis muscle and the lower filling out what should have been the lower pole of the breast. At the same time she underwent a periareolar mastopexy to diminish the large diameter of her nipple areola complex. Her photos were obtained the following day since she lived at a considerable distance. They show that the essential goals have been nicely achieved. The breasts are symmetric and round with a nice enhancement of the lower pole, the nipple areola complex is smaller and at the same height. Over the next several months the breasts will soften and take on a less tight and round appearance.

This set of before and after photos features "tuberous breast deformity" correction of a 28 year old female (height: 5'3"; weight: 123lbs) from Sydney, Australia who contacted me via email after I answered question she asked about her tuberous breasts on RealSelf.com. After several discussions through email, she decided that I was the plastic surgeon she was looking for and made plans to fly to Albany and have her surgery. Her bra size was a 34A/B with asymmetry. On the right side she had a classic tuberous breast with a large and herniated nipple-areola-complex (NAC). Her right breast also had a narrow base width with a short nipple to infra-mammary fold distance. The left breast was less so with just a tight, constricted base. The left breast was slightly smaller than the right. She had consulted with numerous plastic surgeons throughout the world and ultimately contacted me through the Real Self website, where I was able to answer her questions about tuberous breasts deformities. To correct the issues detailed above, I performed a differential augmentation, utilizing a 375cc moderate plus, smooth silicone implant on the left and a 350cc implant on the right. The inferior pole was released through a dual plane augmentation. I also debulked the right nipple/areola and performed a bilateral, peri-areola mastopexy. Photos taken during her initial post operative photos show symmetric, excellently positioned breasts that are no longer tuberous. The peri-areola mastopexy succeeded in minimizing all puffiness in the nipple areolas (by flattening them out) while the dual plane augmentation enabled generous release of the constricted inferior pole. After 2 weeks of rest, relaxation, a visit to NYC patient flew home to Australia. We kept in close contact throughout the recovery period via email and were able to track her progress using the photos she included with her updates. Her latest email - which included photos taken 11 months after surgery - showed well healing and beautiful looking breasts that fit her frame perfectly. Her happiness with the result and new found confidence it has provided her is the greatest gift a patient can give their their surgeon.

If you'd like to read more about this case, click here to read her tuberous breast surgery diary on RealSelf.com

This is a healthy 19 year old young woman who had no previous surgery. She is 5’3” and 120lbs. Her bra size was a 34A with asymmetry. The breasts themselves were also tuberous in nature. The right had a tight inferior pole with a protuberant nipple areola complex. The left was markedly deficient in tissue with no lower pole at all. She had traveled to see me from another state and we discussed at length the techniques needed to correct her tuberous condition. On both sides a dual plane augmentation was necessary with release of the lower pole and a right periareolar mastopexy to diminish the herniation in the nipple areola complex. She also would require differential augmentation because of the significant asymmetry. Due to her age she was required to use saline implants. She decided to proceed and underwent bilateral dual plane augmentation with a right periareolar mastopexy. On the right side we used a 250cc moderate smooth saline prosthesis that was filled to 310cc. On the left we used a 300cc moderate plus smooth saline prosthesis that was filled to 350cc. Her postoperative course was unremarkable. Two months later she is completely healed. The breasts are symmetric, natural in appearance and no longer have any signs of a tuberous deformity. Her personal self-esteem has been greatly enhanced. She is wearing normal clothing for the first time.

This is 23 year old healthy white female with no history of previous surgery. She is 5’5” and 140lbs. Her bra size was a 34A with a tuberous component and deficient lower pole. The nipple areolas are also situated in a slightly lateral position. She had mild asymmetry. Her desire was to be as full as reasonably possible in the C cup range. She was from out of town and knew that she would need to stay in the area for two days. She came in the day before surgery and underwent external sizing and a 400 and 425cc moderate plus implants were chosen. In order to correct her tuberous deformity she underwent bilateral dual plane augmentation though a periareolar approach with significant release of the very tight lower pole. Utilizing a Keller Funnel a 400cc moderate plus smooth saline implant was placed on the right and a 425cc was placed on the left. She then underwent a bilateral periareolar mastopexy to elevate the nipple slightly and diminish the puffy appearance. She returned home the day following surgery and photos obtained at two weeks, when she returned for suture trimming shows the early appearance of a tuberous breast reconstruction. She now has fullness and the lower pole has been markedly improved without any risk of a double bubble. The nipple areolas are properly situated on the breast mound. She has no pain, she is back at work and quite pleased with her result knowing that this will continue to improve and settle over the coming months.

This is a healthy 22 year old white female. She is 5’7” and 137lbs. She is a nurse. She had not had any previous surgeries. Her bra size was a 32A with asymmetry. She has had no children and only wished to increase her cup size to the B range. Examination showed mild to moderate tubular breast deformity with the left breast being a bit larger than the right by approximately 25cc. Her base width was only 11.5cm. In order to correct her deformity she underwent a bilateral differential dual plane augmentation with 300cc Mentor moderate plus smooth silicone implant on the right and a 275cc implant on the left and a periareolar mastopexy to raise the left side a bit more. Her postoperative course was uneventful. Photos obtained at four months show that she has achieved her desired results. The breasts are fuller without being overly large. She’s had excellent correction of the tuberous deformity with a normal inferior pole. She is back to all normal activity and now can wear any type of clothing she desires.

This is a 28 year old white female. She is 5’4” and 145lbs. She has not had any children. Her bra size is a 34A with mild tuberous breast deformity, more so on the left side. She has a short nipple to inframammory fold distance and a tight lower pole. We discussed the fact that she would need a classic tuberous breast reconstruction through a periareolar approach, lowering of the crease with a release of the lower pole and a dual plan augmentation with the periareolar mastopexy. External sizing was performed and she decided on a 375cc moderate plus silicone prosthesis. Her surgical procedure and recovery was unremarkable. Photos obtained at two months show that she has had a nice reconstruction. The breasts are full and natural in appearance with a nicely delineated lower pole. The nipple/ areola are in proper position and she has nice cleavage in her clothing which she never had before. She is quite pleased.

This is a 22 year old white female. She is 5’4”, 120lbs and has long been concerned about her breasts. She demonstrated a tubular deformity with slight asymmetry. The right breast was slightly larger than the left with some mild herniation and a tight poorly defined lower pole. She had seen several other physicians for correction, but was not completely happy with their recommendations. Having discussed all of the risks and benefits she decided to proceed and underwent a bilateral dual plane differential augmentation with a 325cc moderate plus smooth silicone implant on the left and a 300cc implant on the right along with a periareolar mastopexy. Her postoperative course was uneventful. Three months later things have settled in nicely. She now has normal appearing breasts with good lower pole fullness. She is back to all normal activity and is quite pleased that she can wear any type of clothing that she desires.

This is a 34 year old white female who is a nonsmoker. She is 5’ 6”, 165 lbs. Her bra size si a 36A with mild asymmetry (re: left breast = slightly smaller than right), mild tuberous deformity and mild ptosis (droop). She did not want to be significantly larger after surgery, but rather more natural and perky in both shape and size. In order to achieve her desired outcome and correct the tuberous deformity, she underwent a biplanar augmentation utilizing 300cc moderate plus profile smooth silicone implant and a periareolar mastopexy (breast lift). Her postoperative course was unremarkable (re: complication free) and photos taken 4 months after surgery show beautiful, tear-drop shaped breasts. She has a clearly defined lower pole and the nipple areolas now point straight ahead instead of down as they did before surgery. And while the final breast shape is close to being realized and the patient is back to all normal activities, the incision scars will continue to fade over the next 6 to 8 months. The patient is delighted with her result and the increase in confidence achieved.

This is a 19 year old young black woman. She is 5’4” and 142lbs. She was able to lose 65lbs on her own. Her bra size is a 34A but she had a tubular component with a narrow base width and a poorly defined inferior pole. She also had first to second degree ptosis. In order to correct this she needed to be treated as a tubular breast situation through a periareolar approach; release and lowering of the crease with a biplanar augmentation and periareolar mastopexy. She was required to utilize saline implants because of her age. She underwent the above procedure utilizing 325cc moderate plus smooth saline prosthesis that were filled to 360cc bilaterally. Her postoperative course was uneventful. Photos obtained at two months show that she has had a nice improvement in the appearance of her breasts. She has more lower pole fullness with a resolution of the tuberous component. The areolas have been elevated to appropriate height while maintaining their normal diameter. Over the ensuing months the breasts will continue to soften and drop. She is quite pleased with her early postoperative results and is back to normal activities.

This set of breast augmentation before and after photos features a 36 year old woman (5'2", 130 lbs) who had ptotic (droopy) tubular breasts with larger nipple areola and herniation of the breast tissue into the areola (aka puffy nipples). Her bra size was roughly a 34B (though achieving proper support or fit proved difficult due to the tubular nature of her breasts). She expressed a desire to have round, perky breasts after surgery that fit her frame - not too large, but not too small either. To achieve her desired results and correct her tubular breast deformity, I performed a dual plane augmentation through a periareolar incision using 375cc silicone implants and a periareolar mastopexy with debaulking of the areola. Photos taken 3 months after surgery show round, perky and naturally shaped breasts (particularly medially) with smaller areola. The incisions are healing nicely and will continue to fade and blend with time. The patient has no trouble filling out a 34C cup bra, feels significantly more comfortable and confident and is overjoyed with the result of her tubular breast correction surgery.

This set of breast augmentation before and after photos features a 26 year old woman (5'7", 140 lbs) from Albany NY. She presented with a very narrow breast mound that also was mildly tubular with moderately ptotic (droopy). Her bra cup size was a 34 A/B. We corrected this with a biplanar breast augmentation through a periareolar approach using silicone prothesis and a peri-areolar mastopexy. Photos taken 3 months later show that her breasts are now round, perky and naturally full. Her nipple areola are nicely positioned are more clearly defined due to the periareolar approach. She has a normal/ideal amount of cleavage and her base width has been extended so that she no longer appears tubular. Lastly, her bra cup size is now a 34 C.

This set of breast augmentation before and after photos features a 30 year old woman (5'7", 122lbs) who displayed the characteristics of tubular breasts. Her breast had a very narrow base width, a short nipple to IMF (inframammary-fold) distance and large nipple-areolar complexes. This was corrected by releasing the lower breast tissue through an inframammary incision with a biplanar augmentation utilizing 325cc moderate profile saline prosthesis. She also had a periareolar mastopexy to diminish the size of her areola and raise their position. Three month later, the patient is well healed and her breasts have a very natural, normal and pleasing appearance. Of particular import, the skin below the lower border of her areola is finally visible and of ideal proportion.