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Breast Augmentation is Great Option for Tubular Breasts

By James J. Romano, MD

Breast size is important to many women. Some women feel that small or unusually shaped breasts can limit their choice in clothes as well as lead to a less than fulfilling body image. Breast augmentation to increase fullness and projection of the breast can improve the balance in a woman’s figure and greatly enhance her self-image and confidence.

Some women have small and tight breasts with an unusual, tubular shape. Called tuberous or tubular breast, they are characterized by a constriction at the base of the breast, as if someone had pulled a drawstring around the bottom of the breast. It is often associated with large areolae that are puffy and protrude and an oval shape to the breast tissue.

This is a developmental variation of normal. In the most severe cases, the breast tissue is "squeezed" so tightly by the constriction at the base that it "herniates" the breast tissue behind the areolae. Milder cases are characterized by an oval shape to the breast and a tight lower breast fold, often with a downward pointing areolae. Augmentation alone usually will not produce a good looking breast except in mild forms; most of the time internal incisions are used to release the constriction and scar tissue and occasionally some type of breast lift is necessary to reduce the herniation of the tissue behind the areolae and expand and round out the base of the breast in more severe cases.

Breast augmentation can enlarge a woman’s breast through the surgical placement of breast implants. For women with tubular breasts, this correction is a slow development of your eventual round breast look. The lower breast needs time to expand and stretch, both from the internal incisions that relax the breast tissue and the pressure of the implant.

This patient is an example of severe tubular breast anatomy with a small breast, tight skin especially at the bottom of the breast and large puffy areolae. Here shown 9 months later after subpectoral smooth round implants with internal incisions to release the tight breast, areolar reduction, and criss-cross sutures to flatten the nipples.

This patient has a less severe degree of tubular breast that was corrected internal breast tissue relaxing incisions and smooth round 475cc subpectoral implants, shown six months later. Note the natural roundness to the base and bottom of the breast.

This patient is shown with severe tubular breasts. She is 9 months after surgery. Notice how her areolae has flattened and her breasts have a nice natural shape to them.

A Short Procedure

The surgery to correct tubular breasts usually requires a very light general anesthesia and usually takes about two to three hours. The incisions are usually confined around the areolae entirely so it will be very inconspicuous. The procedure involves making internal incisions to release the tight tissues, and making a bigger and rounder space to accept the implant and make the oval shape to the breast now rounded..

Dressing and a light compression garment are used for several days after your surgery and drains are rare. The procedure can also be combined with other plastic surgery procedures if you desire.

Types of Breast Implants

Saline or silicone breast implants can be used to correct tubular breast anatomy. Saline implants are great because they have the "water hammer" effect where the bounciness of the saline, along with the internal incisions, helps to round out the lower part of the breast. However with saline implants you can feel some of the edges of the implants. Since silicone implants come pre-filled, their edges are not felt as much as they are with saline implants. There is no right or wrong answer on which implant to choose. Your anatomy will along with the goals you wish to achieve will make the decision for us.

What to Expect in Recovery

Patients can go home several hours after surgery or you can stay overnight. You can expect to have only minimal pain that is mostly gone by the second or third day and is easily controlled with medication.

Swelling should be mild to moderate, peaking at two to three days and then disappearing over the next several weeks. You will be able to shower on the second day after your surgery.

Patients can experience some grogginess for the first week but you should be able to resume many activities within that first week and most activities by two weeks. You can expect to be off of work for about three to seven days, and your stitches will be removed at seven days.

Long-Lasting Results

With breast augmentation to correct tubular breasts, you can expect to have a natural and presentable appearance in the first several weeks that will improve over the next three to six months. The final result will be a beautiful, balanced and proportioned contour as well as improvement in the size and shape of your areolae.

Fast Fact

Lipikaur Baume

Lipikaur Baume from La Roche-Posay is beneficial to all of our tubular breast correction patients. Shea butter is the key ingredient that helps keep the skin smooth, supple and soft. It is used in our office to help soften the skin around the breast pre operatively so tighter skin can accommodate an implant better.