How To Correct A Tuberous Breast

If you’ve ever looked in the mirror and wondered why your breasts look different, you are not alone. One of the lesser-known, but surprisingly common, breast shape variations is called a tuberous breast. It’s not something people hear about often, but as a Plastic Surgeon who specializes in breast and body cosmetic procedures, it is something I encounter regularly. And it can not only affect the physical appearance of the breasts, but a tuberous breast deformity can have a profound affect on a person’s self-esteem.

In this blog post, we’re diving deep into the world of tuberous breasts—what they are, how to identify them, what causes the condition, and what can be done if you want to correct it.

What Is a Tuberous Breast?

Let’s start with the basics. Tuberous breasts (sometimes called tubular breasts) refer to a developmental breast anomaly. There is a wide spectrum of presentation; however, overall you see a constricted breast gland, large and often puffy areola, and tight lower pole of the breast. The result is a breast that appears narrow, disproportionately shaped, and often smaller and asymmetric from the other breast. 

This isn’t just a cosmetic issue (and even if it was, that is perfectly fine!). The unique structure of a tuberous breast can impact self-esteem, clothing choices, and even the ability to breastfeed. In fact, I either see post-pregnancy women who realized their breasts were tuberous when they were unsuccessful breastfeeding or  young patients who are self-conscious that their breasts look different than they should. Fortunately, tuberous breasts can be corrected surgically with a procedure that requires both technical precision and an artistic eye.

Anatomy of a Tuberous Breast

In a typical (non-tuberous) breast, most of the glandular tissue sits beneath the nipple and areola, filling out the lower portion of the breast in a teardrop or round shape. In a tuberous breast, however, the tissue is underdeveloped or constricted. This breast gland sits directly behind the areola, which pushes the gland outward and creates a puffy or domed appearance. As a result, the breast base doesn’t fill out, and the areola often looks enlarged and protuberant.

Common Traits of a Tuberous Breast

• A narrow breast base

• Constricted or tight lower pole

• Enlarged, puffy areolas

• High inframammary fold (the crease beneath the breast)

• Breasts that appear long, tube-like, or droopy despite small volume

• Asymmetry (one breast may be more affected than the other)

• A downward-pointing nipple

The severity of the condition can vary widely. Some people have subtle characteristics, while others experience a more pronounced difference in breast shape.

Are Tuberous Breasts a Health Concern?

Tuberous breasts are not dangerous. They don’t increase your risk of breast cancer or other health conditions. But they can be emotionally and psychologically distressing. In addition to aesthetics, some people with more severe tuberous breast deformity may face challenges with breastfeeding due to the limited development of the glandular tissue.

Can Tuberous Breasts Be Corrected?

The good news is yes, they can.

Tuberous breast correction is a specialized type of breast surgery. It goes beyond traditional breast augmentation because the anatomy needs to be reshaped—not just filled with an implant. The goal is to release the constricted tissue, reshape the breast, reposition the inframammary fold, and create a natural, rounded appearance.

Goals of Tuberous Breast Correction

Successful surgical correction involves several key steps:

1. Releasing the Constricted Gland: This allows the breast tissue to spread out and fill the lower portion of the breast.

2. Lowering the Inframammary Fold: The natural crease under the breast often sits too high in tuberous breasts. Lowering it allows the implant and tissue to sit in a more natural position.

3. Expanding the Lower Pole: This is often the most challenging part, as the skin and tissue in this area have never been stretched before.

4. Reducing the Areola Diameter: If the areola is enlarged or puffy, it can be reshaped during surgery.

5. Adding Volume with or without Implants: Depending on the patient’s goals, implants or fat grafting may be used to create fullness.

   
   

This type of correction is highly customized. No two tuberous breast cases are the same, and a tailored approach is critical.

What Does the Surgery Involve?

Tuberous breast correction is usually performed through a periareolar incision—meaning the cut is made at the edge of the areola. This incision gives access to the constricted breast tissue, which can then be scored (surgically released) to allow expansion.

The Steps of Surgery Typically Include:

• Incision Placement around the areola

• Tissue Scoring to release the tight breast gland

• Dissection of the Lower Pole to create space for the implant

• Implant Insertion to provide volume and shape

• Areola Resizing if necessary to match proportions

• Inframammary Fold Adjustment to position the breast naturally on the chest wall

In more severe cases, a staged approach may be needed. The first stage will be placing the implant, scoring the gland, and repositioning the fold, while any areolar adjustments are done in a second stage when the tissue tension has settled. In severe cases, a tissue expander may be needed for temporary pocket expansion first, followed by implant placement months later.

Why Tuberous Breast Surgery Is Complex

Operating on tuberous breasts is not the same as a routine breast augmentation. It’s more like a breast reconstruction. The challenge lies in the skin and tissue that have never stretched or filled out normally. This tightness means the implant may sit high at first, and it can take months for the breast to "settle" into its final shape.

Common Postoperative Challenges:

• Bottoming Out: When the implant drops too low due to an unstable fold.

• Double Bubble: When the native high fold creates a visible crease despite implant placement.

• Areola Widening: Even after resizing, the areola can stretch again due to pressure.

Despite these challenges, excellent results are absolutely possible in experienced hands. Surgeons who specialize in this type of correction know how to minimize risks and achieve natural, symmetrical outcomes.

Recovery and Results

Recovery from tuberous breast correction is similar to other breast surgeries, though swelling and shape changes may take longer to resolve. Most patients can return to non-physical work in a few days, but should avoid strenuous activity for several weeks.

Patience is key. It can take several months for the implants to settle and the breast tissue to stretch and adapt. Trust the process and stay in close communication with your surgeon.

Final Thoughts: You Are Not Alone

Discovering you have tuberous breasts can feel isolating at first. But the truth is, this condition is more common than most people realize. And more importantly, it can be corrected.

If you’re unhappy with the shape or size of your breasts and suspect you may have tuberous breast deformity, talk to a board-certified plastic surgeon. With the right plan and the right surgeon, beautiful, natural-looking results are within reach.

---

Dr. Megan Dreveskracht is a Seattle-based Female Plastic Surgeon who specializes in Aesthetic Surgeries of the Breast, Body & Face. To schedule your consultation, call 206.860.5582 or fill out a contact form here.