Tubular Breast, Are my Breasts Tubular?

   Hello, I'm an 18 year old female and ever since I was about 14 I've been concerned that my breasts are tubular. However, when my nipples are erect (as pictured) they look perfectly fine in my opinion. It's almost as if the tissue gets pinched back and creates a rounder shape. But I don't have naturally erect nipples, they're quite puffy. In your professional opinion, are they tuberous? Because I'm young, do I still have a chance of developing more rounded breasts in the future? 


     
Tubular breasts is a descriptive term that indicates certain features that are variably present to variable degrees. Some call it constricted breasts because the base of the breast is tight and as a result the breast tissue tends to herniated into the nipple causing the "puffiness" in the areola . The tuberous breast is small and often asymmetric. The difference between this scenario & small breasts is that small breasts are symmetrically smaller with respect to the circumference & center of the breast..

 You appear to have constricted breasts But you do not fit all of the criteria. Your nipple may have some tendencies of a tuberous breast however your breast is fairly normal on the whole . If you look carefully, the lower slope of the breast is a straight line instead of a gentle convex curve , with the right breast more tuberous than the left. . As in tuberous breasts , which the contraction literally prevents the breast contents from bulging forward and assuming a hemispheric shaper, yours have a bit of that characteristic .Also you do have some herniation of tissue into the areola along with a tight/"constricted" lower pole of your breast. . You have to remember that breasts come in all shapes and sizes. Very few are "perfect." Your breasts are going to develop the way they will and they will continue to change as you grow, age, become pregnant, etc. As you mature there is a chance of some improvement but It is unlikely that the general breast shape will change as much as you get older

 If you decide to correct this, it can be achieved through an augmentation where the inferior pole and the infra-mammary crease is released to prevent double bubble formation.. At the same time, herniated tissue behind the areola can be removed and this is done through the peri-areolar incision , and then doing some scoring on the inside of the lower pole. If only the areolar puffiness bothers you, it would be a relatively straightforward procedure to tighten the areolar area. This could typically be done under local anesthesia


 if you wished. Tuberous breasts are generally defined by the following: 

• short distance from the nipple --> infra-mammary fold 

 • dilated and/or "prominent" areola
           The issue with the tubular or tuberous breasts is that the lower aspect of the breast from nipple to breast crease is short (yours fits) and the nipple and areola are wide and allow the breasts to protrude through this area making them more prominent

 • loss of rounding to the lower pole with obvious constriction 
          In the tuberous breast the skin of the lower half of the breast remains attached to the chest wall &           does not grow with the remainder of the breast during puberty.

Tubular Breasts- Diagnosis and Surgical Treatment

One of the most common abnormalities of breast shape is called a tubular breast. Such breasts, also known as tuberous breasts or constricted breasts, result from congenital variation in the development of the breast tissue that can affect one or both breasts. Although there is considerable variation, tubular breasts all share some common features.


 Tubular breasts are characterized by some or all of the following: 
• Narrow and elongated shape
• Little or no breast tissue in the lower half of the breast 
• An areola (pigmented area around the nipple) that appears disproportionately large
• Protrusion of the breast tissue behind the nipple and areola that makes the nipple and areola look puffy
• A wide space between the breasts 
• Tendency for the location at which the underside of the breast joins the chest (known as the inframammary fold) to be relatively high on the chest, thus causing the breast to droop and look long and constricted.

   Keep in mind, that there is no such thing as a "normal" or "perfect" breast shape. The shape and appearance of women's breasts vary widely; what matters is whether or not you are happy with your breasts, not whether or not they are "tubular"

Surgical Correction 
Surgery to correct tubular breasts is challenging. The most commonly performed procedures almost always augment the breast, either with an implant or using a woman’s own tissue. In addition to adding volume to the breast, the base of the breast must be widened to a normal size, the inframammary fold lowered and the internal constrictions that caused the tubular shape must be released with internal incisions. In addition, the areola is usually reduced in size. 



Breast implants have traditionally been used to provide the volume needed to correct a tuberous breast. Although implants continue to be widely used, both perforator flaps and fat grafting can be used as alternatives to breast implants. By using your own tissue, complications unique to breast implants (implant leakage or rupture, rippling, and capsular contracture) can be avoided. Reconstruction using your own tissue means a having a reconstruction with tissue that is yours for life and without having to worry about needing to replace implants from time to time.. Since there is a great deal variability in the severity of tubular breast deformities, the approach or approaches best suited to you will depend upon the condition of your breasts and your goals for reshaping them.