While breast implants will certainly enhance a woman’s figure, breast augmentation is not necessarily a solution that can correct the overall shape of your natural breast. There are a few concerns that can lead women to consider breast enhancement, and shape may be just as important as size to many. This is especially true if you are a woman who experiences significant sagging (ptosis) or tubular (“tuberous” or constricted) breasts.
Implants in Ptotic (Droopy/Saggy) Breasts
Before your breast augmentation, it’s important to think about how you want your results to look. If you suffer from more than modest ptosis, either due to genetics, dramatic weight loss or breast size fluctuation from pregnancy/breastfeeding, you will likely need to combine a breast lift with implants to achieve a higher, fuller breast shape. See a diagram of the different grades of breast sagging (“ptosis”).
Implants alone cannot create sufficient fullness and cleavage if the sagging skin is not corrected as well. A breast lift can also resolve concerns over too-large areola or downward-pointing nipples. See a diagram of the different surgical approaches and incisions.
Implants in Tubular (Tuberous/Constricted) Breasts
A woman who has tuberous breasts may look to breast augmentation as an option for creating a rounder breast shape as well as a larger cup size. Breast augmentation in tubular breasts requires a few extra surgical steps to correct the elongated appearance and release constricted tissue. In many patients, this is best treated with the dual plane approach where rearrangement of the breast tissue is performed in the plane above the muscle but the implant is placed under the muscle.
Adding an anatomical teardrop-shaped breast implant can also help to give you a flattering, fully tapered upper breast profile. By using a firmer implant (like gummy bear implants) to help maintain shapelier breast contours in combination with a lift and tissue constriction release, women with tuberous breasts can enjoy a naturally enhanced appearance.
Fat Transfer in Ptotic or Tuberous Breasts
For those women wishing to avoid implants natural selective breast augmentation of either the upper or lower portions of the breast can be achieved with fat transfer. The lack of upper breast fullness that is commonly reported by women with mammary ptosis (sagging) can be achieved via fat injection acquired from the hips to create a more perky profile than a breast lift (mastopexy) alone. Similarly, the soft tissue deficiency in the lower half of the breast that is observed in tubular (tuberous/constricted) breast deformity can be corrected with lipoinjection. The advantage of fat transfer in both of these scenarios is that just the upper or lower half of the breast can be selectively enlarged without making the entire breast larger (which occurs with breast implants).
Otto J. Placik, M.D. received his medical degree from Northwestern University where he also completed residencies in general and plastic and reconstructive surgery. He completed a fellowship in the aesthetic reconstruction of complex nasal and facial deformities at St. Joseph Hospital in Chicago and an additional fellowship in microvascular and hand surgery at Davies Medical Center, an affiliate of the University of California, San Francisco.
Dr. Placik is certified as a diplomate by the American Board of Plastic Surgery and is an active member of The American Society of Plastic Surgeons. He is an active member of several local and national professional organizations. Dr. Placik is a member of the Northwestern University Division of Plastic Surgery Teaching Staff. He holds an academic appointment as a Clinical Assistant Professor of Surgery (Plastic) at Northwestern University Medical School.
