07 April 2025 | 5 minute read
Why Patients Seek Tuberous Breast Correction
One of my principal interests is in helping and treating patients who have developed tuberous (or tubular) breasts. Patients come to see me from all over the UK and from abroad. I have had patients coming from the United States, from Canada, from different European countries and elsewhere in the world. I think the (mostly) young women come to see me because, through their internet research, they realise that treatment can be complex with variable outcomes and that this is a particular interest of mine.
Treating the Whole Person — Not Just the Breasts
I take great care in treating my patients with tuberous breasts – I really try and break the problem down and understand it from their perspective (physically but also psychologically and emotionally). I think very laterally when approaching a tuberous breast situation, because I really, truly believe no two patients should be treated in exactly the same way. Treatment really needs to be tailored for them as an individual.
Prioritising Breast Shape Over Size
In my view, the breast shape is crucial and that comes before size every time. Of course, if we can address concerns with the breast size at the same time that is ideal. I also prefer, whenever possible, to discuss options that do not involve a breast implant. This may involve fat grafting or sometimes internal rearrangement and reshaping of the breast tissue (such as unfurling flaps of modifications of Puckett flaps). These can be complex internal breast plastic surgical techniques that are not performed by many surgeons, which is why I think I have a lot of interests from patients from far and wide.
My Principles for Surgical Assessment and Planning
My principle approach is to not only assess the shape of the breast, but also the whole person, their physique, the position of the breasts on the chest wall, the definition and position of their breast crease, as well as, of course, the puffiness of the areolae. Whereas many surgeons focused principally on the puffiness of the areola, I think this tends to be a predictable aspect of tuberous breasts to treat.
Lower Pole Challenges and Preserving the Natural Breast Crease
In many cases the most challenging aspect of correcting a tubers breast is, I think, addressing the lower pole of the breast (between the nipple and breast crease). Sometimes we see sub-optimal results with a very flat lower pole, or in the worst case scenario a so-called “double bubble” is created where there is a take-off from the chest wall from the start of the breast implant and effectively the memory of the old breast crease present, that forms a groove transversely across the breast, which can be very difficult to treat. Treating this may require fat grafting or other procedures, or even taking the implants out and starting again.
Therefore, if someone has a very marked and well defined breast crease, which is often the case with tuberous breasts, if it is possible to keep the breasts crease where it starts, then we can avoid creation of the double bubble. So my first assessment focusses on the breast creases position relative to the chest wall, nipple position and the breast itself, as well as analysing other aspects of the breast and chest. That helps me decide what options I might suggest to the patient.
Addressing Asymmetry with Fat Grafting
Many tuberous breast patients will have a degree of breast asymmetry as well, and this is certainly also factored into decision making. I think the most revolutionary approach to breast plastic surgery in the last 10 or so years has been fat grafting and this has been a real game changer as it not only helps us to refine and improve on subtle nuances and differences between the breasts, but it can be used as a sole procedure to treat breast asymmetry and breast reshaping. Sometimes it might require more than one operation. In fact, it’s not uncommon for three operations to be required that separate intervals. However the final result really can be superb. Interestingly, in fascinatingly, the fat always behaves as it does where it came from. So if the fat used came from your tummy, it’s always tummy fat just now sitting in your breasts. Therefore, any weight fluctuations to this fat will always take place in the manner of its original home.
The Emotional Impact and Reward of Tuberous Breast Correction
I really enjoy undertaking tuberous breast corrective surgery – it is truly life changing for my patients. To see the confidence that radiates from them when they return and tell me what they feel they now finally, for the first time in their lives, have the freedom to do is extraordinarily rewarding. Often these are things that most people take for granted, such as being able to go swimming or go to the beach. But in addition the surgery can have a profound impact positively on their personal and intimate lives. It really is something that unlocks many peoples’ suppressed confidence, self esteem and “joie de vivre”; so I feel incredibly lucky to be able to help treat those with tuberous breasts.
Moving Forward
If you think you may have tuberous breasts and are exploring your options, I’d be very happy to see you in clinic. This isn’t about rushing into anything — it’s about having an open, honest conversation about what might be possible.
Every patient’s journey is different, and the first step is simply understanding your situation fully. When you’re ready, you’re welcome to get in touch by calling the clinic or filling out the contact form. We can then arrange a consultation to discuss things carefully and thoughtfully — with you at the centre of the process.