Tuberous Breast Correction in Beverly Hills

What are tuberous breasts (tubular breasts)?

Tuberous breasts, also called tubular breasts, constricted breasts or tuberous breast deformity (tubular breast syndrome and tuberous breast disorder in some sources), are a developmental condition that affects the size and shape of the breasts. During puberty, tight fibers inside the breast tissue hold the base of the breast in and stop it from spreading across the chest, so the breast grows forward into a narrow cone. The same fibers explain the rest: a wide chest with a large gap between the breasts, a short lower pole with the fold sitting high, droopiness, a difference from side to side, and a large, puffy areola. The two sides are often different grades, so Dr. Cat starts with a detailed analysis of each breast.

A tuberous breast correction is a breast augmentation with extra steps: the constricting fibers are released and the tissue reshaped first, then the implant is placed, then the areola is reduced and lifted. An implant alone leaves the cone on top of the implant or a double bubble, and a tuberous breast operated on elsewhere without the fibers released is corrected as a breast revision.

Types of tuberous breasts

Surgeons grade tuberous breasts by how much of the breast base is constricted, and the grades are numbered, type 1 being the mildest. In the mildest form the constriction sits at the lower inner part of the breast: the lower pole is short and the fold high, the upper breast and areola close to normal, and the breast is often mistaken for one that is simply small. In the middle grades the whole lower half is constricted, so the breast points outward and downward. In the most constricted form the base is narrow all around, the breast is small, and the areola is enlarged and herniated. Dr. Cat grades the two sides separately, because they are rarely the same.

The puffy areola and the periareolar lift

A puffy areola, wide and domed, is the most recognizable sign of a tuberous breast: the areola is the weakest part of the breast envelope, so when the fibers stop the breast from spreading, the tissue herniates forward through it. An implant makes a puffy areola more prominent. Dr. Cat corrects it with a periareolar lift (periareolar mastopexy), the form of breast lift whose only incision runs around the edge of the areola: the excess areola and breast skin is removed, the areola resized and reshaped, and the breast lifted into a rounder, perkier shape, with the scar hidden in the change of skin color at the areola's edge.

Who is a good candidate for tuberous breast correction?

Most of Dr. Cat's tuberous breast correction patients noticed at puberty that their breasts grew differently, were told elsewhere that a standard augmentation would fix it, or had that augmentation and were left with a double bubble. The examination decides the plan.

Tuberous breast augmentation: why an implant alone is not enough

Tuberous breast augmentation done the standard way fails: the implant pushes forward against a base that cannot spread, and the result is a double bubble, the old high fold showing as a crease over the implant, or the cone on top of a round implant with the puffy areola pushed further out. Dr. Cat's correction adds three steps: the constricting fibers are cut and released from the inside, the tissue is spread and reshaped over the implant so the lower pole rounds out and the fold sits lower, and the areola is reduced and lifted, in one surgery for most patients, which is why she calls it one of the most dramatic breast surgeries she performs.

Can tuberous breasts be fixed without implants?

Generally, no. Breast augmentation with fat transfer adds about one cup size and keeps the breast's own shape, only fuller, but it cannot release the constricting fibers, lower the fold or create the round, full lower pole a tuberous breast lacks, so fat transfer generally cannot fix a tuberous breast, and Dr. Cat does not combine fat transfer with an implant. In a rare mild case with enough tissue of its own, releasing the fibers and rearranging the tissue can be enough; that is decided at the consultation. Our comparison of implants vs fat transfer sets out what each can do.

How Dr. Cat does it

Dr. Cat is a board-certified plastic surgeon who completed two surgical residencies, one in head and neck surgery, microvascular and facial reconstructive surgery, and advanced training in general plastic and reconstructive surgery, Harvard-educated and UCLA trained. She considers tuberous breast correction one of the most challenging breast surgeries she performs, has had breast implant surgery herself, and takes extreme pride in her attention to detail with every single step.

Releasing the constricting fibers and reshaping the breast

Through an incision around the areola, Dr. Cat creates a precise pocket for the implant, working gently so the pocket stays clean with little to no bleeding. The internal fibers that constrict the breast are carefully cut, and the tissue is spread and shaped so the lower pole rounds out over the implant and the fold sits lower: the step a standard augmentation skips.

The implant: Mentor, her sizing formula, and sizers before the final placement

Dr. Cat uses Mentor implants and recommends silicone for most patients; they range from small 175 cc "ballet breasts" to as full as 700 cc. She reviews sizing with you in detail before surgery and has developed a special formula for implant selection in tuberous breast correction: the base width of each breast and the tissue over it set the safe range, and the two sides often take different sizes. In the operating room she creates and tests each pocket with a temporary sizer, adjusts until both pockets are symmetric, then re-preps the entire field and places the final implants with a no-touch technique. See our guide to breast implant sizes and our comparison of saline vs silicone implants.

The periareolar lift and the closure

After the implants are placed, the periareolar lift removes the excess areola and breast skin, lifts, reshapes and resizes the areola, and contours the breast into a rounder, perkier shape. The closure around the areola is precise and meticulous, in layers, for the best possible scar, with silicone scar care from two weeks; an incision around the areola carries a small risk to nipple sensation, which Dr. Cat discusses with you before surgery.

Asymmetry: the two sides planned side by side

Tuberous breasts are rarely the same on both sides: one may be a mild grade and the other severe, one areola much larger, one nipple lower. Dr. Cat plans each side separately, with a different implant size where the volumes differ, the fibers released as far as each side needs, and the areola reduced by a different amount on each side. For the majority of patients the correction is a single surgery; when the asymmetry is large she performs it in two stages. Our page on uneven breasts covers breast asymmetry on its own.

Anesthesia, surgery day and one surgery per day

Tuberous breast correction is performed under general anesthesia with a board-certified physician anesthesiologist in Dr. Cat's QUAD A accredited surgery center on Rodeo Drive, with a numbing solution in the breasts so you wake numb rather than sore. The surgery takes about five to six hours depending on complexity, anatomy and incision; Dr. Cat schedules one major surgery per surgical day and performs every step herself. You go home the same day with the person driving you, and someone stays the first night. A labiaplasty can be combined with the breast surgery; a tummy tuck or a Brazilian butt lift is never on the same day.

Tuberous breast correction recovery timeline

Dr. Cat's gentle technique means little to no pain and a quick recovery for most of her patients; for the long version, read our breast augmentation recovery guide, week by week.

• Consultation and sizingEach breast examined and graded, the base width measured, implant sizing reviewed with her formula and sizers in a bra, and the plan set: one surgery or two stages, and the implant for each side.
• Surgery dayAbout five to six hours under general anesthesia with a numbing solution in the breasts. You wake numb rather than sore, in the supportive bra the office measures and provides, and go home with the person driving you.
• The first night at homeSomeone stays with you. Tightness rather than pain; Tylenol is typically all that is needed. Sleep on your back propped up and walk that evening.
• Week oneDr. Cat checks the incisions the day after surgery. Most patients feel almost back to normal around one week and are back at desk work; arm movement stays minimal for two weeks, no lifting, no underwire.
• Two weeksSilicone scar care starts. Walking and a stationary bike resume. Swelling subsides over about a month, a little longer for larger implants.
• Four to six weeksJogging resumes at four weeks; at six weeks the restrictions end, all exercise included. The supportive bra continues to two months.
• Three to six monthsThe tissues stretch and the implants drop into their final position, for most patients by four to six months. The areola scar fades over the first year; then yearly check-ups, the FDA screening scans for silicone implants, and an exchange about every 8 to 10 years.

Risks and safety

A tuberous breast correction carries the risks of a breast augmentation and a periareolar lift, plus one of its own: an incomplete release. What can happen and what Dr. Cat does to prevent it:

Tuberous breast correction before and after: what to look for

In tuberous breast correction before and after photos, look at four things: the lower pole, which before hangs in a cone under a high fold and after is a round curve down to a lower fold; the gap between the breasts, which narrows as the base is released; the areola, smaller, flatter and level with the other side; and the two sides against each other. The four cases below are Dr. Cat's, each a tuberous breast repair with breast augmentation and a periareolar lift: TBC-0595 with 350 cc high-profile silicone implants, TBC-0569 and TBC-0539 with 535 cc ultra-high-profile implants, and TBC-0471 with 450 cc high-profile implants. Her tuberous breast correction before and after photos show every angle of each case.

How much does tuberous breast correction cost in Beverly Hills?

Dr. Cat's surgeon's fee for tuberous breast correction with implants is $19,500 to $24,500; the operating room and anesthesia are quoted at your consultation, because the operating time depends on your anatomy and on what is treated together. Surgeon's fees are typical ranges: a more complex case can cost more, and your fee is set at your consultation and is final only in your written quote. The fee runs a little above a standard breast augmentation with implants, $17,500 to $22,500 in surgeon's fees, because the constricting bands are released and the tissue reshaped before the implant is placed. The implants (Mentor) are quoted at your consultation, and the written quote itemizes every line.

The price reflects one surgeon who performs every step herself, one major surgery per surgical day, a physician anesthesiologist and an accredited facility. Please do not shop a tuberous breast on the price of a standard augmentation: an implant placed without the release becomes a revision that costs more than the correction done well. Our breast augmentation cost guide explains what a quote is made of.

Consultation fee, deposit and financing

A consultation with Dr. Cat is $500, credited toward your surgery, or $1,500 for a revision consultation when a previous surgeon has operated on your breasts, also credited in full. The practice partners with Cherry, its primary financing partner, and also accepts CareCredit and Alphaeon Credit; see financing and payment plans. Surgery dates are booked once the quote and pre-op paperwork are signed and the $2,500 deposit is paid; quotes are valid six months.

Your consultation with Dr. Cat

It starts with a free 15-minute discovery call with our Patient Concierge, who books your consultation. Patients come to Dr. Cat for tuberous breast correction from across Los Angeles and from out of town: in person on Rodeo Drive or, for out-of-town patients, by private video consultation through OnPatient, the HIPAA-secure patient portal, with the sizers tried in person before surgery. Dr. Cat examines and grades each breast, measures the base width, checks the nipples, folds and areolas, asks about pregnancy plans and any previous breast surgery, and tells you plainly whether your correction is one surgery or two stages. You leave with a size for each side, an incision plan and an itemized written quote.