Tuberous Breasts: What They Are and How They’re Corrected

Many of the women I see with tuberous breasts have never heard the term. They know their breasts look different from other women's, and usually that they always have, but no one ever told them the shape has a name, or that it can be corrected. Some have spent years assuming they were simply small-breasted.

Tuberous breasts, also called tubular or constricted breasts, are a variation in how the breast develops during puberty. They aren't a disease, there is no evidence they raise the risk of breast cancer, and they are nothing you caused. But they are a problem of shape as much as size, and that changes how they have to be treated.

What Are Tuberous Breasts?

A breast grows outward from behind the nipple during puberty. In a tuberous breast, tight tissue at the base of the breast holds that growth back, mostly in the lower half. Breast tissue that can't expand downward and outward pushes forward into the areola instead. The result shows up as some combination of these features:

• A narrow base. The breast is narrow from side to side, and often taller than it is wide.
• A short, tight lower half, with little distance between the nipple and the fold under the breast.
• A high breast fold.
• A wide gap between the breasts.
• Large, puffy areolas, where breast tissue has pushed forward into the areola. Surgeons call this herniation.
• Breasts that point downward or outward.
• Asymmetry. One breast is often more affected than the other, and sometimes only one is.

Not every woman has all of these. Tuberous breasts range from mild, where only the lower inner part of the breast is short, to severe, where the whole base of the breast is constricted. A widely used classification, described by Grolleau and colleagues in 1999, divides them into three types: type I affects the lower inner quarter of the breast, type II the whole lower half, and type III the entire base. The mild forms are the most common, and the ones most easily missed.

Tuberous Breasts or Just Small Breasts?

The difference is shape, not size. A small breast is a normal breast in miniature: the base is a normal width, the fold is where it should be, and the areola is in proportion. A tuberous breast is a breast whose shape was restricted as it grew. It can be small, but it can also be a normal size or even large.

So the question isn't how much breast there is, but how it is distributed: how wide the base is, how far the nipple sits above the fold, and whether the areola looks puffed out. Those are things I measure at every breast consultation, because the two are treated differently, and too often the difference is discovered only after an augmentation that didn't account for it.

What Causes Tuberous Breasts?

No one knows exactly. The shape appears during puberty, as the breasts develop, and the leading explanation is a ring of tight connective tissue around the lower breast and the base of the areola that keeps the breast from expanding normally. It is not caused by anything you did, by your weight or by the bras you wore.

Women sometimes ask about polycystic ovary syndrome (PCOS). A few small studies have reported PCOS more often in women with underdeveloped breasts, but a link to tuberous breasts hasn't been established, and having one doesn't mean you have the other. If you have symptoms of PCOS, that's a question for your gynecologist or endocrinologist.

Can Tuberous Breasts Be Fixed Without Surgery?

No. Exercise, massage, creams, supplements and special bras don't change the shape of the breast. Chest exercises build the muscle under the breast, not the breast itself. A well-chosen bra can disguise the shape under clothes, and for some women that is enough. But the constriction is in the breast tissue, and the only way to release it is surgically.

Why a Breast Augmentation Alone Often Isn’t Enough

In some mild cases, a breast augmentation alone is enough. In most, it isn’t, and this is the most important point in this article. An implant placed under a tuberous breast without correcting the constriction leaves the tight lower breast exactly as it was. The implant fills out below and behind it, and the result can be a double bubble, where the old fold shows as a line across the lower breast, or a "snoopy" shape, where the breast and areola sit on the front of the implant and point downward. A herniated areola can also stretch further under the pressure of the implant.

Many of the revisions I see after augmentation of a tuberous breast come back to this. The shape was there before the first operation, and it either wasn't recognized or wasn't treated. Correcting it the first time is simpler, and gives a better result, than correcting it afterward.

How Tuberous Breasts Are Corrected

Correction is planned around what each breast actually needs, so it is rarely identical on the two sides. Most plans address some or all of the following:

• Releasing the constriction, so the lower breast can expand and take a rounder shape.
• Lowering the breast fold when it sits too high. This has to be done judiciously: moving the fold too far down can create a different kind of double bubble, where the implant drops below the breast and the old fold shows across it.
• Reducing the areola and correcting the herniation with a mini lift, through an incision around the edge of the areola. The scar tends to blend into the areola's border.
• Adding volume with an implant, which also fills and stretches the newly released lower breast.
• A larger lift, when the breast has also drooped.

For most women this is done in a single operation. When the asymmetry is severe or the tissue is very tight, it can be better done in stages, and I'll tell you at your consultation if I think that applies to you.

It is worth being clear about what correction can and can't do. The breasts will be fuller, rounder and better proportioned, with smaller, flatter areolas. Because tuberous breasts are so often uneven to begin with, and the two sides respond differently to surgery, perfect symmetry isn't a realistic goal. Good balance is.

There is one more limit, and I want you to know it before surgery rather than after. Releasing the constriction inside the breast doesn't guarantee that the skin over it will stretch to match. Some women's skin does; some women's stays tight, and the lower breast stays shorter than we would like. There is no way of knowing which until the surgery is done and healed, which takes several months.

What Correction Costs

What correction costs depends on what it involves. In the mild cases where a breast augmentation alone is enough, the price is the same as any augmentation, which at Edition starts at $11,100. Most women need a breast augmentation with a mini lift, which starts at $14,100. The cost estimator on our pricing page gives a starting point for either plan, and your exact quote is set at your consultation. I've explained what goes into a quote in How Much Does Breast Augmentation Cost?

This is also an operation where the surgeon matters more than usual. Recognizing a tuberous breast, deciding what each side needs and carrying it out all depend on judgment and experience, and no two surgeons will approach the same breast the same way.

Frequently Asked Questions

What are tubular breasts?

Tubular breasts, also called tuberous or constricted breasts, are a variation in breast development during puberty. Tight tissue at the base of the breast restricts its growth, leaving a narrow base, a high fold, a short lower half and often large, puffy areolas.

Are tuberous breasts related to tubular breast cancer?

No. Tubular carcinoma is an unrelated type of breast cancer that happens to share the name. There is no evidence that tuberous breasts raise the risk of breast cancer.

Can tuberous breasts be fixed without surgery?

No. Exercise, massage, creams, supplements and bras don't change the shape of the breast. A bra can disguise the shape under clothes, but the constriction is in the breast tissue and can only be released surgically.

Can I just have a breast augmentation?

Sometimes, in mild cases. Most women need a breast augmentation with a mini lift, because an implant placed without correcting the constriction and the areola can produce a double bubble or a drooping "snoopy" shape.

Can I breastfeed with tuberous breasts?

Many women with tuberous breasts breastfeed. Some produce less milk, because tuberous breasts can contain less glandular tissue. Any breast surgery that involves the areola can also affect breastfeeding, so it's worth discussing if you plan to have children.

Will my breasts be symmetrical after correction?

Better balanced, but not perfectly symmetrical. Tuberous breasts are often uneven to begin with, and the two sides respond differently to surgery.

Will the lower breast stretch out after the constriction is released?

Often, but not always. Releasing the tissue inside the breast doesn't guarantee the skin over it will stretch to match, and there is no way of knowing until the surgery is done and healed.

Starting prices reflect the simplest version of each plan and can change. Your exact quote is set at your consultation.

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