These are the most common breast problems and their corresponding solution, according to LA plastic surgeons:

• Drooping breasts

Due to aging, pregnancy, and major weight loss, some women develop drooping breasts with nipples pointing downwards.  To treat this problem, plastic surgery experts use breast lift which involves removing the excess skin, manipulating the underlying muscles, and raising the bust to a higher position.  In some cases, they complement this surgery with implants to further make the breast, particularly the upper pole, appear fuller.

• “Swooping” breasts

While the breasts do not have a pronounced droopiness, they bend inward above the areola resulting to a “swooping” appearance.  To treat this aesthetic problem, plastic surgeons use breast implant surgery to improve the contour of the bust.

• Smaller breasts

Due to genetic predisposition, some women have extremely small breasts almost comparable to men’s.  Fortunately, breast augmentation through the use of saline or silicone implants can increase their bust size.

For women who do not want to use synthetic materials to increase their breast size, they can opt for fat grafting, a procedure in which doctors collect fats from their tummy (or areas where fats tend to accumulate), which are purified to separate the blood and tissue and then re-injected to the breasts.

However, fat grafting can only increase the breast with less than a cup, which means that it is not ideal for women who want to significantly augment their bust.

• Tuberous-shaped breasts

In this problem, the breasts have a prominent outward projection from the chest wall and are very narrow at the base, thus resulting to a tubular shape.  This condition usually happens on women who have small breasts with noticeable droopiness due to skin and tissue laxity.

In LA plastic surgery, most doctors treat this problem through breast implant surgery that is usually combined with breast lift especially for women with extremely sagging bust.

• Enlarged areola

In some cases, women who need breast lift or breast reduction will also benefit from areola reduction surgery to further create a more natural-looking appearance.  Fortunately, combining this procedure with other breast surgeries does not require additional incisions because they usually have the same surgical site.

• Tuberous breasts

Tuberous breasts, which usually happen on women with a small bust size, have a very narrow base and have an outward, tubular-shape projection from the chest wall.  Fortunately, this problem can be corrected by breast implant surgery which can be performed with or without breast lift or other enhancement procedures.

• Swooping breasts

This problem occurs when the breasts bend inward above the areola or the pigmented part of surrounding the nipple.  While they do not have a noticeable sagging, a breast implant surgery can still improve their contour.

Meanwhile, this problem is primarily caused by the lack of volume rather than skin and tissue laxity, which is the case in tuberous breasts.

• Breast ptosis or sagging

This aesthetic problem is often manifested by nipples pointing downward, lack of volume especially in the upper poles of the breasts, and elongated appearance of the bust.  According to leading Los Angeles plastic surgeon Dr. Tarick Smaili, this condition may be caused by the natural effects of aging, pregnancy, or hereditary predisposition.

Mild to moderate ptosis can be treated with breast implant surgery alone, although women with a more pronounced sagging can benefit if this is complemented with breast lift in which the loose skin and tissue is excised.

Ideally, the complete submuscular implant placement is used to prevent ptosis from recurring.  In this technique, the top two-thirds of the device is covered by the pectoral muscle and the bottom one-third is supported by a thicker wall of connective tissue instead of skin alone.  It is important to remember that it is anatomically impossible to place the entire implant under the muscle.

If the breast implant surgery is performed in conjunction with breast lift, doctors often used the areola incision in order to remove the loose skin around the area.  But women with a more pronounced sagging may need another cut from the areola down to the crease, a technique referred to as lollipop incision.

• Pigeon breast

This happens when the breasts significantly protrude from the sternum and ribs.  Fortunately, this deformity, which is often caused by hereditary predisposition, can be easily treated with breast implant surgery.

• Loss of breast tissue

Due to the natural effects of aging and pregnancy, many women suffer from this aesthetic problem especially in the upper poles of their breasts.  Fortunately, this can be treated with breast implant surgery particularly with the use of round implants which are shaped like a sphere.

Another advantage of round implant over its teardrop-shaped version is that it can create fullness particularly in the upper poles, leading to a more noticeable cleavage.

• Sagging breasts

Contrary to a popular belief, breast ptosis or sagging not just occurs due to the heavy weight of larger breasts, in fact, some women with small- to medium-sized bust experience this problem after significant weight loss or pregnancy, or due to the natural effects of aging.

For mild to moderate sagging, breast implant surgery alone can provide a dramatic improvement.  But to prevent or at least postpone the ongoing ptosis, the implants should be placed under the chest muscle so they are covered and supported by a thicker wall of muscle, tissue, and skin.

But for women with a severe case of sagging, the best approach is to combine breast implant surgery with breast lift in which a plastic surgeon will create an incision around the areola (or if the ptosis is significant, another vertical excision is made from the areola down to the breast crease) so he can remove the loose skin and tissue.

Through the same incision, a surgeon will insert the breast implants and place these under the chest muscle, thus creating more breast volume.

• Asymmetrical breasts

It is not uncommon to have asymmetrical breasts (either one of them is bigger or sags more than the other), although there are some cases in which this condition is extremely noticeable.  Fortunately, this problem can be treated with breast implant surgery.

• Tuberous breasts

Tuberous breasts have a very narrow base and project outward from the chest wall in a tubular shape; in most cases, they are small and have the tendency to sag.  To treat this aesthetic problem, breast implant surgery can be used and is often complemented with breast lift.

Tubular breasts are considered a bona fide medical deformity, even though most patients with the condition are not aware they have an actual deformity. Most just assume they have very small breasts. Some aren’t aware a correction is possible

As you might guess from the name, Tubular breasts are usually small, very long and narrow, have large areola and often sag even though the patient is a teen or very young woman. In some places, Tubular breasts are known as “snoopy breasts”.

Often, a Tubular breast patient requires only an A or AA cup and is usually embarrassed about her appearance.

For instance, one patient with size AA tubular breasts who finally had her breasts surgically corrected recalled how humiliated she felt during her competitive swimming career when she showed up at poolside in a skin tight Speedo bathing suit.

Away from the pool, she wore a padded bra. After her breast enlargement, she shed tears of joy the first time she saw the results and was over the moon with her new, natural appearance.

It requires extreme skill to correct the condition because the surgeon must do, all in one surgical session a:

• Breast enhancement
• Breast lift
• Breast reduction

The surgeon enlarges the base of the Tubular breasts — and makes room for the implants – by reaching down from the areola and making a series of incisions around the bottom of the breast. Surgeons who use that approach say it also reduces the overly large areola.

That does two things:

• Reduces the projection of the tubular breasts
• Creates a natural-looking cleavage between the breasts

Some surgeons prefer to enter the breasts from the inframammary fold, the area where the very bottom of the breast meets the chest wall.

View examples of tubular breast correction in a surgeon’s before and after pictures.