Patient Info
Age:
20-29
Ethnicity:
White
Height:
5’ 0” - 5’ 5”
Weight
100 - 149 lbs
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Breast Reconstruction
My Approach
Congenital tubular breast deformity is more common than many realize and can significantly affect confidence, clothing fit, and body image — especially in young women. This 24-year-old Hispanic female presented with classic tubular breast features including lower pole constriction, asymmetry, limited breast base width, and significant volume imbalance between the two breasts. In complex developmental deformities like this, rushing into implants alone rarely produces a natural or stable result. The foundation must first be corrected. For that reason, I performed a two-stage reconstruction four months apart. The first procedure focused on reshaping and equalizing the native breast tissue. A 100-gram reduction on the right breast was performed to balance volume, combined with a bilateral circumvertical lift to expand the lower pole, release constriction, and create a more natural breast footprint. This stage established symmetry and proper anatomy before adding volume. Once the breasts were balanced and healed, bilateral round smooth saline implants (480cc) were placed under the muscle to restore fullness and projection. I strongly believe that establishing similar breast size before implant placement allows the use of equal-sized implants, which promotes better long-term symmetry. Placing different sized implants may look acceptable early on but often leads to progressive imbalance as tissues change over time. At nine months after the second stage, the breasts appear balanced, soft, and natural — with improved contour, proportion, and long-term stability.
Dr. John Shamoun
MD FACS
The Healing Process
Because this is a staged approach, recovery occurs in two shorter, more manageable phases rather than one aggressive surgery. After Stage One (Lift + Reduction) Patients typically resume light activity in a few days, return to work within 1 week, wear a supportive surgical bra and avoid heavy exercise for 4–6 weeks Swelling improves over several weeks as the breast shape settles. After Stage Two (Implants) Recovery is similar: Mild tightness or muscle soreness for several days; Return to daily activity within a week; Gradual implant settling over 6–12 weeks. Final shape continues improving over several months as swelling resolves and tissues relax. Because the structure was corrected first, the implants sit naturally and age more gracefully over time. This thoughtful sequencing often leads to more refined contours, fewer complications, and a softer, longer-lasting, natural-appearing result overall.
FAQs
Implants alone cannot release tissue constriction or correct shape abnormalities. Without proper restructuring, results may look artificial or unstable.
Equal implants maintain long-term symmetry. Different sized implants may initially look balanced but can age unevenly as tissues stretch over time.
Submuscular placement provides better soft-tissue coverage, a more natural slope, and reduced risk of visible implant edges.
Most patients return to normal activities within one week after each stage, with exercise resumed around 4–6 weeks approximately.
Circumvertical lift scars fade significantly over time and are strategically placed to become less visible as they mature.
Young women with congenital breast asymmetry, constricted or tubular breasts, or shape abnormalities seeking a natural, balanced, and permanent correction are excellent candidates.