Is fat grafting or an implant better?

Fat avoids foreign material and shapes softly, but the volume gain is moderate and partly resorbed. An implant delivers reliable volume in one step. Combining both gives the best control over shape, at the cost of a longer procedure.

Can the areolar bulge be corrected?

Yes. Releasing the ring and reducing the herniated tissue, combined with an areolar reduction where needed, reshapes the areolar complex.

Will asymmetry be fully corrected?

Marked asymmetry can be substantially improved. Complete symmetry is not achievable in any breast; we aim for a result that is not noticeable in clothing and looks natural without.

Bleeding, infection, delayed healing, fat necrosis or cysts after grafting, capsular contracture, malposition or rippling with implants, changed nipple sensation and asymmetry. All are discussed individually before surgery.

How long until I can travel home?

Most patients can fly after five to seven days, provided the wound checks are unremarkable. We plan follow-up and, if needed, a handover to a doctor at home.

Congenital deformity

Tubular breast: release the ring, then rebuild the shape

A constricting fibrous ring keeps the breast from developing. Correction always starts with releasing that ring – volume with fat, an implant, or both follows as the second step.

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Good to know: tubular breast is a shape disorder, not simply a small breast. Volume alone without releasing the ring makes the deformity more visible.

Surgical planning for the correction of a tubular breast

General

anaesthesia

3 options

fat, implant, both

6 weeks

compression bra

Features

How the deformity presents

Not every feature is present in every patient – and the two sides usually differ.

Narrow breast base

The base is constricted horizontally and/or vertically. The breast looks narrow and pulled forward instead of sitting broadly on the chest wall.

Constricting ring

A fibrous ring at the transition to the chest wall prevents the gland from expanding, so tissue herniates forward into the areola.

Areolar herniation

Glandular tissue pushes into the areolar complex, which bulges and appears enlarged.

High inframammary fold

The fold sits too high and the lower pole is underdeveloped; it has to be redefined surgically.

Asymmetry

Both sides are very often affected to a different degree, up to unilateral deformity. Planning is therefore always side-specific.

Significant distress

The deformity usually becomes apparent during puberty and is a genuine shape disorder with clinical relevance, not a question of size or aesthetics alone.

Techniques

Three routes after the ring release

Volume can come from your own fat, from an implant, or from both together.

Option 1

Ring release + fat grafting

The constricting ring is released from inside and the gland is scored and unfolded. The resulting space is filled with your own fat harvested from abdomen, flank or thigh.

No foreign material – no implant exchange later
Fine contouring of the lower pole
Moderate volume gain, a second session may be useful
Requires a sufficient donor fat depot

Option 2

Ring release + implant

After release, an anatomically selected implant defines volume and the lower pole in one step – the option for markedly hypoplastic breasts.

Reliable, immediately visible volume
Precise definition of the lower pole
Implant follow-up and possible exchange over a lifetime
Implant pass and documentation included

Option 3

Ring release + implant + fat

The implant provides volume, fat grafting softens the transitions – the most versatile approach for asymmetry and visible implant edges.

Natural transition at the décolleté and lateral border
Corrects asymmetry with fine adjustment
Longer procedure, two donor areas involved
Best control over the final shape

Comparison of correction techniques for tubular breast
Technique	Ring + fat	Ring + implant	Ring + implant + fat
Suitable for	mild to moderate volume deficit, good fat donor area	marked hypoplasia, clear volume requirement	asymmetry, thin tissue cover, high shape demands
Volume gain	moderate, partly resorbed	defined by implant size	high and finely adjustable
Foreign material	none	implant	implant
Anaesthesia	general	general	general
Duration	approx. 2–3 h	approx. 2 h	approx. 3–4 h
Second session	often planned	rarely needed	occasionally for refinement
Sport	approx. 6 weeks	approx. 6 weeks	approx. 6 weeks

Process

From analysis to final shape

01
Analysis
Measurement of base width, nipple position and fold height, assessment of skin envelope, glandular volume and asymmetry, with photo documentation.
02
Planning
Choice between fat grafting, implant or a combination, including donor area planning and, where relevant, implant selection.
03
Surgery
Release of the constricting ring, scoring and unfolding of the gland, redefinition of the lower pole, then volume build-up.
04
Healing
Compression bra for six weeks, no sport for six weeks, protection of the donor areas, close follow-up.
05
Result and refinement
Assessment after three to six months. With fat grafting a second session is often planned from the outset.

Correction is best performed once breast development is complete. If you are planning pregnancy in the near future, we discuss whether waiting produces the more stable result.

This page provides information on treatment options and does not replace medical advice. Whether a procedure suits you can only be assessed after a personal examination.

FAQ

Frequently asked questions

It is a congenital shape disorder of the breast. The constricting ring prevents normal development. Because of the level of distress and the structural nature of the deformity, correction is usually assessed differently from a purely aesthetic augmentation – private insurers do sometimes contribute.