The constricted breast is characterized by both a small breast volume and a drooping appearance. In severe cases, this breast shape is referred to as a tuberous breast, or a tubular breast deformity. The constricted breast has a fold beneath the breast (the infra-mammary fold) that appears to be too high. The presence of a high infra-mammary fold constricts the lower portion of the breast. The upper portion of the breast sags over the lower portion of the breast. The base of the constricted breast is narrow. Often, the breast is so constricted that the tissues behind the areola will bulge and make the areola very large.
A constricted breast is treated with a submuscular breast implant and lowering of the elevated infra-mammary fold. The inferior border of the pectoralis muscle is released to allow the implant to occupy more space in the inferior pole of the breast. In severe cases of tubular breast deformity, the constricted base of the breast is released.
With tuberous breast deformity there is often a large areolar size and differences in nipple position. These problems can be corrected at the time of breast augmentation surgery using a breast lift (mastopexy) technique that places a scar around the areolar. This is a called a 'donut mastopexy' and will move the nipple and reduce the size of the areola to match the opposite side.