A 16 y/o patient saw me last week with complaint that her breasts don't look like what she wants. When dressed she appeared very well proportioned but undressed her breasts are large behind the nipple/areola but sagging and not much breast tissue up against her chest. I've seen tubular breasts but this is not quite the same. Her description is apt, "like a tennis ball inside a sock". Is this something that can be corrected?

16 year olds are too young for this! Meanwhile, is she wearing bras with good support? The concept of "normal breasts" is so distorted. Natural boobs sag! But the media is saturated with augmented boobs that stick straight out.

I would be reluctant to do any surgery until she is at least 18;she's still developing and at 18 or older she can legally sign her own consent.

Plastic MD, yes but she complains that bras that cover her completely are the only kind that she can wear and she'd like to be able to wear a bikini that is more in fashion, ie., revealing.

I guess in this circumstance, I'd get her a referral to a TEACHING plastic surgery program and let them discuss the pro's and con's with her.

I am a general surgeon and have seen a number of young ladies "unhappy" with their boobs. I do not touch these boobs surgically until they are 25 or when they are fully developed. There are many flattering bras and bikinis that these girls can use in the meantime. Once these boobs are surgically touched, they will never be the same nor "normal".

Also would recommend waiting to have any reconstructive procedure performed. This sounds like a variant of tubular breast deformity and her development should be stable prior to any surgery. Although this can be psychologically difficult to cope with, waiting to perform any corrective surgery will give the best chance at aesthetically acceptable result

I agree mental maturity and physical maturity are important. These patients when corrected are some of the most gratified patients I have had. The best time for correction is before college where she will be most self conscious and thrust in to potentially embarassing situations. She needs to see someone who is familiar with and good at this kind of surgery as it can be challenging

Thanks to all, especially to the plastic surgery docs for your thoughtful comments. This patient is not eager for surgery but I think she will be pleased to hear that something might be possible.

Although the patient may be physically mature in the future, she must still be carefully evaluated to determine her willingness to have potentially noticeable scarring of the breasts and possible interference with breast feeding.

I agree with Fil and Jack. Help her solve her self-image issues. Educate her on the wonderful benefits of breastfeeding.