What is a tuberous breast

Tuberous Breast

The Tuberous or Tubular Breast is a congenital (from birth) abnormality of the breast shape. There are several theories that try to explain how this condition occurs, but the exact cause is yet unknown.

Normal Breast

The pictures below show a normal breast

The common features of tuberous breasts are:

1. Small (hypoplastic breast)
2. Enlarged and puffy areola.
3. Narrow base. 
4. Higher than normal breast fold
5. Very small distance between the nipple and the breast fold.
6. Lower pole hypoplasia.

Other types of tuberous breasts

a. Hypoplastic tuberous breast with large and puffy areola

b. Breast asymmetry with funnel chest (pectus excavatum) and hypoplastic tuberous breast with areola of normal diameter

c. Sagging tuberous breast of normal volume

d. Great asymmetry of enlarged sagging tuberous breast

e. Breast asymmetry with normal chest and hypoplastic tuberous breast (Right)

Tuberous breast is rare in the general population. However, in patients who present for breast augmentation the numbers are much higher, reaching 30-40%.

In studies that we have carried out, in 2000 of our own patients who came to us for breast augmentation, tuberous breast reaches 33%.

A new technique

It is very important for a patient to know that she has tuberous breasts. By identifying the condition of tuberous breasts on our patients we are able to plan the procedure in such a way as to avoid problems following breast augmentation. A patient with tuberous breasts must know that the breast(s) need(s) to be handled differently compared to a breast that is not tuberous.

Because of the difficulty in treating this problem, we propose a new combinatorial technique.

Our new technique was first presented at the ISAPS Geneva World Congress in September 2012.

To achieve a good result in tuberous hypoplastic breasts the following were necessary:

Firstly: To achieve good expansion of the breast’s lower pole

1. Placement of silicone implants
2. Incisions made internally at the breast’s lower pole (view photo)
3. Good contact of silicone implants with the breast’s lower pole to allow the breast to expand upon constant pressure of the implant (MUST technique).

For this purpose, the appropriate technique is the MUST technique.

Secondly: To correct the areola when and if necessary

It is very important to decide when to correct the areola and when not. The success of this surgery depends exactly on this detail.

Our decision is based on the x/y ratio. “x” is distance 1 and “y” is distance “2”. When the x/y ratio is less than 0.3 we do not interfere with the areola. But when the ratio is greater than 0.3 then we fix the areola

How is the areola corrected?

With a periareolar incision we reduce the areola to the desired size and manage breast projection. For closing we use a special technique and CV-3 suture.

Conclusion

Tuberous breasts can be easy to fix when the deformity is diagnosed before surgery and when all appropriate measures are taken to correct it. The new technique involves:

1. Correction of the areola, where and when needed (ratio X/Y>0.35)

(ATTENTION, THIS IS NOT ALWAYS NECESSARY!)

2. The Must technique in placing silicone implant for better expansion of the lower pole of the breast

Adhering to the above principles we may expect a very good result.

Wrong treatment of tuberous breast

Take a look at what can happen when a tuberous breast is not properly handled

What went wrong?

In the first case the breast develops an excessive "double bubble deformity" due to failure to correct the problem

Effort to correct the areola diameter: if performed alone it fails to correct the deformity, and, if not performed correctly, it leads to further problems.

Take a look at the before and after pictures of tuberous breast surgeries