Tuberous breast is characterized by a breast shape abnormality. This is a relatively rare breast malformation which frequency is difficult to determine because of the different forms of the syndrome.
The common abnormality in all the breast tuberous cases is an abnormality in the breast implantation base which takes a tuber like appearance. The base of the breast is concentrated (narrower than normal) and breasts develop as if they were enclosed in a tube.
Other criteria for breast tuberous include:
- A high position of the infra mammary fold.
- A large nipple areola complex compared to the breast volume, with a protruding areola, as if the breast wanted to develop through the areola
- Abnormal breast volume: the breasts are usually smaller than usual but may appear normal in size and sometimes hypertrophic.
- In 2/3 of cases, the two breasts are asymmetrical
There are 3 stages which each surgical treatment is different. Both breasts are usually tuberous and certain aspects may be associated.
Stage 1: The crease under the breast presents an aspect of S italic and the breast presents underdevelopment on the lower inner segment with areola looking down and inwards.
Stage 2: Breasts presents insufficient development of the whole bottom segment. The areola then looks down.
Stage 3: The breast has an insufficient development of the lower and upper segments with a base within the narrowed breast giving it a tuber-like appearance.
The treatment will aim to achieve the most natural and symmetrical breast possible. The affected breast will be treated by mammoplasty, breast implant or lipofilling. In cases of hypoplasia, lipofilling can be a possible choice to increase the volume while also correcting the defect. Proceeding like with a breast reconstruction after cancer, balancing may be required.
Before the surgery
It is necessary to have 2 consultations, a radiological assessment with mammography and an ultrasound done before the operation.
It is mandatory to stop smoking one month before the operation because the surgery needs a perfect vascularization of the gland.
The operation is performed under general anesthesia in a semi-sitting up right position to be able to see the results from a standing view.
The procedure can take from 2 to 3 hours in total.
The goal of this surgery is:
- To replace the mammary base by providing a crease under the breast downwards
- To redistribute the mammary glands volumes in the insufficient segments. This will be achieved by an implant and / or glandular plasty remodeling
- So sever fibrosis constricting the gland and giving it a tuberous appearance
- To concentrate the areola area treating the hernia that may exist
Depending on the stage, the scars may be exclusively around the areola or placed as an inverted T.
Often, two operations may be necessary.
In hypoplasia cases, malformation needs to be corrected before processing the volume, which therefore will be addressed in a second time. For a lipofilling, 2 operations are often necessary to obtain the desired size and shape.
There is no drainage after this type of surgery. A tight bandage is put in place which is replaced the next day by a medical bra. The bra must be worn day and night for at least one month. The final result will show 3-6 months after the operation.
Sport is allowed after one month.
In case of breast implant with tuberous breast, a post-operation bra is mandatory because it will help to develop the low segment by pushing down the breast implant.