What are tuberous breasts?
Tuberous or tubular breasts are those that during pubertal development undergo an abnormal development of the breast, most frequently of the lower quadrants. This lack of expansion of some areas of the breast generates a tubular or little expanded appearance, hence the name tubular or tuberous breast.
It can affect one or both breasts and there are different degrees of involvement. That is why a significant percentage of patients with this congenital deformity come to our office unaware that they have tuberous breasts and asking for a breast augmentation or an elevation.
Why is a tubular breast formed?
They begin to manifest themselves at the moment of development when the breast begins to increase in volume and, due to a lack of elasticity due to the presence of a constricting ring, a fibrous band that constricts some parts of the breast, does not allow it to expand in a proportionate and aesthetic way.
Are there different types of tuberous breasts?
Yes, they are divided into three or four grades according to the classification:
– Grade 1: are those with a lack of development of the lower inner quadrant, so they give the appearance of separate breasts. They usually present with dilated areolas.
– Grade 2: in this case the abnormal development affects the entire lower breast pole.
– Grade 3: there is a deficit in the development of all quadrants of the breast, and usually present a protrusion or prolapse of the breast contents through the areola.
Are the women who come to your office usually aware that they have tuberous breasts or are they diagnosed at the visit?
Patients are currently well informed, however, in this case it is very common that the patient comes to our office asking for a breast augmentation or an elevation without knowing that it is necessary to perform a remodeling and expansion of the lower quadrants to improve their appearance and correct their shape.
It is very important in these cases to perform a correct exploration and diagnosis of the tuberous breast in order to achieve a satisfactory result.
Is the surgery to correct tuberous breasts the same as a breast augmentation?
No. It is similar, although it requires a correct remodeling of the affected quadrants of the breast and even, sometimes, of the areola. The type of technique used will depend on the degree of affectation of the breasts that each patient presents.
The physical and aesthetic change is incredible. It is one of the most grateful surgeries that a plastic surgeon with dedication to senology can perform.
How is the procedure performed?
It is an intervention that lasts about two hours approximately and that we perform with an overnight hospital stay. In cases of low or moderate grade tuberous breasts and in those that do not require elevation or areola symmetrization, I am in favor of performing the procedure endoscopically through the axilla. This technique, which we published in the American magazine a few years ago, allows us to perform a good expansion of the tuberous breast with the same scars and the same postoperative period as a conventional breast augmentation.
In cases in which an elevation is required or it is necessary to reduce or elevate the areolas, or in severe cases of tuberosity and with important asymmetries, it is necessary to perform other approaches by making periareolar scars or the classic mastopexy scars (vertical or inverted T).
It is common in patients with tuberous breasts that there are also asymmetries in the cleavage area that are difficult to correct. In these cases, the best option will be to perform as a complement to the augmentation our technique of lipofilling or remodeling of the cleavage with fat.
How do women feel when they see their new breast?
It is an incredible change, it is a very grateful intervention. With this intervention we achieve a breast with an anatomical shape, much more harmonious, symmetrical and aesthetic.
Can this operation affect breastfeeding if the patient decides to breastfeed in the future?
It depends on the degree of tuberosity, and therefore, on the degree of remodeling that needs to be performed. In mild cases the expansion is very localized so it will not be affected. However, in cases where elevation or major remodeling is performed, it is very likely that lactation will be affected.
If someday the patient decides to remove the implants, will the breast become tuberous again?
Before the augmentation is performed, a correction of the tuberosity is always performed so the shape of the breast is corrected. In cases where the patient rejects the use of implants or breast prostheses there are other alternatives such as filling with the patient’s own fat, also known as lipofilling. This is currently an alternative that offers very good results, although it is necessary that the patient has enough fat accumulation to obtain sufficient volume.