Tuberous breast deformity is a developmental condition. During the breast developmental phase, an aberration occurs that causes a constricting ring to grow around the base of the breast. This ring keeps the breast from developing properly, stopping its horizontal and/or vertical expansion. The extra pressure from this process causes the breast tissue to herniate and move toward the area of the nipple/areola. The end result of this process is misshapen breasts, large areolas and irregular nipples, known as tuberous breasts. This problem can range greatly in severity. Some patients with minor tuberous breast deformity will only have breasts that have a high fold, tight base or a constricted appearance while others may suffer from a more severe problem where the breasts resemble tubes.
A tubular breast can take on several different forms, in some cases even varying greatly between a single patient’s two breasts. Regardless of these variations, tubular breasts are classified by several features. These include the breast protruding into the areola, large, possibly deformed nipples and/or areola complex, an abnormally short distance between the areola and the breast fold or misshapen, under developed breasts with a constricted base. A dark ring around the areola may also exist.
Tuberous breasts are deformed. The condition does not refer to undeveloped breasts, insignificant size, protruding areola or underdeveloped nipples. The basis of the condition lies in developmental abnormalities and irregular breast tissue placement. Where many patients who undergo breast augmentation may wish to correct properly developed breasts that they find aesthetically unpleasant, treatment for tuberous breasts can be more complicated.
The goal of tuberous breast augmentation is to create a more rounded, regular shape and decrease large areola and large nipples, if necessary. Ideal breasts are comprised of evenly distributed tissue while tuberous breasts are characterized by tissue that is concentrated directly underneath the protruding nipples.
Because of this, a common treatment technique involves releasing this constricted breast tissue by making internal radial incisions that allow it to splay out properly. These incisions are done internally so the patient doesn’t see anything externally. In most cases the Plastic Surgeon will suggest the placement of an implant, typically in the sub-mammary position to better influence the breast’s shape and to add greater volume. If excess or sagging skin is present, surgeons may recommend performing a breast lift as part of the procedure as well.
Patients with severe tuberous breast deformity may undergo tissue expansion, infra-mammary fold lowering and reduction to the large nipple and/or areola before the implant is inserted.
As mentioned above, one patient’s irregular breasts can present varying degrees of deformity. This difference in size and shape may make it necessary for Plastic Surgeons to employ different treatment techniques for each deformed breast, as well as to properly address massive nipple abnormalities, as well as the appearance of a “herniated areola”.
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