Summary
Background
The tuberous breast presents a problem for which many surgical solutions have been
described. Current teaching describes how the tuberous breast deformity is the result
of skin shortage as well as herniation of breast tissue through the nipple–areola
complex. However, through careful clinical observation we now believe that the only
abnormality present is herniation of breast tissue through the nipple–areola complex.
Methods
Using this principle, we have refined a one-stage surgical procedure that can be used
to correct any type of tuberous breast deformity. Since 2001 we have performed our
technique on a series of 13 tuberous breasts of widely varying appearances in eight
patients (age 17–24 years) with a follow up varying between 3 and 56 months. Our new
understanding of the tuberous breast deformity has also made it possible to develop
an objective, reproducible method for defining the tuberous breast based on the degree
of areola herniation.
Results
All patients reported high levels of satisfaction with the procedure. Assessment of
the results by an independent panel of attending surgeons showed all results to be
good/excellent. Moreover, the results have improved with time and no revisions have
been needed. Our method of defining the tuberous breast (based on the ratio of areola
herniation:areola diameter) enabled us to identify a cut-off to decide (objectively)
when a breast was tuberous. This allowed us to anticipate when an areola reduction/tightening
procedure would be necessary to avoid a ‘double-bubble’ deformity.
Conclusion
We propose a one-stage surgical procedure which is applicable to all degrees of tuberous
breast deformity. The results appear to confirm our theory that the only abnormality
present in the tuberous breast is herniation of breast tissue through the nipple–areola
complex. In patients with small breasts and a tuberous deformity, correction of the
herniation changes the tuberous breast into a simple hypoplastic breast. The volume
deficit can then be corrected by augmentation (if desired by the patient). In patients
with sufficient breast volume, correction of the herniation alone will correct the
deformity.
Keywords
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Article info
Publication history
Published online: February 26, 2007
Accepted:
January 9,
2007
Received:
June 29,
2006
Footnotes
☆Presented at: the Annual Meeting of The British Association of Aesthetic Plastic Surgeons in London, UK, September 2005.
☆☆Financial disclosure: The authors do not have any financial or commercial interest in this study.
Identification
Copyright
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
