Tubular Breast Deformity or Tuberous Breasts is a congenital or inherited condition in which the breast fails to develop properly at puberty. Tubular Breasts are very distressing to the women who have this condition and are a cause of embarrassment and can interfere with the development of a normal body image and self-confidence especially in young adolescent and post-adolescent women.
The correction or reconstruction of Tubular or Tuberous Deformity remains a very challenging issue for most Plastic Surgeons. Older traditional surgical methods often produced unacceptable scarring and often poor results. However more modern techniques have improved results significantly and in many cases this deformity can now be corrected with much less visible scarring.
What is the Tubular or Tuberous Breast Deformity?
Tubular Breast Deformity is an inherited or congenital condition that appears during puberty when glandular development starts. The breast is small with inadequate growth of glandular tissue and what is called a constricted shape. The skin of the breast is constricted or tightened around the developing gland tissue which causes the breast to have a tubular or elongated shape.
In some cases the areola appears unusually large as it appears larger than the diameter of the gland. In some cases when the nipple-areola also fails to develop the nipple-areola can be very small. In some cases this is called Hypoplasia or Agenesis. In many cases there is asymmetry with unevenness and in some cases Tubular Deformity can occur on only one side.
Breast Implants to Correct Tubular Deformity
Fortunately, today many patients with Tubular or Tuberous Deformity can achieve an excellent cosmetic result with simple Augmentation with Implants. This technique requires a Sub glandular Implant rather than the Sub muscular Augmentation and requires a modification of the breast gland. There are constricting bands that hold the gland in a tubular shape and these bands are released surgically from underneath the breast gland. This allows the implant to stretch the overlying gland tissue and skin to a more natural appearing breast shape.
In the photo below the patient had a tubular shaped breast on one side and Agenesis or Hypoplasia on the opposite side. She chose, wisely in my opinion, not to have a nipple-areola enlarging procedure on the left side, as this would have created very visible scarring. The implants do provide some stretching and enlargement of the hypo plastic nipple-areola complex.
Soft Tissue Expansion for Tubular Breasts with Ptosis or Sagging
In patients who have Tubular Deformity with significant Ptosis or sagging, a technique called Soft Tissue Expansion of often works well. A small inflatable saline implant is placed beneath the breast and gradually inflated by injecting saline through a small port beneath the skin. Over a few months, the expanding implant gradually stretches the breast and creates a more normal shape. This technique can also increase the size of the nipple-areola complex. When the final breast and shape is achieved the expander is removed and a final implant is placed.
Mastopexy or Lift and Implants
In patients who have Tubular or Tuberous Deformity with a very large Areola or significant asymmetry or uneven breasts a Dermal Mastopexy or Breast Lift is often done to achieve better symmetry.The Mastopexy allows for reduction of the Areola if necessary and lifting of the sagging breast.
In the patient pictured below a lift or Mastopexy and Implant was done on the left side and an implant on the right. The left side was sagging or Ptotic and both breasts were constricted but were not “extreme” forms of Tuberous Deformity. These photos are only 2 weeks after surgery and there is still a scab on the left side which went on to heal very nicely. Notice how the left Areola has been reduced to match the right side.
Donut Mastopexy is an operation that excises or removes the tight or constricted skin surrounding the breast done to leave behind a more normal shape. The problem with this operation is that the scarring is terrible. I have never used this procedure and doubt that it is done very often now that newer soft tissue expansion is available for severe cases.
Who Should Do Your Surgery?
You should consult a surgeon who is certified by the American Board of Plastic Surgery and who is experienced in Cosmetic Breast Surgery. Ask the doctor if he has experience treating this deformity and if possible show you the results that he/she has achieved. Good results require an expert who knows how to treat this condition.
Call me at 978-369-4499 for more information or read about Breast Implants on my blog. You may contact me and submit breast photos and I will answer your questions by email. You may want to sign up for our Plastic Surgery Newsletter to learn about new non-surgical and surgical treatments in Plastic Surgery.