CC BY-NC-ND 4.0 · Indian J Plast Surg 2016; 49(02): 166-171
DOI: 10.4103/0970-0358.191293
Original Article
Association of Plastic Surgeons of India

Tuberous breast deformity: A modified technique for single-stage correction

Shweta Aggarwal
St. Andrew’s Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex CM1 7ET, UK
,
Niri S. Niranjan
St. Andrew’s Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex CM1 7ET, UK
› Author Affiliations
Further Information

Address for correspondence:

Dr. Shweta Aggarwal
St. Andrew’s Centre for Burns and Plastic Surgery, Broomfield Hospital
Chelmsford, Essex CM1 7ET
UK   

Publication History

Publication Date:
13 August 2019 (online)

 

ABSTRACT

Introduction: Tuberous breast deformity is one of the most challenging congenital breast anomalies. Severe forms present as hypoplasia of lower medial and lateral quadrants and breast base constriction. We present a modified technique based on redistribution of breast tissue for single-stage aesthetic correction of this deformity. Material, Methods and Surgical Technique: The technique is based on Lejour’s method of single vertical scar breast reduction. The breast tissue is divided into three superiorly based pedicles. However, instead of joining the three pedicles, they are spread to redistribute tissue to quadrants which are deficient. This technique is combined with implant insertion if the breast volume is deficient or mastopexy if there is significant ptosis. The level of nipples is matched to achieve symmetry and areolar reduction done where indicated. We have used this for six patients with Type I/II/III (von Heimburg, 2000) tuberous breast deformity. Results and Discussion: The aesthetic results have been very good in terms of shape, volume, symmetry and patient satisfaction. A historical summary of the development of techniques for correction of tuberous breast is presented along with description of our method and its results.


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Conflicts of interest

There are no conflicts of interest.

  • REFERENCES

  • 1 Rees TD, Aston SJ. The tuberous breast. Clin Plast Surg 1976; 3: 339-47
  • 2 Williams G, Hoffman S. Mammoplasty for tubular breasts. Aesthetic Plast Surg 1981; 5: 51-6
  • 3 Gruber RP, Jones Jr HW. The donut mastopexy: Indications and complications. Plast Reconstr Surg 1980; 65: 34-8
  • 4 Bass CB. Herniated areolar complex. Ann Plast Surg 1978; 1: 402-6
  • 5 Vecchione TR. A method for recontouring the domed nipple. Plast Reconstr Surg 1976; 57: 30-2
  • 6 Puckett CL, Concannon MJ. Augmenting the narrow-based breast: The unfurling technique to prevent the double-bubble deformity. Aesthetic Plast Surg 1990; 14: 15-9
  • 7 Grolleau JL, Lanfrey E, Lavigne B, Chavoin JP, Costagliola M. Breast base anomalies: Treatment strategy for tuberous breasts, minor deformities, and asymmetry. Plast Reconstr Surg 1999; 104: 2040-8
  • 8 Mandrekas AD, Zambacos GJ, Anastasopoulos A, Hapsas D, Lambrinaki N, Ioannidou-Mouzaka L. Aesthetic reconstruction of the tuberous breast deformity. Plast Reconstr Surg 2004; 113: 2231-2
  • 9 von Heimburg D, Exner K, Kruft S, Lemperle G. The tuberous breast deformity: Classification and treatment. Br J Plast Surg 1996; 49: 339-45
  • 10 von Heimburg D. Refined version of the tuberous breast classification. Plast Reconstr Surg 2000; 105: 2269-70
  • 11 Toranto IR. Two-stage correction of tuberous breasts. Plast Reconstr Surg 1981; 67: 642-6
  • 12 Teimourian B, Adham MN. Surgical correction of the tuberous breast. Ann Plast Surg 1983; 10: 190-3
  • 13 Dinner MI, Dowden RV. The tubular/tuberous breast syndrome. Ann Plast Surg 1987; 19: 414-20
  • 14 Elliott MP. A musculocutaneous transposition flap mammaplasty for correction of the tuberous breast. Ann Plast Surg 1988; 20: 153-7
  • 15 Wilkinson TS. Mammaplasty for the tuberous breast. Ann Plast Surg 1988; 21: 294-6
  • 16 Versaci AD, Balkovich ME, Goldstein SA. Breast reconstruction by tissue expansion for congenital and burn deformities. Ann Plast Surg 1986; 16: 20-31
  • 17 Versaci AD, Rozzelle AA. Treatment of tuberous breasts utilizing tissue expansion. Aesthetic Plast Surg 1991; 15: 307-12
  • 18 de la Fuente A, Martín del Yerro JL. Periareolar mastopexy with mammary implants. Aesthetic Plast Surg 1992; 16: 337-41
  • 19 Muti E. Personal approach to surgical correction of the extremely hypoplastic tuberous breast. Aesthetic Plast Surg 1996; 20: 385-90
  • 20 Ribeiro L, Canzi W, Buss Jr A, Accorsi Jr A. Tuberous breast: A new approach. Plast Reconstr Surg 1998; 101: 42-50
  • 21 Atiyeh BS, Hashim HA, El-Douaihy Y, Kayle DI. Perinipple round-block technique for correction of tuberous/tubular breast deformity. Aesthetic Plast Surg 1998; 22: 284-8
  • 22 Persichetti P, Cagli B, Tenna S, Simone P, Marangi GF, Li Vecchi G. Decision making in the treatment of tuberous and tubular breasts: Volume adjustment as a crucial stage in the surgical strategy. Aesthetic Plast Surg 2005; 29: 482-8
  • 23 Ho Quoc C, Sinna R, Gourari A, La Marca S, Toussoun G, Delay E. Percutaneous fasciotomies and fat grafting: Indications for breast surgery. Aesthet Surg J 2013; 33: 995-1001
  • 24 Derder M, Whitaker IS, Boudana D, Marchac A, Hivelin M, Mattar N. et al. The use of lipofilling to treat congenital hypoplastic breast anomalies: Preliminary experiences. Ann Plast Surg 2014; 73: 371-7

Address for correspondence:

Dr. Shweta Aggarwal
St. Andrew’s Centre for Burns and Plastic Surgery, Broomfield Hospital
Chelmsford, Essex CM1 7ET
UK   

  • REFERENCES

  • 1 Rees TD, Aston SJ. The tuberous breast. Clin Plast Surg 1976; 3: 339-47
  • 2 Williams G, Hoffman S. Mammoplasty for tubular breasts. Aesthetic Plast Surg 1981; 5: 51-6
  • 3 Gruber RP, Jones Jr HW. The donut mastopexy: Indications and complications. Plast Reconstr Surg 1980; 65: 34-8
  • 4 Bass CB. Herniated areolar complex. Ann Plast Surg 1978; 1: 402-6
  • 5 Vecchione TR. A method for recontouring the domed nipple. Plast Reconstr Surg 1976; 57: 30-2
  • 6 Puckett CL, Concannon MJ. Augmenting the narrow-based breast: The unfurling technique to prevent the double-bubble deformity. Aesthetic Plast Surg 1990; 14: 15-9
  • 7 Grolleau JL, Lanfrey E, Lavigne B, Chavoin JP, Costagliola M. Breast base anomalies: Treatment strategy for tuberous breasts, minor deformities, and asymmetry. Plast Reconstr Surg 1999; 104: 2040-8
  • 8 Mandrekas AD, Zambacos GJ, Anastasopoulos A, Hapsas D, Lambrinaki N, Ioannidou-Mouzaka L. Aesthetic reconstruction of the tuberous breast deformity. Plast Reconstr Surg 2004; 113: 2231-2
  • 9 von Heimburg D, Exner K, Kruft S, Lemperle G. The tuberous breast deformity: Classification and treatment. Br J Plast Surg 1996; 49: 339-45
  • 10 von Heimburg D. Refined version of the tuberous breast classification. Plast Reconstr Surg 2000; 105: 2269-70
  • 11 Toranto IR. Two-stage correction of tuberous breasts. Plast Reconstr Surg 1981; 67: 642-6
  • 12 Teimourian B, Adham MN. Surgical correction of the tuberous breast. Ann Plast Surg 1983; 10: 190-3
  • 13 Dinner MI, Dowden RV. The tubular/tuberous breast syndrome. Ann Plast Surg 1987; 19: 414-20
  • 14 Elliott MP. A musculocutaneous transposition flap mammaplasty for correction of the tuberous breast. Ann Plast Surg 1988; 20: 153-7
  • 15 Wilkinson TS. Mammaplasty for the tuberous breast. Ann Plast Surg 1988; 21: 294-6
  • 16 Versaci AD, Balkovich ME, Goldstein SA. Breast reconstruction by tissue expansion for congenital and burn deformities. Ann Plast Surg 1986; 16: 20-31
  • 17 Versaci AD, Rozzelle AA. Treatment of tuberous breasts utilizing tissue expansion. Aesthetic Plast Surg 1991; 15: 307-12
  • 18 de la Fuente A, Martín del Yerro JL. Periareolar mastopexy with mammary implants. Aesthetic Plast Surg 1992; 16: 337-41
  • 19 Muti E. Personal approach to surgical correction of the extremely hypoplastic tuberous breast. Aesthetic Plast Surg 1996; 20: 385-90
  • 20 Ribeiro L, Canzi W, Buss Jr A, Accorsi Jr A. Tuberous breast: A new approach. Plast Reconstr Surg 1998; 101: 42-50
  • 21 Atiyeh BS, Hashim HA, El-Douaihy Y, Kayle DI. Perinipple round-block technique for correction of tuberous/tubular breast deformity. Aesthetic Plast Surg 1998; 22: 284-8
  • 22 Persichetti P, Cagli B, Tenna S, Simone P, Marangi GF, Li Vecchi G. Decision making in the treatment of tuberous and tubular breasts: Volume adjustment as a crucial stage in the surgical strategy. Aesthetic Plast Surg 2005; 29: 482-8
  • 23 Ho Quoc C, Sinna R, Gourari A, La Marca S, Toussoun G, Delay E. Percutaneous fasciotomies and fat grafting: Indications for breast surgery. Aesthet Surg J 2013; 33: 995-1001
  • 24 Derder M, Whitaker IS, Boudana D, Marchac A, Hivelin M, Mattar N. et al. The use of lipofilling to treat congenital hypoplastic breast anomalies: Preliminary experiences. Ann Plast Surg 2014; 73: 371-7