TUBEROUS BREASTS

What are tuberous breasts?
Tuberous breasts form a type of deformity of breasts. Such breasts tend to be constricted in the lower part of the breasts. This gives them an elongated appearance. The areola (pigmented skin surrounding the nipple) tends to be large. The appearance of tuberous breasts can lead to distress in the affected individuals.

What causes tuberous breasts?
Tuberous breasts occur as a result of abnormal development of the breast tissues. There is a deficiency in the lower part of the breasts. The tissues that support the glands of the breasts tend to be constricted (tight). This deformity tends to become apparent with the development of the breasts during puberty.

What are the changes seen in tuberous breasts?
Tuberous breasts can occur with varying degrees of severity. It can affect one or both breasts. Also, the changes can be asymmetric. This means that one side can be affected differently compared to the other side. The following changes are noticed in tuberous breasts:

Deficiency of breast tissues in the lower part of the breasts
Wide areola
Wide separation between the breasts
Reduction in the area where the breasts arise from the chest
Higher position of the fold below the breast (inframammary fold)
Sagging of the breasts

What are the effects of tuberous breasts on pregnancy and lactation?
Tuberous breasts do not affect pregnancy. Individuals without severe hypoplasia are usually able to lactate.

Why do we treat tuberous breasts?
Individuals with tuberous breasts can be psychologically affected by this condition. It can lead to feelings of low self-esteem. An improvement in the appearance of the breasts can lead to the resolution of such symptoms.

How are tuberous breasts corrected?
The treatment of this condition is with surgery. Medical management is not useful for this condition. The surgical treatment depends on the clinical presentation of this condition. Different techniques and sometimes staged corrections are done to improve the appearance. The surgical techniques include the following:

Areola reduction
Fat grafting of the breasts
Tissue expansion with an expander followed by breast augmentation
Breast augmentation
Mastopexy (breast lift)

The choice of procedure will also depend on inputs based on the patient. The surgical techniques may be associated with a reduction in sensation of the nipple and can affect lactation. Breast augmentation with silicone implants has to be revised with time. The improvement in appearance with surgery will change as patients age. It also gets altered with changes in body weight, pregnancy, and lactation.

What are staged surgical corrections?
During staged surgical procedures the reconstruction is carried out in stages with an interval of a few months in between. For example, in severely hypoplastic breasts a tissue expander may be surgically placed under the breast. This is gradually inflated to reach a desirable proportion to the opposite breast. The expander is replaced with a silicone implant at a later date. Advantages of doing staged reconstruction include improvement in the surgical outcomes and more likelihood of obtaining predictable results.
However, not all deformities need to be treated as staged reconstructions. The treatment plan is customized depending on the clinical presentation and aesthetic goals of the affected individual.

What are the advantages of correction of tuberous breasts?
Milder cases of tuberous breasts are not associated with any functional problems during lactation. The surgical treatment of tuberous breasts does not lead to an increase in lactation. The goal of surgery is an improvement in the appearance of the breasts. This leads to an improvement in the self-esteem and self-confidence of the affected individual.