A SPECIALIST PLASTIC SURGEON WHEN IT COMES TO TUBEROUS BREAST CORRECTION SURGERY
Asymmetry of the breast can cause anxiety and angst cosmetic surgery can help with advice and discuss options. At Panthea Clinics, we specialise in a range of breast surgeries.
WHAT ARE TUBEROUS BREASTS?
Tuberous breast is a rare congenital abnormality of the breasts caused by breast tissue not proliferating properly during puberty. During puberty, breast development is stymied and the breasts fail to develop normally and fully.
WHY CHOOSE OUR CLINIC?
Tuberous breast and asymmetry correction is one of Dr Farhadieh’s areas of special interest and expertise. He brings innovation in surgical art, and uses modern techniques to achieve the optimal outcomes. As an internationally peer recognised plastic surgeon educator he has both provided expert commentary for international plastic surgery journals, as well as authored a chapter on breast augmentation in two international plastic surgery textbooks: Plastic and Reconstructive Surgery: Approaches and Techniques.
If you are thinking about undergoing tuberous breast correction surgery, get in touch with Panthea Clinic in either Canberra or Sydney. Our aim is to provide advice and state of the art care for each and every patient.
THE PREOPERATIVE AND POSTOPERATIVE PROCESS
The first step in getting any surgery is an initial consultation, where your surgeon will learn more about you, what your expectations are and what is possible to achieve. In this consultation, Dr Farhadieh will thoroughly examine your medical history, discussing at length factors such as:
- History – Patients may present with either unilateral or bilateral breast deformity. This may have both a functional and psychological impact, such as difficulty wearing certain clothing or relationship issues. The patient with unilateral breast will have noticed her problem post puberty as breast development occurs. It is important to ascertain whether the patient has breastfed or plans to breastfeed and counsel then on the potential impact on breastfeeding post surgical correction.
- Examination – The breasts should be examined to ascertain the presence of bilateral or unilateral deformity. An assessment must be made as to whether or not the constricted lower pole skin can be expanded to allow primary placement of an implant to create a natural lower pole contour. A general examination of breast for masses and axillary palpation for lymphadenopathy should be performed routinely to exclude malignancy.
- Management – The principles in correcting tuberous breast are; the constricted skin envelope and malpositioned imframammary fold (IMF) should be corrected as much as possible; areolar pseudoherniation must be addressed and the areolar size reduced to normal range; and aesthetic breast volume and symmetry should be achieved.
- Constricted Skin Envelope – Correction of the right skin envelope and high IMF play a large part in the final aesthetic outcome following surgery for tuberous breasts. A constricted skin envelope will limit the final volume of the breast. Therefore a tight skin envelope will limit the size of any potential implant used to add volume to the breast. This tight skin envelope also means that the IMF is abnormally high. The constricted skin envelope in mild forms of tuberous breast can be managed with primary placement of a breast implant. However, this is a difficult to make as a persistent IMF skin crease may be the source of patient dissatisfaction and may not soften and relax with time. A tight skin envelope and high IMF can be stretched and lowered over time using a tissue expander. This can be followed at a second stage with exchange of the expander for an implant.
- Areolar Size and Pseudoherniation – Reducing the areolar size in cases with areolar pseudoherniation has the effect of evenly distributing the forces of the underlying breast tissue on the entire skin as well as adding symmetry to the breast appearance.
- Breast Volume and Symmetry – If bilateral disease exists then both breasts are treated with skin envelope expansion, lowering of the IMF, correction of areolar diameter and the addition of volume. However, many patients persist with asymmetry.
Once your surgery day arrives, your incision lines will be marked while you’re awake and you will be able to ask any remaining questions as we go through our checklist with you. Tuberous breast correction surgery is performed under general anaesthesia and patients will usually be discharged either the same day. Long-lasting local anaesthetic is injected into the surgical area, alleviating any immediate discomfort postoperatively.
The incisions are closed using absorbable sutures before being sealed with dermal glue and covered with tape. There may be some discolouration or mild swelling, however this will disappear quickly and will be completely resolved within 10-14 days. Throughout this healing time, straining, bending or lifting should be avoided and you should wear your supportive bra for at least 8 weeks. You will be able to go back to work within a few days of surgery and your breasts will find their final shape within 3 months.
YOUR PEACE OF MIND IS OUR BIGGEST PRIORITY
All surgery carries risk and associated complications. Asymmetry, scarring, postoperative bleeding, infection, sensory changes, postoperative leg blood clots are amongst them. Dr Farhadieh will discuss these risks with you, during your consultation. With Panthea Clinics, you can have complete peace of mind knowing that you’re being cared for by a team of dedicated specialists.
After your initial postoperative review, we will organise a follow-up appointment at regular intervals. Your relationship with your surgeon is the most important aspect of your surgical journey, which is why we make sure that we’re guiding you through the process every step of the way.
LEARN MORE ABOUT PANTHEA
If you’ve been thinking about getting cosmetic surgery for a while now, Panthea Clinics are more than happy to guide you through the process of achieving the look you want. Committed to your peace of mind, we aim to make sure you have all the information you want and need before making your decision.
Contact our Sydney or Canberra clinic today and book your initial consultation to begin the process.
Frequently Asked Questions
There is some discomfort associated with surgery. Most patients report a ‘tightness’, rather than pain, due to the excellent modern anaesthetic pain control regimes, which includes local anaesthetic for the immediate postoperative period as well as powerful analgesics. However, its vital that you note that pain perception and recovery may be different with each individual.
The breasts will not only heal during the first 6 weeks, but will also gradually find their natural postoperative position. Gravity, healing and surgery drive this process. The final shape is usually reached by 3 months. The incision scars will fade over the first 12 months and will often be barely visible beyond the first year.
Within 2 weeks you will be back at work and able to resume most normal activities. During the subsequent weeks you will return to your pre-surgery levels of activity. We have a postoperative regime to help you through this time.
Your scars are routinely placed under the breast fold, hidden from view. Not only do bras or swimwear hide the scar, in time it will fade and be barely perceptible. Dr Farhadieh commonly uses a short scar mastopexy approach, which entails an incision around the nipple and extending down the breast vertically.
Dr Farhadieh believes that the relationship between doctor and patient is sacred and privileged. Our practice is based on compassion, honesty, transparency and, above all, patient welfare. We pride ourselves on making sure that you feel supported at all times. We will be available during each stage of your journey and will schedule short-, medium- and long-term follow-up appointments as part of our overall practice.
1. There are some general risks associated with ANY operation, which include:
a) Infection in surgical wound(s) with resultant redness, pain and possible discharge. In severe cases, wound(s) could break open and need to be re-sutured.
b) Possible bleeding in surgical wound(s) with swelling or bruising.
c) Secretions may accumulate in the lungs and cause a chest infection.
d) Deep vein thrombosis.
e) Death is possible during or after an operation following severe complications.
f) Smoking significantly increases the risk of complications. Therefore, you should completely stop smoking at least 4 weeks prior to surgery, and refrain from smoking for at least 4 weeks.
2. The following facts, risks and complications apply specifically to THIS operation:
a) Antibiotics are given during and after the operation to minimise the risk of infection. If infection occurs, it would be treated with the usual techniques. In severe cases, treatment may involve being admitted to hospital for intravenous antibiotics; and further surgery may be required.
b) Bruising and swelling is normal, but the severity can vary with each patient. If bleeding occurs in the implant space, a clot (haematoma) can occur and this may need to be removed surgically. The risk of this occurring within the first few days after surgery is about 0.5-1%. The risk of increased bruising or bleeding can be reduced by abstaining from medications such as aspirin, anti-inflammatory drugs, or other blood thinning agents, for at least 2 weeks prior to surgery.
c) A seroma is a collection of fluid around the implant, which may need to be drained. Clinically significant seromas requiring intervention occurs in less than 1% of patients and may occur many years after surgery.
d) The incisions will result in scar formation. Mr Farhadieh will endeavour to keep the incisions as small as possible, and these scars will soften and fade with time. You will be instructed as to how best care for scars to optimise results.
e) Postoperative pain experienced varies from very mild to significant discomfort. You will be given plenty of pain relieving medication following your surgery and this should keep you comfortable, no matter what your level of discomfort.
f) It is common to have intermittent mild discomfort, or intermittent sharp pains in the first few weeks after surgery, as the swelling resolves and the nerves recover. Some patients experience a temporary increase in the sensitivity of their nipples, which can be unpleasant, but usually settles down after a few weeks.
g) Numbness of the breasts and nipples is normal for a few weeks after this surgery. This usually recovers after 6-12 months, however it can be permanent. <1% will suffer nipple loss.
h) Most patients will need to take about a week off work. Heavy lifting, vigorous upper body exercise or any activity that involves ‘bouncing’ of the breasts should be avoided for 4-6 weeks. See Pre and Post-Op Instructions for more details.
i) The sutures used to close the incisions under your breasts are completely dissolvable, but they may be felt through the skin for up to 6-9 months after surgery.
j) Any surgery results in internal breast tissue scar tissue, which creates extra challenges for any secondary surgery, tissue are not as supple this may require additional procedures. This fact makes your outcomes from surgery less predictable, and no guarantees can be made in regards to your aesthetic outcomes.
k) During the time you have had breast implants, excess skin will have formed as a result of tissue expansion. Often a ‘breast lift’ procedure is required to achieve the best aesthetic outcomes following the removal of breast implants. If you choose not to undergo some form of ‘lift’ surgery, however, you can expect to be left with at least some level of skin redundancy and sagging. It is difficult to predict the level of skin sag and/or asymmetry you will be left with following this operation.
l) It is impossible to achieve ‘perfect’ breasts. In nature asymmetry is the norm rather than the exception. There is likely to be minor differences between each breast, as there are in all women. For women whose nipples are naturally at different heights, they will remain so following breast implant removal surgery, unless additional procedures are performed to correct this. This is also true for any other asymmetry between the breasts. If asymmetry was present before the primary augmentation, it will remain after implant removal unless further surgery is used to correct it.
m) The aim of breast implant removal surgery is improvement rather than perfection. Further operations may occasionally be required to improve the results.
n) Permanent keloid or hypertrophic scar may occur as a result of any surgery.
o) You may not be satisfied with the final aesthetic outcome.