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.
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.
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.
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.
It is important to note that although perfect symmetry is the ultimate goal, realistic expectations are that perfect symmetry cannot be achieved in many patients.
BREAST RECONSTRUCTION WITH DR FARHADIEH
WHY TRUST US WITH YOUR SURGERY?
During his surgical training in Melbourne, Panthea Clinic’s own Dr Farhadieh amassed extensive experience in all of the aforementioned surgical procedures. He has had the opportunity to further consolidate his practice during his time spent in London working at St Thomas’ Hospital with Mr Jian Farhadi, a world authority in breast reconstruction. He also gained further experience in breast reconstruction while working as Microsurgical Fellow with Mr Ash Mosahebi at the Royal Free Hospital, London.
If you are thinking about undergoing breast reconstruction, get in touch with Panthea Clinic in either Canberra or Sydney. Our aim is to provide state of the art care for each and every patient, allowing you to feel great in your own skin once again.
TUBEROUS BREAST RECONSTRUCTION BY DR FARHADIEH:
ASK OUR TEAM
Your relationship with your surgeon and medical team is an integral aspect of your care. It is a journey that patients should take with good knowledge and consideration, having nothing but the utmost confidence in their ability to deliver outstanding results.
Here at Panthea, we are dedicated to being there for every step of the journey with you. Whether you’re looking for a breast lift or augmentation, rhinoplasty, tummytuck or eye lift surgery, get in touch with our Sydney or Canberra team to book your initial consultation.
Dr Rostam D Farhadieh
BSc(Med)Hons, MBBS, MD, EBOPRASF, FRACS(Plast), FRCS(Plast)
Plastic & Reconstructive Surgeon
Clinical Senior Lecturer
University of Sydney Medical School
Australian National University Medical School