Aesthetic Reconstruction of the Tuberous Breast Deformity

Abstract

The tuberous breast deformity is a rare entity affecting teenage women unilaterally or bilaterally. There is a deficiency in the vertical and/or horizontal dimensions of the breast, usually underdevelopment of the breast, and often herniation of breast tissue into the areola with expansion of the areola. At the level of the periphery of the nipple–areola complex is a constricting fibrous ring that inhibits the normal development of the breast. This constricting ring of fibrous tissue is denser at the lower part of the breast and does not allow the developing breast parenchyma to expand during puberty. The author transects the constricting ring at the 6 o’clock semi-axis of the breast, thus creating two pillars in the inferior part of the breast. The pillars are then either loosely reapproximated using absorbable sutures or folded over each other in the fashion of a double-breasted jacket to add volume in the inferior portion of the breast, with the optional addition of a breast implant underneath the breast or the pectoralis major muscle to correct any volume deficiency.