Tuberous Breast Deformity is a congenital anomaly that prevents the full expansion of one or both breasts during puberty, on the horizontal and/or vertical axis. Even though tuberous breasts are not common, this deformity affects symmetry, self-image and sadly sometimes self-esteem Correcting this deformity has been a challenge for plastic surgeons in the past, but reconstructive surgery has allowed for improved correction of the deformity.

History of Tuberous Breast Deformity

This abnormality was first described in 1976 by Rees and Aston and during the years has garnered many names: from tuberous breasts to tubular breasts, snoopy breasts, domed nipple, nipple breasts, constricted breasts and narrow-based breast - they all refer to the same condition, which is a deficiency in the breast dimension (horizontal or vertical) and a herniation of the breast tissue towards the areola (accompanied by an expansion of the areola).

Types of Tuberous Breast Deformity

Type I - Hypoplasia of the lower medial quadrant (slightly smaller breast/breasts)
Type II - Hypoplasia of the lower medial and lateral quadrants, sufficient skin in the subareolar region.
Type III - Hypoplasia of the lower medial and lateral quadrants, deficiency of skin in the subareolar region.
Type IV - Severe breast constriction, minimal breast base (significant bulging of breast tissue through the areola)

Image source: https://www.drbalti.net/treating-tuberous-breasts/

Techniques of reshaping the deformed breasts

Several different operative procedures had been used to correct the tuberous breast deformities:

Breast augmentation with an implant
Spreading of the breast tissue by incision and/or ‘unfurling’
Spreading of the breast tissue combined with augmentation by a silicone implant
Reconstruction with autogenous tissue (fat transfer)
Tissue expansion to correct skin deficiency
Reducing the breast tissue that is bulging through the nipple-areolar complex (NAC) and reducing the NAC size

Rozina’s technique

Rozina Ali, an expert in reconstructive plastic surgery in London, shared with us her preferred technique for the correction of tuberous breast deformity.

Her method is based on reconstructing the breast in the best scenarios with fat transfer that allows fine-tuning of symmetry and maintains soft supple breast tissue.

In more severe cases, then reconstruction using expander/implant sequence may be offerred, but with implant(s) alone if the breast is less constricted. At the same time, areola reduction is designed to reduce the herniation and reposition the nipple areola more aesthetically.

For larger breasts or those with a great deal of ptosis (droopiness) then mastopexy (breast lift) is the procedure of choice with/without fat transfer (a lipolift).

If nothing else, tuberose breast deformity and the myriad of solutions possible indicate the need for a good doctor-patient relationship, a constructive consultation and taking into account both breasts, patient lifestyle and aesthetic preference.