Tuberous breasts

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Tuberous breasts
A pair of tuberous breasts displaying typical characteristics.jpg
A pair of tuberous breasts displaying typical characteristics such as minimal breast tissue and enlarged, puffy areola.
Complications low milk production [1]
Usual onset puberty
Durationlife
Treatment breast augmentation
Prognosis benign
Frequencyunknown

Tuberous breasts (or tubular breasts) are a result of a congenital abnormality [2] of the breasts which can occur in both men and women (also see Hypoplasia), one breast or both. During puberty breast development is stymied and the breasts fail to develop normally and fully. The exact cause of this is as yet unclear; however, a study in 2011 of the cells in the breasts of both males and females with tubular breasts suggested a genetic link in a disorder of collagen deposition. [3] The condition is thought to affect one to five per cent of breast augmentation patients; [4] however, the proportion of the general population affected is unknown as surgery is not always sought.

Contents

Background

The tuberous breast deformity was first described by Rees and Aston in 1976 [5] following which a method of classifying the severity was developed. The surgical classifications refer to which areas of the breast are affected and is divided into three grades; mainly in the inferomedial quadrant (Grade I); in the two inferior quadrants (Grade II); or affecting the whole breast (Grade III). [6]

This condition is also known as constricted breasts, tubular breasts, or herniated areolar complexes. [3]

Effects

Tuberous breasts are not simply small or underdeveloped breasts. The effect of the condition on the appearance of the breast can range from mild to severe, and typical characteristics include enlarged, puffy areola, unusually wide spacing between the breasts, minimal breast tissue, sagging, higher than normal breast fold, [7] and narrow base at the chest wall. The condition can cause low milk supply in breastfeeding women. [8] However, other physical aspects of fertility and pregnancy are not affected by the condition.

Tubular breasts may lead to psychosexual problems with girls in very early puberty being affected psychologically due to the unusual shape of the breast. [6]

Treatment

The appearance of tuberous breasts can potentially be changed through surgical procedures, including the tissue expansion method, use of autologous fat grafting [9] and breast implants. [10] Depending on the extent of the tuberous breasts, a surgeon will release the constricted tissue and create a new breast fold. [11]

The procedure to change the appearance of tuberous breasts can be more complicated than a regular breast augmentation, and some plastic surgeons have specialist training in tuberous breast correction. A less complicated single-stage approach using saline implants can also provide a satisfactory aesthetic result. [12] As tuberous breasts are a congenital deformity, referral for treatment under the National Health Service may be possible in the United Kingdom. [13] For those seeking non-surgical solutions, counseling may be recommended as a way of coming to terms with body image.

Related Research Articles

<span class="mw-page-title-main">Breast reconstruction</span> Surgical rebuilding of a breast

Breast reconstruction is the surgical process of rebuilding the shape and look of a breast, most commonly in women who have had surgery to treat breast cancer. It involves using autologous tissue, prosthetic implants, or a combination of both with the goal of reconstructing a natural-looking breast. This process often also includes the rebuilding of the nipple and areola, known as nipple-areola complex (NAC) reconstruction, as one of the final stages.

<span class="mw-page-title-main">Plastic surgery</span> Medical surgical specialty

Plastic surgery is a surgical specialty involving the restoration, reconstruction or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery includes craniofacial surgery, hand surgery, microsurgery, and the treatment of burns. While reconstructive surgery aims to reconstruct a part of the body or improve its functioning, cosmetic surgery aims at improving the appearance of it.

<span class="mw-page-title-main">Rhinoplasty</span> Surgical procedure to enhance or reconstruct a human nose

Rhinoplasty, commonly called nose job, medically called nasal reconstruction is a plastic surgery procedure for altering and reconstructing the nose. There are two types of plastic surgery used – reconstructive surgery that restores the form and functions of the nose and cosmetic surgery that changes the appearance of the nose. Reconstructive surgery seeks to resolve nasal injuries caused by various traumas including blunt, and penetrating trauma and trauma caused by blast injury. Reconstructive surgery can also treat birth defects, breathing problems, and failed primary rhinoplasties. Rhinoplasty may remove a bump, narrow nostril width, change the angle between the nose and the mouth, or address injuries, birth defects, or other problems that affect breathing, such as a deviated nasal septum or a sinus condition. Surgery only on the septum is called a septoplasty.

<span class="mw-page-title-main">Mammaplasty</span> Surgically modifying the appearance of the breast

Mammaplasty refers to a group of surgical procedures, the goal of which is to reshape or otherwise modify the appearance of the breast. There are two main types of mammoplasty:

  1. Augmentation mammaplasty is commonly performed to increase the size, change the shape, and/or alter the texture of the breasts. This usually involves the surgical implantation of breast implant devices.
  2. Reduction mammaplasty is commonly performed to reduce the size, change the shape, and/or alter the texture of the breasts. This involves the removal of breast tissue.
<span class="mw-page-title-main">Breast augmentation</span> Surgical procedure

Breast augmentation and augmentation mammoplasty is a cosmetic surgery technique using breast-implants and fat-graft mammoplasty techniques to increase the size, change the shape, and alter the texture of the breasts. Augmentation mammoplasty is applied to correct congenital defects of the breasts and the chest wall. As an elective cosmetic surgery, primary augmentation changes the aesthetics – of size, shape, and texture – of healthy breasts.

Grafting refers to a surgical procedure to move tissue from one site to another on the body, or from another creature, without bringing its own blood supply with it. Instead, a new blood supply grows in after it is placed. A similar technique where tissue is transferred with the blood supply intact is called a flap. In some instances, a graft can be an artificially manufactured device. Examples of this are a tube to carry blood flow across a defect or from an artery to a vein for use in hemodialysis.

Chin augmentation using surgical implants can alter the underlying structure of the face, providing better balance to the facial features. The specific medical terms mentoplasty and genioplasty are used to refer to the reduction and addition of material to a patient's chin. This can take the form of chin height reduction or chin rounding by osteotomy, or chin augmentation using implants. Improving the facial balance is commonly performed by enhancing the chin using an implant inserted through the mouth. The goal is to provide a suitable projection of the chin as well as the correct height of the chin which is in balance with the other facial features.

<span class="mw-page-title-main">Buttock augmentation</span> Cosmetic and corrective surgery

Gluteoplasty denotes the plastic surgery and the liposuction procedures for the correction of the congenital, traumatic, and acquired defects and deformities of the buttocks and the anatomy of the gluteal region; and for the aesthetic enhancement of the contour of the buttocks.

<span class="mw-page-title-main">Accessory breast</span> Condition of having an additional breast

Accessory breasts, also known as polymastia, supernumerary breasts, or mammae erraticae, is the condition of having an additional breast. Extra breasts may appear with or without nipples or areolae. It is a condition and a form of atavism which is most prevalent in male humans, and often goes untreated as it is mostly harmless. In recent years, many affected women have had a plastic surgery operation to remove the additional breasts, for purely aesthetic reasons.

<span class="mw-page-title-main">Capsular contracture</span> Response of the immune system to foreign materials in the human body

Capsular contracture is a response of the immune system to foreign materials in the human body. Medically, it occurs mostly in context of the complications from breast implants and artificial joint prosthetics.

<span class="mw-page-title-main">Breast implant</span> Prosthesis used to change the size, shape, and contour of a persons breast

A breast implant is a prosthesis used to change the size, shape, and contour of a person's breast. In reconstructive plastic surgery, breast implants can be placed to restore a natural looking breast following a mastectomy, to correct congenital defects and deformities of the chest wall or, cosmetically, to enlarge the appearance of the breast through breast augmentation surgery.

Mastopexy is the plastic surgery mammoplasty procedure for raising sagging breasts upon the chest of the woman, by changing and modifying the size, contour, and elevation of the breasts. In a breast-lift surgery to re-establish an aesthetically proportionate bust for the woman, the critical corrective consideration is the tissue viability of the nipple-areola complex (NAC), to ensure the functional sensitivity of the breasts for lactation and breast-feeding.

Amazia refers to a condition where one or both of the mammary glands is absent. This may occur either congenitally or iatrogenically. Amazia can be treated with breast implants.

Andrew A. Jacono, M.D., FACS is an American facial surgeon and creator of the minimal access deep-plane extended facelift, a minimally invasive hybrid facelift. Jacono starred in the Discovery Fit & Health television program Facing Trauma as the volunteer surgeon who reconstructed faces disfigured in abusive relationships and other violent circumstances.

Non-surgical rhinoplasty is a medical aesthetic procedure in which injectable fillers, most commonly hyaluronic acid ones like Restylane and Juvederm or calcium hydroxyapatite (Radiesse), are used to alter and shape a person's nose without a surgery. The procedure fills in depressed areas on the nose, lifting the angle of the tip or smoothing the appearance of bumps on the bridge. Non surgical rhinoplasty is an augmentation procedure, so it cannot reduce the size of someone's nose. The cosmetic procedure carries the risk of causing serious skin damage or distant complications like blindness. If the filler product is injected into an artery, filler can travel in the arteries and blocks smaller size arteries like ophthalmic artery and cause blindness. If blood vessels of the skin is blocked, skin necrosis can develop. Hyaluronic acid based fillers can be reversed even if injected into a blood vessel with an enzyme called hyaluronidase, which can be also injected like fillers.

Perforator flap surgery is a technique used in reconstructive surgery where skin and/or subcutaneous fat are removed from a distant or adjacent part of the body to reconstruct the excised part. The vessels that supply blood to the flap are isolated perforator(s) derived from a deep vascular system through the underlying muscle or intermuscular septa. Some perforators can have a mixed septal and intramuscular course before reaching the skin. The name of the particular flap is retrieved from its perforator and not from the underlying muscle. If there is a potential to harvest multiple perforator flaps from one vessel, the name of each flap is based on its anatomical region or muscle. For example, a perforator that only traverses through the septum to supply the underlying skin is called a septal perforator. Whereas a flap that is vascularised by a perforator traversing only through muscle to supply the underlying skin is called a muscle perforator. According to the distinct origin of their vascular supply, perforators can be classified into direct and indirect perforators. Direct perforators only pierce the deep fascia, they don't traverse any other structural tissue. Indirect perforators first run through other structures before piercing the deep fascia.

Free-flap breast reconstruction is a type of autologous-tissue breast reconstruction applied after mastectomy for breast cancer, without the emplacement of a breast implant prosthesis. As a type of plastic surgery, the free-flap procedure for breast reconstruction employs tissues, harvested from another part of the woman's body, to create a vascularised flap, which is equipped with its own blood vessels. Breast-reconstruction mammoplasty can sometimes be realised with the application of a pedicled flap of tissue that has been harvested from the latissimus dorsi muscle, which is the broadest muscle of the back, to which the pedicle (“foot”) of the tissue flap remains attached until it successfully grafts to the recipient site, the mastectomy wound. Moreover, if the volume of breast-tissue excised was of relatively small mass, breast augmentation procedures, such as autologous-fat grafting, also can be applied to reconstruct the breast lost to mastectomy.

<span class="mw-page-title-main">Ted Eisenberg</span> American plastic surgeon

Ted Eisenberg D.O. is a Philadelphia, Pennsylvania based plastic surgeon who specializes in cosmetic breast surgery. He holds a Guinness World Record for the most breast augmentation surgeries performed in a lifetime (male)— 3460.

Facial Autologous Muscular Injection is also known as Fat Autograft Muscular Injection, as Autologous Fat Injection, as Micro-lipoinjection, as Fat Transfer and as Facial Autologous Mesenchymal Integration, abbreviated as FAMI. The technique is a non-incisional pan-facial rejuvenation procedure using the patient'own stem cells from fat deposits. FAMI is an Adult stem cell procedure used to address the loss of volume in the face due to aging or surgery repair in restoring facial muscles, bone surfaces and very deep fat pads. The procedure involves removing adult stem cells of fatty tissue from lower body, and refining it to be able to re-inject living adipose stem cells into specific areas of the face without incision. FAMI is an outpatient procedure and an alternative to artificial fillers, blepharoplasty or various face lifts. The procedure does not require general anesthesia and risks of an allergic reaction are minimal due to the use of the patient's own tissue used as the facial injection.

Fat transfer, also known as fat graft, lipomodelling, or fat injections, is a surgical process in which a person's own fat is transferred from one area of the body to another area. The major aim of this procedure is to improve or augment the area that has irregularities and grooves. Carried out under either general anesthesia or local anesthesia, the technique involves 3 main stages: fat harvesting, fat processing, fat injection.

References

  1. "Some mothers can't breast-feed". Chicago Tribune .
  2. Panchapakesan V, Brown MH (January 2009). "Management of tuberous breast "deformity" with anatomic cohesive silicone gel breast implants". Aesthetic Plast Surg. 33 (1): 49–53. doi:10.1007/s00266-008-9234-7. PMID   18752021. S2CID   25422938.
  3. 1 2 Klinger, Marco; Caviggioli, Fabio; Klinger, Francesco; Villani, Federico; Arra, Erseida; Di Tommaso, Luca (2011). "Tuberous breast: Morphological study and overview of a borderline entity". Canadian Journal of Plastic Surgery (in English and French). 19 (2): 42–44. doi:10.1177/229255031101900210. PMC   3328117 . PMID   22654530.
  4. "Breast Augmentation...on Tubular Breasts" . Retrieved 2010-03-14.
  5. Rees, S; Aston, S (1976). "The tuberous breast". Clin Plast Surg. 3 (2): 339–46. doi:10.1016/S0094-1298(20)30232-7. PMID   1261187.
  6. 1 2 Gabka, Christian J; Heinz Bohmert (2008). Plastic and Reconstructive Surgery of the Breast. p. 72. ISBN   9783131035721 . Retrieved 7 December 2013.
  7. Tubular Breast Correction
  8. Amir, LH (2006). "Breastfeeding--managing 'supply' difficulties". Australian Family Physician. 35 (9): 686–9. ISSN   0300-8495. PMID   16969436.
  9. Gutierrez-Ontalvilla, Patricia; Naidu, Nina S (April 2020). "Autologous Fat Grafting with Percutaneous Fasciotomy and Reduction of the Nipple–Areolar Complex for the Correction of Tuberous Breast Deformity in Teenagers". Aesthetic Plastic Surgery. 44 (2): 264–269. doi:10.1007/s00266-019-01531-1. PMID   31673737. S2CID   204942620 . Retrieved 31 October 2019.
  10. Dennis C. Hammond (3 December 2008). Atlas of Aesthetic Breast Surgery. Elsevier Health Sciences. pp. 187–. ISBN   978-1-4160-3184-0 . Retrieved 2 May 2010.
  11. How to Correct Tuberous Breasts
  12. Eisenberg, Ted (2019). "One-Stage Correction of Tuberous Breast Deformity Using Saline Implants: Without the Need for Radial Scoring or Lowering the Inframammary Fold". American Journal of Cosmetic Surgery. 36 (4): 191–196. doi:10.1177/0748806819841466. S2CID   145932734.
  13. Policy for Cosmetic Surgery Referrals