Case 37 Tuberous Breast Deformity

Lauren O. Roussel and Karl H. Breuing

Case 37 Tuberous Breast Deformity

Case 37 A 28-year-old female requesting correction of breast appearance and asymmetry.

37.1 Description

  • Bilateral tuberous breast deformities with ptosis

    • Left breast slightly larger and more ptotic appearing than right

  • Skin and soft tissue deficiency in inferior pole of both breasts with short nipple–areola complex (NAC) to inframammary fold (IMF) distance

  • Protuberant areolar complexes bilaterally

37.2 Work-Up

37.2.1 History

  • Patient’s age/pubertal maturity

  • Patient’s goals and expectations

  • History of prior breast surgeries

  • History of smoking/tobacco use

  • Plan for future childbirth

  • Anticipated changes in weight

  • Personal or family history of breast cancer

37.2.2 Physical Examination

  • Evaluate size and shape of bilateral breasts

    • Note breast asymmetries

  • Examine for presence of ptosis or pseudoptosis (see Table 37.1)

    • Pseudoptosis: The nipple is at or above IMF with lower pole breast ptosis

  • Important preoperative measurements include IMF level, NAC to IMF distance, sternal notch to nipple distance, and breast and chest width

  • Characteristics of Tuberous Breast Deformity

    • Constricted skin envelope in vertical and horizontal dimensions

      • Constricted or narrowed breast diameter

      • Elevated IMF

      • Short NAC to IMF distance

      • Deficient skin envelope in inferior pole

    • Hypoplasia of breast parenchyma

    • Herniation or pseudoherniation of breast parenchyma into NAC

  • Grolleau’s classification of tuberous breast deformity

    • Type I: Lower medial quadrant deficiency

    • Type II: Lower medial and lateral quadrant (entire lower pole) breast deficiency

    • Type III: Deficiency of all quadrants

      Table 37.1 Regnault classification of breast ptosis



      I (Mild)

      Nipple at IMF

      II (Moderate)

      Nipple below IMF, above most dependent part of breast

      III (Severe)

      Nipple at inferior-most aspect of breast


      Nipple at or above IMF with lower pole breast ptosis

      Abbreviation: IMF, inframammary fold.

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Jul 17, 2021 | Posted by in General Surgery | Comments Off on Case 37 Tuberous Breast Deformity
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