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

      Grade


      Findings


      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


      Pseudoptosis


      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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