Surgical Strategies in the Correction of the Tuberous Breast

Management of the tuberous breast represents one of the greatest surgical challenges in aesthetic breast surgery, requiring careful assessment and a methodical approach to obtain an acceptable result. The surgeon must be familiar with multiple techniques that can be performed individually or may be combined to address various aspects of the tuberous deformity. This article describes the etiology, anatomic features, identification, and classification of the tuberous breast, focusing on surgical management and potential pitfalls. Through case study, expected outcomes in the management of this complex problem are described.

Key points

•

The tuberous breast is a congenital abnormality of breast development that incorporates a constricted base of the breast and 1 or more of the following: high inframammary fold, areola hypertrophy, pseudoherniation of tissue through the areola, ptosis, hypoplasia, and breast asymmetry.
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Advanced forms of tuberous breast are readily apparent clinically; however, the diagnosis of more minor forms of tuberous breast requires careful examination and a high index of suspicion.
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The principles of treatment of the tuberous breast include:
- a.
  
  Release of the constricted base through expansion, scoring, or internal flaps.
- b.
  
  Lowering of the inframammary fold and restoring a normal nipple to inframammary fold distance.
- c.
  
  Correction of herniated breast tissue.
- d.
  
  Reduction of the size of the areola.
- e.
  
  Augmenting the breast volume, when necessary.
- f.
  
  Correction of underlying breast asymmetry.