Tuberous breast deformity also known as tubular, snoopy breast, herniated areola complex, constricted breast, narrow based breast, lower pole hypoplasia is a deformity that usually becomes evident at puberty in young women. It is characterized by a wide spectrum of presentation including constriction of the breast base, glandular and skin hypoplasia (especially at the lower quadrants), mal-position of the infra-mammary fold, breast tissue herniation into the areola region and sometimes increased areola diameter. The condition may be unilateral or bilateral and is often asymmetric. It may present as a severe mal-formation and is extremely physically and psychosocially relevant; the patient sometimes avoids medical check ups, give up outdoor sports, wear clothing hiding their shape and avoid sexual intercourse. Treatment can be a surgical challenge. The main goals are to correct the deformity in a one stage operation, restore the mammary base dimensions, correct the hypoplasia of the lower quadrant of the breasts, re-position the infra-mammary fold, reduce the areola dimensions and achieve good symmetry.
The procedure begins with marking of the “new” infra-mammary fold by projection of the unilateral breast in unilateral cases or by using a sixth rib as a landmark in bilateral cases. In severe constriction, the location of the new infra-mammary fold is selected so that approximately 50-60% of the planned breast implant will fit from the nipple to the fold. Again, treatment is based on the anatomic deformity of deficiency in the horizontal and vertical dimensions of the breast characterized by underdevelopment of the breasts with “herniation” of breast tissue into the areola associated with hypertrophy of the areola. Access is through a circumareola approach. This access allows for correction of disproportionate diameter of the areola and closure of the lower pole of the breast. The lower pole of the breast is addressed with radial incisions on the deeper aspect of the breast.
This results in the release of the constricting ring at the breast space. This release allows for the rounding out of the lower pole of the breast which will be maintained with a breast implant. Size adjustment of the breast may include reduction and/or lifting of the larger breast. This glandular resection of the larger breast may allow for placement of implants of same or similar size. These maneuvers are used to achieve as much symmetry as possible.
Testimonial: I have struggled with the insecurity of having small, misshapen breasts for years. Shopping for clothes was a nightmare and nothing ever fit or looked the way I wanted. I swam competitively for many years and the humiliation of wearing a speedo swimsuit as an AA cup size was almost unbearable. After years of wearing padded bras and praying every night that my boobs would grow I finally decided to explore the option of plastic surgery. I toyed with the idea on and off for about 4 years and finally last December became very serious and started researching plastic surgeons. I didn’t limit my search to just SD and ended up visiting with doctors in both northern and southern CA. I am a complete Type A so I had folders and folders of information about the procedure, doctors, testimonials, side effects- everything. I saw quite a few plastic surgeons and was looking for someone special. Someone who was not only a top expert in their field but who also had the ability to understand my wants and needs and work with me to achieve them. After meeting Dr. Pousti for the first time I was positive I had met my match. He is not only a phenomenal surgeon but he is also extremely dedicated to his patients and in touch with their wants and needs. I didn’t feel like just another number as I had in other offices. Given I was not having just a straight forward breast augmentation because of my tuberous breasts, I was anxious and ended up coming in numerous times for long question and answer sessions before even scheduling surgery. When I came into the offices his staff was so friendly and always greeted me by name. Dr. was always prepared and willing to spend as much time as I needed to discuss my questions