Correction of Tubular Breast Deformity

Tuberous Breast Deformity Correction

Tuberous breast deformity is a congenital malformation characterized by underdevelopment of the lower pole during breast development, constriction with band-like tissues, and protrusion of the breast tissue forward, forming a barrel-like shape. This condition involves not only volume deficiency but also shape deformity, asymmetry, areola enlargement, and the upward placement of the breast fold. Therefore, correction of tuberous breasts is one of the most planning-intensive and technically precise surgeries in breast surgery.

Types of Tuberous Breast Deformity

The degree of deformity directly affects surgical planning:

Type I

• Underdevelopment of the lower inner or lower outer quadrant
• Mild deformity

Type II

• Underdevelopment of the entire lower pole
• More pronounced nipple protrusion

Type III

• Complete restriction of the lower pole
• Excessive enlargement and herniation of the areola
• Significantly higher breast fold position
• Most severe deformity

Prominent Features of Tuberous Breast Deformity

• Underdevelopment of the lower breast pole
• Narrow breast base
• Protrusion of the breast tissue forward (tubular appearance)
• Wide and protruding areola
• Upward placement of the breast fold
• Volume deficiency
• Significant asymmetry
• Inability to achieve smooth form with clothing

Why Is It a Challenging Surgery?

Surgical Challenges

• Multiple anatomical problems must be corrected simultaneously
• The lower pole is restricted with tight bands and requires controlled release
• The tissue may be thin and have limited support capacity
• Implants alone are insufficient
• In some cases, a two-stage surgery may be required

Surgical Techniques

Lower Pole Release

• Tight bands are cut to widen the lower pole. This is the fundamental treatment for the deformity.

Parenchymal Plication / Internal Tissue Shaping

• The breast tissue is reshaped from the inside to provide structural support.

Repositioning of the Breast Fold (IMF Repositioning)

• A new and ideal breast fold is created and fixed in place.

Areal Reduction

• The herniated areola is corrected to achieve a more proportional appearance.

Implant Placement (When Needed)

• Dual-plane placement
• Different volumes for asymmetry, if present
• Typically, round implants are preferred

Fat Transfer (Lipofilling)

• Increase lower pole volume
• Soften the tissue
• Correct contour transitions
• Provide implant support in thin tissue

Pre-Surgery Preparation

• Breast ultrasound / MRI
• Type identification and detailed measurements
• Symmetry analysis
• Implant volume planning
• Assessment of donor area for fat transfer
• Stop smoking 2–3 weeks before surgery
• Adjust blood-thinning medications

Surgical Process

• Performed under general anesthesia
• Average duration: 2–3 hours
• Lower pole is released
• Breast fold is recreated
• Areal reduction is performed
• If necessary, implants and fat transfer are applied
• Surgery is completed with symmetry control

Post-Surgery Recovery

• Mild pain and tightness in the first few days is normal
• Return to social life is possible after 1 week
• No heavy exercise for 4–6 weeks
• Supportive bra is worn for 1–1.5 months
• Swelling decreases within 2–3 months
• Final breast form settles in 3–6 months

Potential Risks and Complications

Early Period

• Hematoma
• Infection
• Suture opening
• Circulatory problems in the nipple

Late Period

• Minor shape irregularities may remain
• Asymmetry
• Implant position may not settle perfectly
• Scarring around the areola
• Recurrence of narrowing in the lower pole
• Need for a second corrective surgery

Longevity of Results

• If lower pole release is done correctly, results are generally permanent
• In patients with weak skin elasticity, mild shape changes may occur over time
• Fat transfer helps support the longevity of results