William Callaghan. MD (tubular-breast Surgery)
Tubular Breast Deformity
Tubular breast deformity is a congenital condition with a relatively wide range of severity. It is usually defined by conditions such as the following:
- • A breast that is small or underdeveloped with a constricted base of the breast
- • A high and tight inframammary fold (this also means that the skin in the lower half of the breast is deficient)
- • Herniation of breast tissue into the areola.
- • High and tight inframammary fold with large breasts.
Surgical correction varies according to the specific anomalies that are present. In mild cases where the breast is hypoplastic, a simple augmentation can solve the problem. Often, because the breast tissue is constricted, the augmentation is combined with scoring or releasing the breast tissue. In other cases, mastopexy with correction of the herniation and enlarged areola is also performed. In severe cases where the patient has very little skin in the lower half of the breast, the patient's breasts are reconstructed in stages. First a tissue expander is placed to expand the skin in the lower pole of the breast. The augmentation, scoring of breast tissue, and mastopexy is performed in the second stage.
In the case of a high fold with large breasts, the correction is simply a breast reduction with release of the constriction of the inframammary fold.
Micro-fat grafting has revolutionized tubular breast deformity. Often, grafting of fat is all that may be required to correct the deformity.
Results vary depending on the severity of the deformity. In general, the patient can expect a good result. However, sometimes-inadequate release of the constricted breast tissue or failure to use an expander to expand the lower pole breast skin can lead to a less than optimal result. Patients are often reluctant to go through expansion. The most important aspect of the surgery involves the correct release of the fibrous attachments allowing the breast tissue to spread out. Failure to do this will result in incomplete correction. Finally, if an implant is part of the solution, the patient has to deal with all the related risks and considerations involved with breast augmentation.