Tuberous Breast Surgery
Tuberous breast, also known as constricted breast, is often a congenital condition, which affects the size and shape of the developing breast. It can be unrecognized and some women can have mild involvement without realizing the condition is there. It is important to recognize the condition at the time of the consultation because the breast augmentation operation needs to be tailored for the tuberous breast in order to optimize the ultimate breast shape. Beverly Hills plastic surgeon, Dr. Charles Hsu, usually performs tuberous breast correction surgery at the same time as a breast augmentation.
Best Candidates for Tubular Breast Surgery
Although there is considerable variation, tubular breasts all share several common features:
Little to no skin between the bottom edge of the areola & inframammary fold
Narrow and elongated shape with a wide space between
Disproportionately large, puffy and/or herniated areola
Tendency for the inframammary fold to be relatively high on the chest, thus causing the breast to droop and look long and constricted
Dr. Hsu will start the consultation by getting the patient’s full medical history and the history of the patient’s breast development. After the physical examination and measurements are taken, Dr. Hsu will decide with the patient on the best course of action to fulfill the patient’s needs and goals.
Tuberous breast surgery is done with the patient under general anesthesia in an accredited surgicenter. During the 2-hour surgery, Dr. Hsu will find the ring of constriction causing the tuberous breast condition and release it. This is important so that after the implant is placed, the implant can stretch out the overlying skin, which has been tight and unexpanded throughout the patient’s breast development. The augmentation results can immediately be seen, but the results of tuberous breast correction can sometimes require several months to a year for the skin to stretch out fully. Tuberous breast surgery can be challenging, but most patients obtain pleasing results.
Recovery and Post-Op
Dr. Hsu will wrap the breasts after surgery and give the patient a special surgical bra to speed healing for the first week. During the recovery period, patients should walk as much as possible to encourage circulation and prevent blood clots from forming. Patients can still use their arms as long as the elbow does not go above the shoulder. Patients usually return to their usual activities after 2 weeks, after the swelling and bruising have decreased and they are no longer taking pain medication. After 6 weeks or earlier with Dr. Hsu’s approval, patients can start exercising and trying more strenuous activities. Patients will need to come to several follow up appointments for about a year after the surgery so Dr. Hsu can address any problems or concerns.
From Dr. Hsu
“Tuberous breast (or constricted breast) surgery is challenging and is a slightly different operation than the standard breast augmentation. In my experience, it is often unrecognized. I have seen many patients who have come see me for breast augmentation, and when I inform them after examination that they have tuberous breasts and cannot just have a standard breast augmentation, they tell me that they have never heard of that before.
In my opinion, the key to a good result for tuberous breast correction is careful recognition in the operating room of the specific area of the breast that is constricted, so that it can be released during surgery. Afterward, using the correctly selected implant will help the area stretch out over time. I have found that, depending on the degree of breast constriction, patients may need to allow for several months of patient waiting for the skin to stretch out and for the constriction to improve.”
Frequently Asked Question
What is a Tuberous Breast?
The tuberous or tubular breast deformity refers to a congenital condition in which the breast fails to develop fully. The ideal breast is round with breast tissue spread out across the chest. In a tuberous deformity, the volume of breast tissue may be normal or deficient, but it is concentrated directly below the nipple, and the lower pole of the breast has failed to fully develop. As a result, the breast may appear long and narrow.
The first week after surgery?
The day after surgery, patients are encouraged to get out of bed for short periods of time. After several days, patients should be able to move around the house more comfortably. Patients need to avoid straining, bending, and lifting since these activities might cause increased swelling or even bleeding. Dr. Hsu advises patients to sleep on their back to avoid pressure on the breasts. Any surgical drains will be removed within a few days of surgery, at which time the dressings may also be changed or removed. For 2-5 days, the chest region may feel stiff and sore.
What to do after Tuberous Breast Surgery?
After tuberous breast surgery it is often possible to return to work within a week or so, depending on the patient’s job. Patients should avoid e sexual activity for a minimum of 1-2 weeks and excessive physical activity for at least the first few weeks following surgery. After that, patients must still be extremely gentle with their breasts for the next couple of weeks. Patients may notice that they feel less sensation in the nipple and areola areas. This is usually temporary; however, it may take several weeks to a year before sensation returns to normal. The breasts may require some time to assume a more natural shape as they heal. Patients may continue to experience some mild, periodic discomfort during this time, but such feelings are normal. If a patient is experiencing severe pain, Dr. Hsu should be contacted immediately.